Views & Reviews From The Frontline

Bad medicine: gynaecological examinations

BMJ 2011; 342 doi: (Published 02 March 2011) Cite this as: BMJ 2011;342:d1342
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

My friend glanced at me anxiously. The spitting tutor was puce, veins popping out of his neck, a cartoon characterisation of anger. Odd that a small word like “why” could cause such an allergic reaction. But “why” is the most important word in medicine. So why do doctors routinely conduct gynaecological bimanual and speculum examinations? I visited the gleaming spired evidence websites for guidance, but was left scrabbling around the waste paper bins of the internet.

Consider bimanual pelvic examination. It can detect pelvic masses, but what is the chance of …

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