The Design Flaws in a Traditional Speculum That Your Patients Hate Most
Finding a patient who looks forward to a vaginal examination is about as challenging as finding a needle in a haystack. Women tend to dread virtually every aspect of the vaginal examination from the moment they enter the waiting area until the completion of the exam. If there is a bright spot during the whole process, it is the end of the exam when the doctor or nurse practitioner finally removes the speculum, signaling that the exam is finally over. Below is a look at the reasons why women dread pelvic exams and how some common design flaws in the traditional speculum contribute to poor patient experience.
Why Do So Many Women Dread Gynecological Exams?
“Time after time, I hear from my patients that the GYN exam is simply dreaded and avoided if possible. Many times, exam appointments are made and then cancelled. If an appointment is kept, often the exam cannot be completed because the patient is in tears with high levels of anxiety and the pelvic muscles have involuntarily contracted into “keep out mode” to protect themselves from the agony of the exam.”
– Dr. Peter Pacik, Maze Women’s Sexual Health
There is no single reason why so many women cringe at the mere thought of an upcoming pelvic exam. With over 60 million exams performed annually, the reasons why women shudder in anticipation of their annual exams range from feelings of self-consciousness to fear. Here are just a few of the factors that cause women to dread their gynecological exams:
- Exams are uncomfortable: For some patients, insertion and expansion of the speculum produces physical discomfort
- They take longer than they should: An exam should only take a couple of minutes but instrument prep time can extend the process
- Pelvic exams are embarrassing: The invasive nature of a gynecological exam can make women feel vulnerable and insecure
- They involve scary looking instruments: The appearance of a traditional metal speculum and light source can cause anxiety in patients
What Are Some Key Design Flaws in a Traditional Speculum?
There is one common thread associated with each of the four factors described above: the flawed design of the traditional speculum. In addition, a traditional speculum is associated with delays caused by the sterilization process or repositioning patients. Below are some of the design flaws in a traditional speculum that patients hate the most.
1) A Rigid 90-Degree Angle
“Even providers said there was room for improvement—for example, the way that the speculum is angled, a rigid 90 degrees, makes it more difficult for them to position the patient correctly on an examination table.”
– Michal Lav Ram, Fortune
A traditional speculum’s rigid 90-degree angle frustrates providers and patients alike. In fact, the 90-degree angle often requires the patient to be repositioned to permit the doctor to view the patient’s vaginal cavity and pelvic area. However, failure to reposition the patient can result in poor visibility and missed diagnoses.
2) Exposed Screws
A hallmark of a traditional speculum is an exposed screw on the outside of the device. The purpose of the screw is to secure the speculum in its desired position during an exam. Unfortunately, this screw can end up pinching the labia or vaginal tissue, resulting in a painful experience for the patient. Additionally, the process of tightening and loosening the screw produces a noise that is unnerving to some patients, contributing to an overall unpleasant experience.
3) They Are Time-Consuming to Use
A traditional speculum requires time and effort simply to prepare it for use with a patient. Because traditional specula are reusable, they must be thoroughly cleaned, sterilized, dried, and stored to avoid cross-contamination. Finally, traditional light sources do not feature integrated light sources, requiring the setup of a separate light source to illuminate the pelvic cavity.
4) A Scary Looking Physical Design
“The speculum was invented by James Marion Sims in the 1840s. The inventor of what looks like a medieval torture device is often referred to as ‘the father of modern gynecology.'”
– Natalie Rahhal, Daily Mail
One of the most intimidating aspects of traditional speculum is its scary-looking design. Frequently described as resembling a medieval torture device, the traditional speculum is wide and angled with a design that looks intimidating to many patients.
5) Cold Metal Construction
The traditional speculum is constructed of metal components, which can feel cold and unnatural when inserted into the vagina. Additionally, a traditional metal speculum is designed to be reusable. Using a reusable metal speculum requires providers to invest in a sterilizer and stock plenty of sterilization supplies in order to prevent the spread of infection.
What Is the Most Effective Way to Address These Design Flaws?
The best way to address this is to switch to a single-use speculum that features a sleeker, more contemporary design. In fact, research shows that this switch can virtually eliminate some of the unpleasant aspects of exam experience. For example, findings of a usability study comparing a self-lighted, disposable speculum to a traditional metal speculum highlighted the numerous ways that a single use speculum helps to improve the patient experience during pelvic exams:
“When utilizing the OfficeSPEC speculum in an austere environment, many of the limiting factors confounding adequate gynecological examinations were eliminated. The light source is self-contained in the handle of the light, therefore eliminating the need for external lighting. Sterilization equipment and supplies are not needed, as the speculum is single use and can be disposed with other medical waste.”
– CPT Christina L. Jones, Lt Col Daniel D. Gruber, CDR William Warner, COL Jerome L. Buller; Military Medicine
The Bottom Line
The design flaws present in the traditional vaginal speculum are a primary reason why many women dread gynecological examinations. One of the best ways to address these flaws is to switch to a modern, disposable speculum. Indeed, with its sleek ergonomic design and locking hinges, obp’s ER-SPEC and OFFICESPEC disposable vaginal specula create a more comfortable, less intimidating experience for patients. We invite you to contact us at obp to discover the many benefits of our single-use specula.