Practical Pediatric and Adolescent Gynecology (2013) (PDF) by Paula J. Adams Hillard

Description

Clinicians are often uncomfortable with the gynecologic concerns of young girls and developing women. How can I put the patient at ease? What are the rights of the patient and her parents? How do I ask the questions in a way that allows her to trust me so that I can better understand her medical and social situation?

In Pediatric and Adolescent Gynecology, Dr Hillard has designed a new textbook that puts the patient at the center. It follows the patient’s life and her changing needs as she matures. An emphasis on effective, patient-friendly encounters is the prelude to a sensitive clinical approach to intimate, potentially awkward, clinical challenges. Short, practical chapters provide guidance on the issues rather than an academic treatise.

User’s Reviews

Excellent work with a simple and practical view of the topics. Really a good help at daily work with adolescente pacients.

Filled with priceless information and insights about young people’s health and safety, but without the overly dense technical detail of a comprehensive textbook. The book is intended for “clinicians” (which I am not) in a broad sense – not merely physicians, but includes sections on “patient/parent advice.” The practical format makes it valuable for parents and other non-professionals interested in children’s health. Chapters specifically about medical personnel dealing with parents are especially informative.

However, one imperfection is that this otherwise priceless book is marred by repeated lip-service to the politically correct hysteria over child sex abuse. Throughout the broad spectrum of medical pathology there is widespread recognition of benign normal variations that require no intervention. Only in hysterical matters such as child sex abuse is there a fanatical conviction that any and all sexual experience in youth demands thorough surveillance, investigation and unproven “counseling.”

Some of the authors in this volume repeatedly advise clinicians to “screen” for sex abuse (most states have mandatory reporting laws), and the authors even advise doctors to recommend psycho “counseling,” although there are no specific claims about the need or effectiveness of such psycho-nonsense, which is not surprising since there is no reliable evidence that sex abuse diagnosis or treatment has ever been proven safe or effective by medical standards. Nor is there any acknowledgement of the high rate of false accusations of sex assault and abuse.

Instead of repeatedly reassuring parents (as doctors routinely do every day in the case of common viral infections or increase in vaginal secretion before menarche, etc.) that the best evidence available does NOT support the popular belief that early sex abuse is usually seriously harmful (1), there is not a word in this book disputing the mass hysteria over sex abuse. I got the distinct feeling that some authors see a need to protect doctors themselves from possible charges of inappropriate contact during an exam. Instead of being at the forefront of disputing pseudo-medical claims about the urgent need to address sex abuse, some “professionals” are apparently only interested in protecting themselves.

The authors need to confront the possibility that bowing to the hysteria rather than disputing it leaves the book open to the charge that this is one of many books perpetuating the hysteria. There is clear statistical evidence that physical abuse, emotional abuse and neglect are much more common and more deadly in childhood, but the authors in this volume have little or nothing to say about those more deadly forms of abuse. The popular fixation on sex abuse is clearly and certainly distorted. I highly recommend this book, but only to readers who can overlook the authors’ failure to reassure parents about the mass hysteria over child sex abuse.

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