Dicks House; The second in a three part series on women's health.
The creation of the Women's Health Program last September at Dick's House has decreased the waiting time for students to get appointments and allowed for greater development of programs geared toward women's health, according to the program's manager, Janice Sundnas.
Emphasizing preventative care, Sundnas wrote letters to first-year women who indicated on their health forms that they had never had a pap smear or gynecological exam and inviting them to come for an annual check-up at the beginning of Winter term.
The annual exam, which lasts approximately one hour, allows the health care provider to discuss medical and family history and look at diet, stress management, exercise, relationships and sexual issues.
Sundnas said it is too early to determine how responsive freshmen were to the letter.
"In the first month after sending the letter, at least 40 freshmen came in," Sundnas said. "I still have '97s drifting in."
One female '97 said she felt relieved after visiting Dick's House.
"It took less than a week to make an appointment and the exam was a very small part of it. Most of it was just talking to Sundnas," she said. "I am glad I went, because it was a great relief to have realized that it wasn't that bad."
Sundnas said she hoped the letter would have a cumulative effect on students and that perhaps women would come in later.
But one '97 female said she did not feel comfortable going for such an exam her first time at Dick's House.
"I never have and if I were going to, I wouldn't do it at Dick's House because they are completely unprofessional," she said.
Although she has never been to the Women's Health Clinic, the woman said she was unhappy with the care she received from other physician's assistants regarding an ear infection and the chicken pox.
The Women's Health Program consists of Sundnas, who is a nurse practitioner and Frances Uptegrove, a physician's assistant. Dick's House does not employ any gynecologists. Dr. Barbara Payson, a general medical practitioner who is not part of the Women's Health Program, sees students who request to be seen by a doctor.
"We do have students who are uncomfortable seeing a nurse practitioner or a physician's assistant so we do have a physician as an option for those students," Sundnas said.
But Z, a female student who asked to remain anonymous, said she was given an appointment with Uptegrove when she called Dick's House asking to see a gynecologist
"It was my first time seeing a gynecologist, so I went to see her, " Z said. "But then when I called again and asked for an appointment with Dr. Uptegrove, they said she's not a doctor."
Dr. John Turco, Director of College Health Service, said if a woman calls and asks for an appointment with a doctor, she can see one of the three physicians, but if she calls specifically for an appointment with the Women's Health Clinic, she would see Sundnas or Uptegrove.
"Ninety percent of women in the real world don't see a gynecologist for their routine care. They might be seen by a nurse practitioner or a physician's assistant with some exceptions," Turco said.
Jane Bassick, director of public affairs for Dartmouth Hitchcock Medical Center, said a woman who calls the DHMC for an appointment for an annual gynecological exam is given several options.
"They explain to you that you could have a doctor or a nurse practitioner, a male or a female and screen you for what you're more comfortable with," Bassick said.
Z, who made an appointment seeking treatment for a urinary tract infection, said it took her four visits to Dick's House in six days to receive the proper medicine.
"First they gave me medicine that didn't work, so I went back and had another test. But they couldn't write me a prescription because the lab was closed, so she told me to come back the next day," Z said.
"When I came back the next day the first doctor was not there and someone else tells me the test came out negative and I don't have an infection. He suggested that maybe it's just a yeast infection and gave me medicine for that," Z said.
"When I was still feeling discomfort after a few days, I went back there and the first doctor was there. She said she was glad I came back because the person the day before gave me the wrong results and I did have an infection and she said she tried to reach me, but couldn't and then forgot about it," Z said.
Sundnas, who has only been at Dick's House since the creation of the Women's Health Clinic, said she is not aware of many people being unhappy with the services provided.
"If there are a lot of people out there who are unhappy with the service, then I just don't know about it," Sundnas said.
Although she felt unable to comment generally on complaints, Sundnas said medicine is not always black and white.
"When it comes to things like vaginal infections, it's not always very clear cut," Sundnas said. "You can see yeast cells under a microscope and give them the right therapy, but for some reason they keep itching."
Although Turco admitted to the occurrence of misdiagnoses, he said most of the cases are of miscommunication rather than misdiagnosis.
The Women's Health Clinic offers routine exams and treats such things as vaginitus. Sundnas said the Women's Health Clinic refers students to DHMC in the case of abnormal pap smears or when a student needs a service the Women's Health Clinic cannot provide.
For example, colposcopy, a pap smear done with a microscope, is often the next step after an abnormal pap smear. According to Sundnas, this is a very intricate process and the person who performs such a thing must be licensed in colposcopy.
"We have talked about bringing folks over to Dick's House who have that capability," Sundnas said.
Sundnas said creating a department solely for women's health allows for the development of specific education programs.
