That's absolutely correct, there are many reasons for performing a "pap smear" on patient's without a cervix, the most cogent is a history of dysplasia/cancer to assess the surrounding tissue for spread. The vaginal "cuff" as it's called (the area at the top of the vagina that was closed when the cervix was removed) is "scraped" very much like a pap smear. The ordering of the pap smear test using a lab slip is required to specify the specimen site (ie, cervix, vaginal cuff, etc).

As an ob/gyn, I don't relish the idea of ill-informed beaurecrats telling me how to practice medicine. The beaurecrats want to automate the practice of medicine so they can pigeonhole all diagnosis and treatments into cubby holes and check boxes in order to analyze and arrive at such statistics as pap smears per hour and state--as if it means something--"Dr B does a pap smear for $3.97 while Dr C charges $3.99." Therefor, we're only going to pay $3.97 for any and all pap smears. Think it sounds funny? That's exactly how Medicare pays, without regard to how easy or difficult it may be to perform a pap smear on various patients. You might just as well say you can reduce all of programming to a universal automated system, plug in a description of inputs and desired outputs and some algorithm generates perfect code. There are many aspects of programming that could be considered an "art form". The same is true with medicine, law, research and a host of other disciplines.

Because that's where, in our system, we determine if her claim was factually valid. It was, so she won. I don't see what's so confusing here: court is where it should have gone and been resolved.

I didn't RTFA, but I think the only thing the judge ruled on was her right to free speech, NOT on her claim of a "botched" surgery. Those are key and distinct differences. The problem with reviewing this case from the side lines, is that most of us are not qualified to evaluate this woman's surgery. We can view the results and decide if we like or dislike how she looks now, but we can't assess the surgery. There are many, many variables that may have been involved with her final, "look": she may not have followed surgeon's post-surgical instructions regarding care and precautions (ie, avoid tanning, avoid spa massages, avoid surprise parties). Even if the surgery was perfect, and even if she followed his directions exactly, there's often quite a variance in surgical outcome simply based on good vs poor genetics regarding healing, or simply piss-poor "protoplasm" as many would say.