Your first gynaecology appointment is often filled with a great deal of anxiety and the fear of the unknown, however it’s an essential step for every female older than 13 years of age. Starting the Conversation The consultation starts like any other medical visit, with a brief medical history and discussion into any gynaecological concerns that you may have, ranging from irregular periods, painful sexual intercourse, smelly vaginal discharge or the annoying ingrown on your bikini line. We take an in-depth history into your menstrual cycle, vaginal health and sexual history including contraception and sexual partners. While it can be extremely uncomfortable to discuss sexual activity with your doctor, it is vital that you are completely honest such that you may receive the care you need. All the information you share will be kept confidential. The Examination We will always let you know what the intended examination will be prior to entering the examination room. You will be asked to remove all your clothes including your bra and underwear, if a pelvic examination is to be performed. The examination will include an examination of your breasts, your abdomen and finally your pelvic area. Throughout the examination you will be kept informed as to the nature and reason for the assessment. The pelvic examination entails; an assessment of the vaginal area for any abnormalities, signs of STI’s, rashes, lesions, skin changes or hormonal issues. An internal assessment follows with the use of a speculum, which is inserted into the vaginal canal (only if you are sexually active) to exam your cervix, vaginal and extraction of a pap smear. I often advise patients to prop their pelvis up by placing their clenched fist underneath their buttocks, which eliminates the potential uncomfortable nature of the examination. The Ultrasound An ultrasound is done to assess your uterus, fallopian tubes and ovaries. Initially we begin with an abdominal ultrasound and follow with a transvaginal ultrasound. The transvaginal vaginal ultrasound is an internal scan where a probe is inserted into the vagina to get a better look at the uterus and the ovaries. Such an ultrasound will only be done if you are sexually active and with your consent. Debrief Once we have completed the above, I often discuss my findings and management plan. This is also the point at which we discuss preconception planning, contraception, perimenopause or menopause aspects depending on the stage of life you at.

You can expect to be seen at regular intervals during your pregnancy, allowing us to identify any developing problems at a stage where intervention can be done effectively. Within the first 34 weeks you will be seen every 4 weeks and thereafter 2 weekly, if you are a low risk pregnancy. Please refer to the obstetrics page to see a general outline of your pregnancy schedule.

Making an appointment Appointments can be made either by calling our rooms or via Appointmed. No referral is necessary to make an appointment, but please remember that certain medical aids do not cover direct appointments with specialists, and may not reimburse you. It's always best to liaise directly with your medical aid in this regard. How does payment work? We are a cash practice, therefore consultation fees remains your personal responsibility and is payable on the day of the appointment, after which you may approach your medical aid for reimbursement. All rates are available from our practice. Our aim is to be open and honest about all aspects of the consultation including diagnosis, treatment and the cost thereof so please do not hesitate to ask should you require any additional information. Each medical aid has their own ‘scheme rate’ based on the previously used National Health Reference Price List (NHRPL). In July 2010, Acting Judge Ebersohn of the North Gauteng High Court judged the RPL to be ‘unreasonably low’ with healthcare practitioners not able to cover their costs at this rate and it was therefore set aside. Practitioners are thus allowed to set their own rates, within reason, and some do charge above medical aid rates. As such, there will almost always be a difference between the costs involved and what your medical aid is prepared to cover. Emergency or after hours consultations will be subject to an additional fee. The consultation fee is only for the appointment itself i.e. history, basic examination & diagnosis. Any procedures required to make the diagnosis, including but not limited to blood tests, a pap smear, etc are chargeable separately. These will be charged to the medical aid if applicable. In the event the medical aid rejects the claim for whatever reason, the patient is liable for these charges Surgery An estimate of the total cost will be provided before scheduling surgery. Discovery Health members on Classic options enjoy full cover for surgery. Other medical aids may have a “co-payment”, which is for the patient’s account. Fees for other health professionals, such as anaesthetists and paediatricians, as well as hospital fees, are charged separately by the relevant entities. Repeat Prescriptions In the event of a prescription been issued, it will be at a maximum of a 6 month repeat. If you require a repeat script thereafter you will be expected to email our rooms with all details including the name of the drug and dosage. Please be aware that we do charge R200 for each repeat prescription, which you may claim back from your medical aid. Please allow for at least 7 days from receipt of email. Importantly only one 6 month repeat is allowed medicolegally from date of visit.