Dr. Syan discusses lack of patient knowledge/awareness of pelvic floor disorders


"If you disrupt a good patient-physician relationship to the point where patients actually don't seek the care they need, that's obviously very problematic," says Raveen Syan, MD, FPMRS.

In this video, Raveen Syan, MD, FPMRS, discusses the role of physician counseling and bias and patients’ lack of understanding/awareness of pelvic floor disorders. Syan is an assistant professor in clinical urology at the University of Miami Desai Sethi Urology Institute in Miami, Florida.


When we look at physician counseling and bias, that's a little harder to understand because it's hard to look at and reflect on our own practices and biases. This is another group that looked at what patients reported as their conversations with a clinician. They reported that only 3% of providers initiated a conversation about urinary leakage, so we're not asking the question well enough. We performed focus groups where we, as part of my funded research, asked Black, Hispanic, and other women to describe their experience with pelvic floor disorders and with physicians. Black women reported, "Each doctor refers you to another and it was like running in a circle; it was exhausting." So there's a little bit of a, oh, this is another issue; you have to go elsewhere. Sometimes, when you book an appointment, they're very far out, so you can get your foot in the door, but to get to that end point where you're actually receiving the care is problematic. Hispanic women report that their gynecologist told them it was normal and it wasn't that bad and that she didn't need surgery. However, she states that had she been aware of treatment options, if she'd been appropriately counseled, she would have elected for it. So there's a lack of appropriate counseling going on. "If you see someone who is not nice or understanding, it is hard for you to go back and talk about something because you shut down." So again, if you disrupt a good patient-physician relationship to the point where patients actually don't seek the care they need, that's obviously very problematic. That's something we hold in our responsibility, and we need to do better by our patients. So this is again, my funded work where we looked at women and we asked them how many of you were unaware of treatment options, and about a third were totally unaware. Half of Hispanic women stated they were unaware and half of Black women stated they were unaware. So lack of awareness of pelvic floor disorders and treatment options is highly problematic in this group. When you look by location of service or location where we recruited participants, again, the community, the vast majority just didn't even know that that was an option. So there's a real opportunity here to improve pelvic floor disorders by just teaching, by providing awareness.

This transcription was edited for clarity.

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