joreth: (Bad Computer!)
When calling around in your town to find an affordable clinic that offers all the STD tests that you want, you may come across some clinics with less-than-knowledgeable staff.  It is my opinion that the patients should never have better medical training in the specialty field than the clinic or office the patient would like to patronize.  Here are some tips for weeding out the questionable offices:

1) On the phone, ask what kinds of STDs they test for.  If they say "all of them", repeat the question, emphasizing the word "which".  If they still say "all of them" without giving you a specific list, don't go there.  The receptionist, at least, has no idea what her office handles and will not schedule you for the appointment you want, leaving you to make it all the way up to the doctor herself before discovering that you just wasted your time and now have an office fee or copay for no reason (or will have to have another set of fees for a second office visit somewhere else).

  1b) To really test their knowledge, ask if they have the HPV test for men.  If they say yes, be immediately suspicious and ask to speak directly to the doctor.  The doctor should know that their phone staff is providing bad information and is about to schedule you for a service that doesn't exist, which will cost you time and money.  Then, don't go there.

2) When they list the STDs they test for and leave off "HSV", ask them if they test for HSV.  Be sure to say "HSV" and not "herpes".  If the receptionist doesn't know that HSV is the virus that causes herpes and that the HSV test IS the herpes test, don't go there, for the same reason as point #1.

3) When the receptionist or scheduler does happen to understand that the HSV test is the same thing as the herpes test, ask which test they offer (hint, it should involve letters like PCR or IgG).  If they can't tell you which test, or they are unaware there are multiple tests with different methods and accuracy ratings, don't go there.  Even a receptionist who has no medical training should at least be able to ask a nurse or technician the answer to that question, or to ask her office manager what the lab order code says about which herpes test they would be ordering.

  3b) If, upon asking which test they offer, the receptionist responds with "what do you mean which one?  You either have herpes or you don't!", then don't go there.  First of all, that's not true, there is more than one strain.  Second, that wasn't the question, and even accurate test results don't give you a binary yes/no answer - it's a probability or a yes/no with an error margin for false negatives/false positives.

  3c) If, upon making it clear to the receptionist that there are several different types of HSV tests, and you want to know which one that clinic uses, she STILL doesn't know so she offers to transfer you to the lab, where the lab technician answers and is unable to tell you the name of the test they use, don't go there.  I shouldn't even have to explain why this is a problem.

  3d) If you manage to find out which type of HSV test they offer, get them to state, unambiguously, whether they will be able to distinguish between the types of HSV.  This may not be important to you, but it is important to know if this office knows the limitations of their own tests.

4) When you arrive, if you have the money for the tests you want, and the office offers the tests you want, and the doctor, nurse, or technician tries to talk you out of getting a particular test because "everyone already has it, so don't worry about it" or "if you don't have symptoms, you don't need to be tested for it", be prepared to exaggerate or outright lie about your sexual status and demand the tests that they offer that you are willing to pay for.  When I say "be prepared", this means to have the numbers and situations already in mind, and to also be ready to sit there and be lectured about safer sex practices.

Some clinics do not think that a full battery of regular STD exams should be part of one's regular medical maintenance, while simultaneously believing that multiple sex partners automatically equates one with the crack whores who fuck dozens of strangers a day in exchange for dirty needles to shoot up with.  So you may have to tell them that you have more partners than you do, or that your partners were exposed to all kinds of STDs and just deal with the judgement and the, probably, misinformation based on a skewed sense of morality that places a person's value on their sexuality, or lack thereof.  I once had to break down crying about a cheating boyfriend who tested positive for HSV in order to get an HSV test without symptoms.  I also had to break down crying in order to get the 2nd AND 3rd shot in my hepatitis vaccine schedule, which didn't make any sense at all since they gave me the first shot.

Not all of us have health insurance or the money to afford to shop around for just the right health practitioner who will treat us respectfully.  Some of us have to go for price over comfort.  But we shouldn't also have to sacrifice competence.  In fact, it might turn out to be more expensive if you try going for price alone and discover that you didn't actually get what you wanted and now have to go somewhere else anyway.

*This PSA brought to you from direct conversations I've had in the last 2 days with various clinics around town.  Yes, I actually had to explain to someone that HSV was the virus that causes herpes when I called an STD clinic.*
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