Bioethics Discussion Blog: Patient Modesty: Volume 79

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Saturday, April 22, 2017

Patient Modesty: Volume 79



Yes, the current discourse continues to follow the issue of "speaking up" to the medical system regarding patient modesty and patient dignity.  The image above speaking up by way of the bullhorn appears to be a female.  It is this gender which appears to have taken the lead in the past regarding insisting that the system attends to their desires and needs.  It appears from the conversations going on in the previous Volumes of this thread that it is now the requirement of men to take hold of another bullhorn and bellow out their personal desires and needs. Go to it!!  ..Maurice.


Graphic: From Google Images. Courtesy of Pixabay

70 Comments:

At Sunday, April 23, 2017 10:41:00 AM, Blogger Maurice Bernstein, M.D. said...

I thought it would be worthwhile to start off this Volume with a comment written by a female visiting my well-received series of thread "Chapters" on "I hate Doctors", in this case Chapter 3. How men as well as women relate to physicians is much more complex than simply physical modesty issues. ..Maurice.
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The search words that brought me to your blog were "ambivalent about doctors" and I seriously doubted that I would find much on the topic, so this is an interesting thread. Hate seems like such a strong feeling to have toward someone providing a service to you, depending on the health system you are treated in. If you're not happy go somewhere else. But this ambivalence has followed me through the years and to different doctors. I have moved to so many when I have become upset. Now I am at the same clinic for two years as I am forcing myself to own up to whatever problem it is that I have with your profession. Unfortunately, my doctors have to stick with me too until I can sort these feelings out. I try to be fair and apologize when I have over reacted to things. As I get older I realize that it is going to be in my own best interest to establish a rapport with my doctors. Maybe the need for that causes anger. It's hard. I hate feeling observed like a specimen and I hate feeling like I'm being processed and needled around in a petrie dish. I hate the need for that "relationship" with all its boundaries and I both feel for those who have to maintain them on a daily basis with multiple patients. I also wonder how they could be so emotionally controlled. I've considered some more personal causes for this love/hate thing I feel. Maybe it has something to do with watching my mother die at a very young age and no one being able to save her. Maybe it's because no one saved me in the horrible years that followed. Now that I am older I consider that it's because you belong to an exclusive group and have access to information which I often do not. The world works around you to support you in delivering care to others and what a wonderful thing to be a part of, but this puts you at the center of everything with everyone catering to your needs. Perhaps this is deserved with all you have to face. Perhaps that could be the problem. You and those who work around you are the hopeful solution and as a patient we are part of the problem and to some, but not all physicians... a bit of an inconvenience. I think this is an important thread. What a wonderful topic to discuss especially with all the changes that have taken place in healthcare with mergers and acquisitions and the corporatization of medical facilities and employment of previously independent physicians. I know this thread has been open for many years, but I felt the need to add. I'll look forward to going back through the thread to read more.

Renee

 
At Sunday, April 23, 2017 3:39:00 PM, Blogger Biker in Vermont said...

Dr. Bernstein, I took a few minutes and read some of that "I Hate Doctors" thread, and I don't relate to it at all. Perhaps the difference is that I don't expect doctor's to be all-knowing and perfect. As a child I paid dearly for a missed emergency room diagnosis and so I know the downside of medicine. We say the art of medicine rather than the science of medicine. We use the term medical practice, not medical perfect. There are often going to be multiple possible diagnoses, and the wrong one is sometimes going to be chosen. Get a second opinion if your belly twitch says the doctor missed something.

Many of the posters in that thread talked of doctors that don't listen to what the patient is saying. Find another doctor if you can if that is the case. I love my primary care doctor in part because he is such a good listener. The urologist I recently left after many years was top notch technically but the ego was such that I was afraid to even ask him questions. That's not why I left him but it did feel good to have an actual conversation with my new urologist. After one visit with a cardiologist that wasn't listening to what I said, I heard one of his partners speak at an info session and switched to him. He does listen and puts effort into explaining the options instead of just telling me what he is going to do. I'm sticking with him.

Generally speaking women are better listeners and/or connecting at an emotional level and perhaps that in turn drives their having different expectations of their doctors. For me however I will continue to only go to male doctors for anything that involves or might lead to intimate care. That variable is more important to me than their listening skills.

 
At Monday, April 24, 2017 4:22:00 AM, Anonymous Anonymous said...

In response to Biker's comment above, it's been my experience that women providers tend to be good listeners and are often more sympathetic to patients' feelings -- with the egregious exception of my own "chaperone" experience, recounted in vol. 78. But my (male) PCP has strongly recommended that I stick with male providers if I want to avoid spectators for my intimate care.

BTW, I'd like to repeat my "plug" for folks to try commenting on the following articles:

This one relates to the issue of men's gender preferences in health care:

https://insight.athenahealth.com/new-data-suggests-male-patients-less-likely-return-women-doctors

This one is an abstract for a presentation advocating for a universal law requiring "chaperones" for intimate exams. The speaker (who has "MD" after her name) makes the ridiculous claim that required witnesses would actually increase patient participation in intimate screenings like DRE's:

http://jdc.jefferson.edu/mphcapstone_presentation/135/

Biker and I have both tried unsuccessfully to post responses, but maybe a barrage of them would get through.

Thanks again to Dr. Bernstein for sponsoring this venue for all of us.

RG

 
At Monday, April 24, 2017 7:31:00 AM, Anonymous Anonymous said...

@Biker in Vermont, Which variable are you saying is more important than listening skills? You said you love your primary care because he is a good listener and left your urologist who was not someone you could communicate with. Which thing did you find more important? Their "technical" or diagnostic capability? Another factor for me that plays out at the cardiologist is just how much I am ready to hear about what is wrong. I like my cardiologist but the truth is he doesn't explain things in great detail. He doesn't put the problems he has found into context for me as far as prognosis is concerned. And the truth is I think on some level I'm not ready to hear it and I think he knows that. Maybe that seems silly, but for now or until I'm ready to hear it all that works for me. I have chosen to just trust what he says and I do hope that is the right decision. I think when the time comes that I am ready to hear more he will answer any specific questions I have, but I get the feeling also that there is a reluctance to give a prognosis because of how that may affect the outcome. ie. he likely knows I will stress a great deal over it and that I could potentially make things worse. What a tough call. Even though as a woman I am expected to be a better listener and connect on an emotional level, I don't want the same from the cardiologist. The thought of it scares me to death. I don't want to know the intimate details of the problem. I keep him at arms length. I say do what you have to do and I don't really care to share my symptoms because to me they feel like something personal or something I need to protect. I hope over time I'll become more comfortable and have more open discussions with him. For now, I'm glad to let him worry about it instead of me. For now I'm glad he's willing to take that responsibility.

Renee

 
At Monday, April 24, 2017 12:09:00 PM, Blogger Biker in Vermont said...

Renee, I left my former urologist because he was 4 1/2 hours away in Boston, which is OK for a once per year cystoscopy, but it occurred to me that what if it came back again (doctor said I have a 3% chance in any given year), then I'd be looking at dozens of trips for treatments and such. I figured best to get established somewhere closer while I am healthy. Fortunately there is a world class teaching hospital less than 2 hours away where I was able to get established with one of the senior urologists. An added bonus is that the culture at my new hospital was such that it was OK to ask for a male nurse for my recent cystoscopy, and get one no questions asked. I'd of been afraid to ask at the other place, but I already knew the answer anyway being they didn't employ any male staff in urology other than the doctors.

To more specifically answer your question, if I had to choose I would go for competence over communication style if choosing between two male physicians.

If looking at a good communicator female physician vs a poor communicator male physician, I will go with the poor communicator male for any specialty that might lead to intimate care. The issue for me is less a female physician on a standalone basis but rather the additional female nurses, techs, or chaperones she's going to add to the equation.

I recently had a female surgeon for a minor finger surgery and very much liked her but I knew ahead of time that there would not be any intimate contact. She was a wonderful communicator and her reputation ranges far and wide in this region. It takes months to get an appt.with her.

 
At Monday, April 24, 2017 1:59:00 PM, Blogger NTT said...

Good Afternoon all.

The athena health website RG gave here has finally posted some responses from people.

Regards,
NTT

 
At Monday, April 24, 2017 2:18:00 PM, Blogger Maurice Bernstein, M.D. said...

The web address that NTT just noted is:

https://insight.athenahealth.com/new-data-suggests-male-patients-less-likely-return-women-doctors

and then scroll down to the Comments section
..Maurice.

 
At Monday, April 24, 2017 3:31:00 PM, Anonymous Anonymous said...

Thanks for pointing out the InsightAthena article, question. The question of course is flawed because the male experience is always different than the female experience. But it is good they are trying to learn why the males don’t return as often. They may actually think about the comments. Will they do anything though? - AB

 
At Tuesday, April 25, 2017 5:23:00 AM, Blogger NTT said...

Good Morning Everyone:

Hope everyone is well.

AB if enough men can find their voice & speak up, they will have to listen. Just like they did with the women.

If they don't listen, they will be perceived in the eyes of the public as trading dollars for men's lives. Something that won't go over very well.

It's up to men everywhere to search deep down inside themselves and ask, "It's bad enough for me now, but do I really want to see my kids struggle through what I am going through? Especially when I have the power here and now to change things."

If the answer is no, then you have to look past any perceived male frailty and speak loud and clear that you want things changed.

It's up to US to derail this train NOW and put it back on the right track so our kids don't have to deal with this crap.

It's time to speak now or forever hold your peace.

Choice Privacy Respect.

CPR for ALL not just some patients.

Haven't we waited long enough?

Regards to all,
NTT

 
At Tuesday, April 25, 2017 6:49:00 AM, Anonymous Anonymous said...

@Biker in Vermont, regarding

"The issue for me is less a female physician on a standalone basis but rather the additional female nurses, techs, or chaperones she's going to add to the equation. "

I had never considered what this must be like for men. I probably wouldn't care for that much either.

I have always gone to a male gynecologist. For me, it's just weird to have a woman down there. I know alot of women feel differently. But it's true, there is always someone to chaperone the visit and for men I suppose there is little choice sometimes when there are intimate interactions by mostly female nurses. I hadn't considered that either. In fact, I always thought that doctors would be more likely to listen to and be more responsive to a man since they are less likely to visit the doctor. ie. I figured once a man is in the office that the doctor would do all they could to be sure you returned.

I recently had an abnormal brain MRI. One Neuroradiologist said it was abnormal and when I went for a second opinion at the ACO I treat at, their Neuroradiologist said the lesions on my brain were age related. I just turned 46! I said no way.. If I was a man they would have made a different call. They would have at least called for follow up images at some point and time. Now I'll be getting a third opinion. Funny what factors can play into the interactions and probably the judgments made by doctors as well. Although I can't say for sure he would have said something different for a man, I couldn't help but question it. I just don't see ovoid and diffuse periventricular white matter lesions as age related.

Thanks for answering my question too. I think expertise is important, but I think for me trust comes first, then expertise, then bedside manner. Maybe the trust and expertise go hand in hand for you though.

Renee

 
At Tuesday, April 25, 2017 8:41:00 AM, Anonymous Anonymous said...

Hello Renee,
I'm sorry to hear of your "abnormal" MRI. Although many posters here are concerned with intimate care, I think we all appreciate the fact that the best medical care is achieved only when one is her/his meticulous advocate. I realize that insurance, finances, availability, etc. somewhat determine what medical care is available to us; however, please expend all of your energy obtaining the best medical care that is available to you. See as many specialists as necessary until you're satisfied that you have been diagnosed correctly. At 46, you have many years of life ahead of you, if you are perseverant in securing quality care for yourself. Sometimes this requires being very "adamant" in the health care setting. I wish you well; and, please keep us informed of your progress. There are many listening and compassionate ears on this blog.
Reginald

 
At Tuesday, April 25, 2017 1:35:00 PM, Blogger Biker in Vermont said...

Renee, I'm glad what you've read here has helped you understand what men face. Women suffer indignities too in the OR and ER where they don't have the kinds of same sex options generally available to women otherwise, but men rarely have options anywhere. For reasons most of us here don't understand it is very difficult to find a urologist that has any male nurses or techs on their staff when in fact the majority of patients are men.

It is OK for a woman to prefer a male doctor or for a man to prefer a female doctor. Except for ER and OR settings, we usually get to make that choice. It only becomes an issue when there is no choice, which is just about all the time for men at the nursing & tech level.

Men can choose to speak up but are usually too embarrassed to. That embarrassment carries over to organizing to speak with a unified voice, because men are afraid to confide in other men their discomfort in intimate medical settings. Women are far better at speaking up and in working together for change, and so the medical world is more oriented towards the needs of women. I suffered in silence for most of my life before I finally found my voice and started speaking up. It has been liberating.

Whereas men can empower themselves to speak up, boys can't. These days I understand most parents take their kids to their own doctor for sports physicals, but not every family can do that for a number of reasons. For girl sports physicals, schools will hire female NP's and female nurses to do physicals in private that do not include intimate exams. For boys, schools will hire female NP's and female nurses to do physicals (sometimes in quasi public settings such as gyms) and perform intimate exams of the boys. The mistreatment begins early.

Coming back to choice of doctors, yes trust and expertise go hand in hand for me. I can only think of 3 times that I didn't trust a doctor, and in those cases I just didn't go back. Two were men (specialists) and one was a woman (primary care). She had replaced a primary care doctor that I had been seeing but who left the practice. In her case that one visit was an annual physical which didn't go well on account she was so nervous she skipped all the intimate parts. My guess is she was fresh out of medical school. That visit also told me I really wasn't comfortable with female doctors for intimate matters, even if she didn't do those parts of the exam.



 
At Wednesday, April 26, 2017 7:22:00 AM, Anonymous Anonymous said...

Thank you, Reginald!

Fortunately, I have good insurance through my employer. I'm so grateful for that. I appreciate the support to push or as you said be "adamant" because sometimes I feel a little guilty for that. But I think you're right. I have to advocate for myself or no one else will. I will have a repeat MRI this Tuesday with and without contrast, so I'll let you know when I hear what I hope is just good news.

Thanks also for making yourself available. That's very kind of you.

Renee.

 
At Tuesday, May 02, 2017 4:29:00 AM, Anonymous Anonymous said...

I see that someone was finally successful in getting a dissenting comment posted to Dr. Amanda Kay's presentation recommending a universal legal requirement for chaperones. Here's the URL for comments if anyone else wants to try their luck:

http://jdc.jefferson.edu/mphcapstone_presentation/135/

RG

 
At Tuesday, May 02, 2017 9:14:00 AM, Blogger Biker in Vermont said...

Not modesty related but worth sharing as an example of speaking up. I had a transesophageal echocardiogram (TEE) this morning without sedation. Versed will leave me nauseous and with a headache for the rest of the day and so starting with a colonoscopy last year I decided to just say no to receiving it anymore.

Though there is no intimate exposure for a TEE, the topic of conscious sedation has come up in the past in that it allows medical staff to disregard a patient's modesty. It is often used for staff convenience for that very reason. That's why I am sharing this.

When the cardiologist said he wanted to do a TEE I said fine but no Versed or other sedation, and explained why. He was cautiously receptive and I agreed to have an IV set up just in case I needed to change my mind.

The cardiologist who is only a year or two beyond his residency, the two nurses (one in 50's the other 60's), and the tech (30's) had never done a TEE without sedation before. They were all a bit nervous but were supportive, and in the end I could tell it was a learning experience for them.

As an aside, whereas doing a colonoscopy without sedation was a total non-event, I will admit that swallowing the ultrasound device for the TEE was not easy or pleasant. Once it was all the way in it wasn't a big deal. Taking it out was a little tough but it comes out much faster than it goes in.

Initially it was just me and the two nurses (female) and then the tech (female) came in to get the equipment set up. The older nurse then tells the tech that I won't be sedated so we can't be talking about how cute he is. She was joking of course but at the same time there was a grain of truth in admitting that they do talk.

 
At Saturday, May 06, 2017 8:12:00 PM, Anonymous Anonymous said...

Biker in Vermont

I can see the Cardiologist performing the TEE, the Echo tech of course performing the procedure with the Ultrasound equipment but
I don't understand why there would be two nurses present. In many cases a contrast agent called Definity is injected into the patient
to enhance heart structures but why does it take two nurses? It shouldn't. Something greatly wrong with this picture as well as the
comments they made, highly inappropriate.

PT

 
At Sunday, May 07, 2017 3:23:00 AM, Anonymous Anonymous said...

Hello again. I know there is another purpose for this group but at least one of you suggested I could update you on my MRI results. Reginald, you're last post was so very validating and made me feel better about pushing for another MRI and a 3rd opinion so to speak. The 3rd MRI done last Tuesday with T2, FLAIR and contrast they say is "stable". Ie. Originally MRI with periventricular WMH one confluent area and another ovoid. Subsequent MRI says hyperintensities on T1 an FLAIR are confluent with involvement of the corpus collasum. Yes I had to look that up. Important part of the brain but creates its own work arounds when damaged.... fascinating! Well they called with the "stable but confluent" response and neuro wants me in the office in two weeks. Note: I'be chosen not to stress over this until that time. So yesterday I have an episode at work. Weak in the arms and legs, my head very heavy. Slightly wobbling in the hall. Confused ie. Putting my cereal box in the refrigerator as I try to hurry to put food in my stomach. It was shocking and after it subsided I cried for 20 min and it took several hours before I felt somewhat normal again. I called the neuro and was advised no driving, swimming alone, climbing ladders etc. seizure protocol. I don't know if this is so bad (it doesn't sound good) or if he's just covering to be safe. I wonder how it's stable if the original MRI didn't reference the corpus collasum. Perhaps that is assumed with periventricular lesions and this guy was just more specific? So that's where I'm at and if you have any insight (diagnosis not expected) I'd be glad to hear it. Otherwise, I'm taking it easy until I see the neuro on the 16th! Great weekend to everyone! It was a lovely day hear in FL yesterday. ~Renee

 
At Sunday, May 07, 2017 4:31:00 AM, Blogger Biker in Vermont said...

PT, I had that very conversion with my wife about there being 2 RN's. The best I could come up with is that they had more RN's on duty than patients to tend that day and so spread them around.

Interestingly in March I had a minor surgery on a finger to remove a cyst and bone spur at the same local hospital. It was a 10 minute procedure in which it was only my finger that was numbed up. In addition to the surgeon there were 2 RN's. The surgeon even commented that she was surprised that she had 2, but that she liked it. Again, I thought they must have had more RN's that day than patients to tend.

This hospital is licensed for 144 beds which makes it the 2nd largest hospital in the State. I would think they'd be more efficient cost-wise than what I experienced.

Again, I know the nurse was just joking about talking about me. It is just that such a comment carries with it the proverbial grain of truth that they do talk.

 
At Monday, May 08, 2017 9:54:00 AM, Anonymous Anonymous said...

Hello Renee,
Is there a reason that your doctors don't seem to elaborate on your condition IN PLAIN ENGLISH w/o the medicaleze? At your subsequent meetings, please ask all medical personnel to discussion your situation in terms understandable to you. Do not complete the conversation until you are satisfied that you thoroughly understand your condition. Ask questions and take notes. Bring a friend or family member, if necessary. You'll, no doubt, feel rushed and, you may feel that you're keeping the doctor, nurse, etc. from more important duties. At the time of your conversation, YOU are the MOST IMPORTANT topic. Let them know of your concerns. Ask about your prognosis. What will be your limitations? What lifestyle changes can you anticipate? How can you and they achieve the best outcome for you? If your doc is available via e-mail, write him/her about your concerns. If you're awaiting test results, call the lab or doctor's office DAILY to ask if the results have been obtained. I once waited for half a year for results from a specialist. They had been on the GP's desk for 6 months. Only when I asked the GP, did I get the specialist's written comments dated six months prior. I think that others on this blog will agree that we've all joined the SPEAK UP BRIGADE. This is not a condemnation of the medical profession. Most medical personnel are "swamped", underpaid and under-appreciated. They have to be TOLD OF your concerns and of your desires. Often they will be happy that you are interested in assisting in your care. Let them know that you realize that they may not have all the answers; nevertheless, you'd appreciate their considered judgements regarding your situation. BE COURTEOUS. BE PERSEVERANT. But, most of all, BE HEARD.
Again, I wish you the best of health. Know that you are in our prayers.
Reginald

 
At Thursday, May 11, 2017 11:58:00 AM, Blogger Maurice Bernstein, M.D. said...

WOW! Here is a Comment which I received today from an E.O who wrote on a thread which was inappropriate for the context but certainly would be appropriate for Volume 79 of this thread. This presentation seems to be an angered dissertation attempted to protect a male friend and describe a generalized medical system misbehavior..perhaps a bit more forceful that what was previously written here by out regular visitors.. What is your response? ..Maurice.
__________________________________________



Time for male clients (no, we're not patients) to be treated the SAME AS FEMALE CLIENTS! My male friend was AMBUSHED by the female NP he saw, she slipped in TWO more FEMALES to “PRACTICE" the genital/rectal exam - yep, 3 intimate exams 3 times in a row! My male friend was COERCED - HE WAS NOT OFFERED A MALE, HE WAS NOT ASKED, HE WAS TOLD WHAT THE HAGS DESIRED! THIS IS A SERIOUS VIOLATION OF PATIENT RIGHTS - LEGAL RIGHTS UNDER FEDERAL LAW - AS WELL AS AN ETHICAL ONE! IT’S TERMED DISCRIMINATION! HIGHER COURTS CONTINUE TO RULE THAT BOTH SEXES HAVE EQUAL RIGHTS RE: INTIMATE CARE/PROCEDURES IN CHOOSING A SAME SEX PROVIDER.

As well, this female NP DEMANDED he have a colonoscopy even though he was asymptomatic & she only versed the so-called positive aspects, but deliberately withheld the 70,000 annual injuries & deaths from this procedure; depending on one’s age group, one may be 3 times more likely to die from the screening procedure than disease itself! Less greedy & more ethical medical practices offer the safe FOBT for regular checkups. But of course she was pimping more $ for her organization! & here's the kicker, &, COUPLED WITH 3 PROSTATE EXAMS, is why my friend has avoided this corrupt practice: this same female NP, at his last visit, addressed him this way, verbatim: "You're dirty!" TO SAY ANYTHING OF THIS NATURE IS CLIENT ABUSE, & AMBUSHING MALES FOR GENITAL/RECTAL EXAMS CONSTITUTES SEXUAL BATTERY!

These 3 females violated my friend by making him a GUINEA PIG, A LAB RAT;THEY TREATED HIM AS A THING, AN OBJECT- NOT AS A HUMAN strictly for their own benefit & the primary goal of (NAMED INSTITUTION DELETED) sloughing in the $s! Med schools pay $65 an hour to “professional patients” so that students can learn to examine hands on. But, this greedy group saved $ by subjecting a client to multiple exams;HE RECEIVED NO HEALTHCARE! This group DEMANDS THAT ONE SUBJECT ONESELF TO ALL TESTS THAT THEY DESIRE, & THAT ONE MUST BECOME A DRUGGIE- ID EST - ONE MUST TAKE THE NUMEROUS BIG PHARMA POISONS THAT THEY PUSH! OTHERWISE, THEY’LL THROW YOU TO THE CURB!

An ethical physician would not treat clients as fatted pigs to the slaughter, & throw the less desirable (the clients they can’t make the big $s on) ones in the dog meat grinder!

YOU'D NEVER SEE 3 MALE NPs OR PAs GIVING A FEMALE THREE VAGINAL/RECTAL EXAMS IN A ROW WHILE ALL 3 VOYEURED! No wonder males avoid "health" care in this sickcare industry.It's all over the web!State Boards of Nursing are flooded w complaints by male clients against female nurses/providers re: sexual voyeurism & Sexual battery. BTW, these crimes are Third Degree Felonies!That's why former Gov. Schwarzenegger fired 6 out of the 7 so called professional nurses sitting on that board-they protect they own!

TO DATE, MY FRIEND, THOUGH HE HAS HEALTH ISSUES, HAS REFUSED TO SEE ANY PROVIDER! IF HE IS FORCED TO SEEK MEDICAL CARE I’LL BE RIGHT THERE BY HIS SIDE TO MAKE SURE THIS KIND OF ABUSE & BATTERY IS NOT INFLICTED UPON HIM AGAIN! WHAT A SHAME THAT WE HAVE TO PROTECT OUR LOVED ONES (MALES THAT IS!) FROM FEMALE PREDATORS! THIS SPEAKS VOLUMES OF THE CORRUPTION THAT IS THE UGLY, CORPORATE SICKCARE INDUSTRY TODAY!

E.O.

 
At Friday, May 12, 2017 4:04:00 AM, Blogger Biker in Vermont said...

I wish E.O. had better described the actual sequence of events. A NP does not do colonoscopies so that part must have been a forced referral, perhaps for $ as E.O. suggested, perhaps because something was indicated. Given colonoscopies have to be scheduled & prepped for, the guy would have had time to think through whether he really wanted to go through it. Part of the story seems to be missing.

It is clear the guy had 3 prostate exams but again E.O. wasn't clear on whether he wasn't asked if it was OK or whether he was bullied into agreeing. Neither are acceptable ways of going about it but it would help in understanding what happened. I am guessing the other two people were NP students perhaps?

E.O. doesn't describe the nature of the patient but him being dirty enough for the NP to have commented on leaves me wondering what else is going on here.

Regardless, it was presumptuous of the NP to think subjecting the guy to 3 prostate exams by 3 different women was somehow acceptable. When they go for their mammogram, I suspect they wouldn't think it was appropriate to have 3 successive mammograms by a male tech and his two male trainees.

 
At Friday, May 12, 2017 2:23:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker et al: Do you think I am unrealistically cynical and simply a protector of my medical profession as a whole to surmise that E.O. and even some milder dissertations on this thread provide and paint a totally unrealistic picture of what medical system behaviors and patient experiences are: a common and totally un-rare (i.e.-common) practices and resulting patient consequences. If the arguments are valid and common it is absolutely disgusting for me to think that this is what has turned out despite our medical ethical and behavioral teachings regarding the proper treatment of patients. Is this the example of how poorly students are screened before entering medical school to become and how poorly they are monitored once they leave their formal medical education? And this question applies to all the other professions in medicine education including those entering schools of business who later sit behind the desk of a health institutions. If what is written is commonly true, it is alarming and disgusting. ..Maurice.

 
At Friday, May 12, 2017 3:39:00 PM, Blogger Biker in Vermont said...

Dr. Bernstein, regretfully I have been a frequent flyer in the medical world when it comes to intimate procedures. Most has been bladder cancer related (two surgeries, a year's worth of treatments and a couple dozen cystoscopies) but I've also had a testicular ultrasound, an abdominable ultrasound, 3 colonoscopies (and a 4th coming up later this month), a vasectomy, and as an early bloomer 11 year old in the hospital(am now 64) a traumatic bed bath by a female (don't know what she actually was) that utterly and needlessly embarrassed me. She yanked my gown off and left me there totally exposed for anybody and everybody to observe my pubescent nakedness.

Only two of my many adult experiences have been unprofessional. Most medical staff do conduct themselves in a professional and clinical manner. The norm has been only exposing me to the extent and for the duration necessary and clearly communicating what would occur and asking if it is OK before exposing me. The couple bad experiences I have had have left me permanently leery of female medical staff, but the bad ones are the exception, not the norm.

That most female nurses & techs conduct themselves professionally and in a clinical fashion does not justify men rarely having a gender option.

I would add that conducting oneself in a professional and clinical manner does not guarantee that there is not a sexual component for them. For some it might mean they just kept their game face on. I say this because if there was not a sexual component for them, they wouldn't insist upon only female mammographers, female sonographers, and even if they go to a male GYN, only female staff assisting.

Perhaps nurses maintaining a good game face is enough for some, but it bothers me nonetheless because I have experienced what I call the "attraction reaction" while they are otherwise following professional protocols. Some might say its a good problem to have but I don't like it when I'm the one who is intimately exposed on the table. It is partly why I know there is a sexual component for some nurses & techs.

The true failure is simply that men rarely have a gender option. That is where the medical world has erred. Being professional is not enough.

 
At Friday, May 12, 2017 4:54:00 PM, Blogger NTT said...

Good Evening:

There are a lot of bad men and women out there in the medical profession right now.

Weeding them out & rebuilding the clients confidence in the medical community won't be an easy task.

Especially if the perpetrator is in a position of leadership.

People think twice these days before becoming a whistle blower and possibly losing their job and being black-balled throughout the industry.

Many female doctors are losing their male clients and they're scratching their heads and asking themselves why this is happening.

Many doctors don't believe men have modesty issues so they pass off a clients physical to their female PA's & APRN's without checking with the client first.

Then the PA or APRN brings in a female chaperone for the intimate exam to make matters worse.

Female doctors have a chance here to take the lead and right the wrong doing of the community by advocating for their male patients. Show everybody you really care about a man's dignity by hiring male staff. Then talk to your colleagues and put pressure on the hospitals they do business with to do the same.

Healthcare is in a state of disrepair right now.

Let's work together and rebuild the system using these five words. Do No Harm and CPR.

Choice to each client without always questioning why.
Privacy, given to the highest level no matter the circumstance.
Respect. Give every client the respect they deserve and you will get the same back.

Do No Harm and CPR go hand in hand. You can't have one without the other and successfully build a healthcare system everyone will be proud of.

Regards to all,
NTT

 
At Friday, May 12, 2017 10:16:00 PM, Anonymous Anonymous said...

Biker in Vermont

I'm always more than happy to remind our readers that there are no male mammographers employed let alone trained in the
United States. Furthermore what E.O has stated is only the tip of the iceberg.

PT

 
At Saturday, May 13, 2017 9:19:00 AM, Anonymous Anonymous said...

As with Biker, I'm a male patient who has no problems with female health care providers on their own. I actually preferred them, until my own unsatisfactory experience with a "chaperone" ambush (see vol 78). It has caused me genuine sorrow to accept the advice of my male PCP to "stick with men" in order to avoid the threat of a witness and the ensuing loss of control over who is allowed to see my unclothed body.

I'm surprised and actually puzzled by what appears to be a growing trend for female providers to insist on witnesses when administering intimate care to male patients -- despite mounting evidence that male patients overwhelmingly DO NOT want a third party (of EITHER sex) in the room. I would be very curious to know what their reasons are, what has caused this phenomenon. I've been looking unsuccessfully for a study of women providers' reasons for requiring witnesses (I refuse to dignify the euphemism "chaperone" by using it). If anybody knows of such a study, please direct me to it.

And to address Dr. Bernstein's question above, you have seemed to me to be passionately on the side of patients in this matter -- you are eloquently critical of the existing system, not a defender of it, and I'm grateful that you are.

RG

 
At Saturday, May 13, 2017 12:18:00 PM, Blogger Maurice Bernstein, M.D. said...

RG, yes, as you expressed, I remain "on the side of the patient." This orientation is based on my individual medical practice but also what I and the other instructors in the "doctoring" course (how to take a history and how to perform a physical examination) teach medical students in their beginning years.In addition, my understanding of this same view of vast majority (consensus) of world wide medical ethicists who participate on a university bioethics listserv to which I subscribe.

Gone are the days where physician paternalism was the accepted relationship with their patients. It is no longer acceptable either by physicians, nurses and should be unacceptable also by the entire medical system itself. We should all be "looking to the patient and the voice of the patient" and only secondarily, but with th patient in mind, attempting to integrate other factors and requirements into patient management.

Maybe, part of the solution to everything unpleasant and unwanted discussed on this thread we need a single and unified health care system directed by our federal government oriented solely to the healthcare of everyone and with attention to the everyone's individual needs and not biased toward one business or group of people.

The ethics, I think, has already been established: patient autonomy over paternalism. Now how about changing the politics of healthcare. What do my visitors here think? ..Maurice.

 
At Saturday, May 13, 2017 1:22:00 PM, Blogger Biker in Vermont said...

Dr. Bernstein, I'd personally be in favor a Medicare for all or single payer type system if they could figure out the mechanics of paying for it, but I can't see how such a govt run system would address the issues we have discussed here.

Federal and State govts currently mandate female-only intimate care for female prisoners but see the opposite as discriminatory against female prison staff. Female reporters are allowed in male locker rooms (including school newspaper reporters at the college level) while the guys are dressing and showering, but the opposite is not allowed. Middle and High School boys who for whatever reason do not get the mandated physicals by their own physician and instead get school provided physicals are still subjected to genital checks by female NP's with their female assts. Female student athletes do not get intimate exams. Female medical staff that sexually assault or otherwise violate male patients anecdotally seem to get slaps on the wrist compared to male medical staff that do the same to female patients.

Federal and State govts put much effort into getting women into historically male career paths. At the same time they do nothing to get more men into nursing and medical tech careers. Govt funds Women's Health initiatives but Men's Health Centers are more or less non-existent.

Federal and State govt does not yet recognize male privacy or male modesty as an issue. Though medical staff at all levels are far more professional in this regard than used to be the case, in some ways as a society we are still in the 1960's and earlier decades where the only consideration of male exposure was that it not offend females. And women are the ones who get to decide what is offensive. A man who requests female staff is suspect. A man who refuses female staff is suspect. Men are instead expected to just quietly go along with whatever exposure female medical staff demand of them.

 
At Saturday, May 13, 2017 7:42:00 PM, Blogger Maurice Bernstein, M.D. said...

How about attacking the issue of gender inequality of privacy through the 14th Amendment to the U.S. Constitution?
https://www.law.cornell.edu/wex/fourteenth_amendment_0
Anyone want to give that a try? In the U.S. we do have our Constitution. ..Maurice.

 
At Saturday, May 13, 2017 9:51:00 PM, Anonymous Anonymous said...

Hello,
My experience re privacy issues with the GP was "Oh! What?" I don't think he had ever considered the issue. He wasn't hostile. It's just that this had never entered his head for consideration. Moreover, he is an individual with over 40 yrs. in practice. My feeling is that the medical profession treats the illness or the procedure with little consideration for the privacy feelings of the patient, unless they are made aware of these feelings. At that point it's either, institute a creative alternative to accommodate the patient or indicate that this is the standard operating procedure that the patient must accommodate. Depending on the practitioner there may be accommodation, bewilderment or downright hostility. Until the male privacy becomes mainstream, I'm afraid that the status quo will remain. Reginald

 
At Sunday, May 14, 2017 4:49:00 AM, Blogger Biker in Vermont said...

Dr. Bernstein, there is no doubt but that a major court case based on the 14th Amendment would set in motion gender equality in the medical world. It would have to be a carefully selected case.

My take is that societal level court rulings tend to happen when there has been an ongoing public debate or controversy which the courts finally take a stand on. It is typically a very slow boil.In the case of patient privacy/modesty, at least as pertains to men, society is not yet debating the issue in any substantive way.

The stranglehold that women hold on the medical world at the nursing & tech level is such that they would be a powerful vested interest fighting such a court challenge. They would likely come at it from the perspective that it is discriminatory against themselves and that their professionalism adequately addresses patient concerns. They would maintain that there is not a problem to be solved. Women's groups in general would join the fight using the employment discrimination claim. At issue for them would be maintaining the status quo that advantages women.

I think a parallel could be drawn on the female prison guard court cases and perhaps to a lesser degree the women reporters in male locker rooms case. Courts have been consistent that the employment rights of women outweigh the intimate privacy rights of men. This is why the selection of the right case is so very important. Society didn't much care about male prisoners or athletes. The question is then what kind of male patient scenario might society care about?

Going in the other direction for a moment, the transgenders in boys/girls, men's/women's locker rooms issue is interesting in that the mandates are not differentiating between male/female rights to intimate privacy. Both sexes are being treated equally. That hasn't happened before. A smart legal team might be able to build off of that somehow.

 
At Sunday, May 14, 2017 4:32:00 PM, Blogger Mike said...

Biker,

I think you've zeroed in on the problem here:

Society didn't much care about male prisoners or athletes. The question is then what kind of male patient scenario might society care about?

Regarding the current trans issues, it seems that while males and females are being treated equally, the decision seems to lean toward neither having privacy rights.

I personally doubt the governments ability to produce anything satisfactory on this issue (see the VA), but I realize many will have differing opinions.

Mike

 
At Sunday, May 14, 2017 5:42:00 PM, Blogger Maurice Bernstein, M.D. said...

Mike, how about "town hall" meetings (are they over for the immediate season?). I mean, how about including gender equality with regard to privacy issue, perhaps as part of the political healthcare revision or augmentation? When you think about it, this equality in patient's desires for privacy is bears not only Constitutional significance but can be just as worthy of political consideration as attempts to keep drug prices down and reasonable, keeping insurance companies participating, insurance support of existing medical conditions. With regard to the latter, if PTSD to some degree is a valid complication from exposure to modesty-indignity injury (as many times described on this blog) certainly that should be considered within healthcare legislation. I'm just trying to figure how my visitors here can have their voices heard by the government and medical systems for those "listeners" to develop systems to resolve this "existing medical system" condition. ..Maurice.

 
At Sunday, May 14, 2017 6:55:00 PM, Blogger NTT said...

Good Evening All.

Dr. B as long as I’ve been participating on your blog, you have ALWAYS stood by the client not the healthcare industry. You are a special breed of doctor.

The medical community claims to the country they are “gender neutral”.

To the medical community I ask, “How can you claim to be gender neutral when male x-ray technicians are not allowed to give a woman her mammogram? “Gender bias” would be the more appropriate term.

Again, How can you claim to be “gender neutral” when male nurses are not allowed in Labor and Delivery? More “gender bias”.

You cannot claim you are gender neutral when qualified men are not allowed in these areas. Same goes for the sonographer technician field. More “gender bias”.

If the healthcare system is not going to freely give men the same gender choice they freely give women, then there is a strong case for discrimination. Some male nurses are tired of the healthcare industry’s dog and pony show and have filed discrimination suits against some facilities because they are not allowed in L&D.

In order to build a better healthcare system that will work for all, it must be built with Choice, Privacy, and Respect as its core values for ALL patients not just some.

Congress is currently in the process of coming up with a replacement for the Affordable Care Act aka Obama Care. As they have their own medical plan, they have absolutely NO CLUE how bad things currently are for men who require healthcare services.

I’ve had contact with a couple of senators. One tells me you’re at the mercy of the luck of the draw & the other never responded. They are CLUELESS. Told them don’t expect my vote next election. We need new blood in Washington.

It’s up to us the voters to get our message across to Washington. The new healthcare bill must include Choice Privacy and Respect for all patients when intimate care, tests, and procedures come into play.

If the healthcare industry won’t come to terms with what patients really want and make the changes willingly, it will be up to Washington to make them see the light in the new healthcare bill.

Regardless of your gender. If you want gender choice, NOW is the time to speak up loud and clear & let the people in Washington know, you want gender equality and privacy protections for patients built into the new bill.

Put your fears aside. Stop thinking and saying “It is what it is.” That’s NOT the way it has to be.

A patient centered healthcare system cannot truly be patient centered without Choice, Privacy, and Respect for all built into it.

Change will only come when men and women have the courage to take a stand and force the system to change.

Speak up NOW if you want change.

Regards to all,
NTT

 
At Monday, May 15, 2017 1:48:00 PM, Anonymous Anonymous said...

This comment is drifting a bit off topic but it shows how throughout society, without intervention, there is little regard for men’s health or men’s health issues.

US funding for medical research to solve diseases, cancer, etc. I list the numbers directly from the National Institutes of Health site for FY16 for ALL categories that are GENDER specific (there also is funding at the NIH for categories that benefit all genders, like Lung Cancer, but that is not shown below). You will see that males get about 5% the funding for gender specific research, females get about 95% of gender specific research funds awarded by Congress in the US. Note Breast Cancer alone gets more than Men’s Prostate Cancer funding. This is been true for MANY years. How is this equitable? How is it our Congress feels females are more equal than males?

NIH Research Funding ($ Millions) - FY16
Breast Cancer - 699
Cervical Cancer - 103
Endometriosis - 11
Estrogen - 201
Fibroid Tumors (Uterine) - 10
HPV and/or Cervical Cancer Vaccine - 32
Ovarian Cancer - 123
Uterine Cancer - 54
Violence Against Women - 32
Vulvodynia - 2
Women’s Health - 4140

Prostate Cancer - 299

And yes, the ONLY male specific category funded was Prostate Cancer…Nothing about the higher rate of Male suicides, violence, accident prevention, higher rates of some diseases in males, etc.
FYI.

— AB

 
At Monday, May 15, 2017 6:48:00 PM, Blogger Mike said...

Maurice,
As Biker mentioned, the push back on trying to include something like this would be overwhelming for the politicians involved. Women's groups are already up in arms over any changes, this would merely add fuel to the fire. Cynic that I am, I don't see us getting anyone involved willing to take any kind of chance for us.
Mike

 
At Monday, May 15, 2017 9:56:00 PM, Anonymous Anonymous said...

This months issue of GOLF has an article called locker room talk. The article centers around women reporters in male locker rooms
and of course is written by a female. Her comments are biased and leans toward the female reporters as the ones being victimized.

PT

 
At Monday, May 15, 2017 10:30:00 PM, Anonymous Anonymous said...

NTT

Great comments and I'd like to expand on the subject.

Mammograpy is an on the job training only. You must be at least a licensed medical radiographer then be taught to perform
mammograms. It's not that male radiographers are not allowed to perform them, they are never taught. Male sonographers
are fairly restricted in their employment and are not expected or at least hired in many OB practices. Male nurses are overlooked
as far as employment in female correction centers and L&D suites. If you are a male cna do not expect to be hired at any private
physician's office, although your best job prospects are at a hospital on the night shift. Poor job prospects for male cna's as some
claim on the cna forums that they have been looking for 10 years! There are great job prospects for females at all urology offices
as that seems to be the only gender that's employed there aside from the physician. I fully expect the field of obstetrics and gynecology
to be fully feminized by 2040 not that I disagree, it's just that many women prefer females. The concept of gender neutral was
coined by female hospital administrators, secondly due to the body habitus of many female nurses today, wearing a dress is just
simply not an option and it buys into the gender neutral concept. Thus a hood has been rolled over the eyes of all male patients
along with the false pretense that all male nurses are gay as propagated by female nurses and female hospital administrators.
The growing trend is to hire more female physician assistants to replace aging male physicians and soon there will be female
scribes taking notes at all physician offices, urology too!

PT







 
At Monday, May 15, 2017 10:52:00 PM, Anonymous Anonymous said...

So

With what I've said about gender neutral look at the 4500 or so hospitals in the United States and ask yourself for those hospitals
that provide mammography and L&D suites with no males employed in those areas how can they be called gender neutral when
those facilities don't provide some kind of equivalent privacy for male patients. Now you see how and why the concept of gender
neutral came to be and why female administrators created this phrase and why.

My next challenge is this, find me a hospital, doctors office, outpatient surgical center or any medical facility where a female nurse,
medical assistant, cna is employed that wears a skirt. You won't!!! That is how deeply entrenched the gender neutral concept is.
Even the medical scrub companies have bought into it hook, line and sinker!

PT

 
At Tuesday, May 16, 2017 2:35:00 PM, Blogger NTT said...

Hello:

When women start losing their loved ones sooner than they should because gentlemen will no longer just hand over their dignity just to be embarrassed and humiliated in return, maybe just maybe women will realized there’s something wrong with the system and they better listen to their loved ones and stand with them against the medical community before it’s too late.

Sure, they can replace retiring male physicians with females but that doesn’t mean men will chance going to one just to risk being ambushed by her female staff.

The entire Urology field should be ashamed of itself for their treatment of male patients.

They show men the least respect of any field of medicine.

With more and more male medical procedures moving out of the operating theater into the office surgical suite, I feel it’s going to continue to get worse.

Each procedure will come equipped with your doctor, his female nurse, and of course at least one maybe more female chaperones. All done without even asking you the patient if your comfortable with it.

What’s worse, before you even get to the embarrassment of the surgical suite, you have to sit down first with a female and tell her your entire medical history which may include sexual history then, you get to answer any of her questions no matter how personal she gets.

Finally before you are left alone, you get to listen to HER instead of the doctor tell you all about your MALE related procedure. Including how your female nurse will prep you.

Heaven forbid at some point you ever have to self-cath. Guess who’s gonna teach you how to do it? You got. A female nurse.

It never ceases to amaze me how they manage to influence an intelligent man to cave in and allow this garbage to happen. They do it to men on a daily basis.

Yes, our esteemed urologists and their female staffers have done a bang up job to give all their male patients all the warm and fuzzies you’ll ever want.

Men everywhere need to wise up, put their male insecurities aside for a while and speak up against this crap or it will never end.

If not for yourself, do it for your brothers, sons and grandsons. Do you want to see them have to endure what we have?

Nobody should have to put up with the crap men endure when they are in need of medical services.

Gender EQUALITY for ALL.

While the coals are hot, write or talk to your representatives both local and in Washington and tell them, the next healthcare bill MUST specify gender EQUALITY for ALL patients.

This is 2017 not 1917. It’s time the healthcare industry to stop their willful ignorance towards male patients.

No more trading men’s lived for the almighty dollar. You’ve spent too many of those already.

Talk to your family, your friends, anyone who will listen. It’s time to slam on the breaks and stop this runaway train before it’s too late and you are the next guy that needs to visit your provider.

Regards to all,
NTT

 
At Wednesday, May 17, 2017 3:19:00 PM, Blogger Maurice Bernstein, M.D. said...

Perhaps pertinent to the discussion here, the following is California law signed by Governor Brown last year and has become effective last March 1. ..Maurice.


Justia US Law US Codes and Statutes California Code 2016 California Code Health and Safety Code - HSC DIVISION 104 - ENVIRONMENTAL HEALTH PART 15 - MISCELLANEOUS REQUIREMENTS CHAPTER 2 - Restrooms ARTICLE 5 - Single-User Restrooms Section 118600.
View Previous Versions of the California Code
2016 California Code
Health and Safety Code - HSC
DIVISION 104 - ENVIRONMENTAL HEALTH
PART 15 - MISCELLANEOUS REQUIREMENTS
CHAPTER 2 - Restrooms
ARTICLE 5 - Single-User Restrooms
Section 118600.

Universal Citation: CA Health & Safety Code § 118600 (2016)
118600. (a) All single-user toilet facilities in any business establishment, place of public accommodation, or state or local government agency shall be identified as all-gender toilet facilities by signage that complies with Title 24 of the California Code of Regulations, and designated for use by no more than one occupant at a time or for family or assisted use.

(b) During any inspection of a business or a place of public accommodation by an inspector, building official, or other local official responsible for code enforcement, the inspector or official may inspect for compliance with this section.

(c) For the purposes of this section, single-user toilet facility means a toilet facility with no more than one water closet and one urinal with a locking mechanism controlled by the user.

(d) This section shall become operative on March 1, 2017.effective March 1,2017.

 
At Wednesday, May 17, 2017 3:30:00 PM, Blogger Maurice Bernstein, M.D. said...

Let's see the ethics and consequences of the California law noted above.
Sounds ethical- meets the justice ethical criteria.
Consequences- oh! Instead of only women lining up outside a toilet room to be emptied, men intending to enter the room will have to enter the line too along with the women. Got the picture?

Actually, Governor Brown has shown his interest and desire to, in this one respect, make California, gender "equal".
A first step. Or is it? I would appreciate the comments of my visitors here. ..Maurice.

 
At Wednesday, May 17, 2017 6:26:00 PM, Blogger Biker in Vermont said...

Vermont just passed a similar law concerning single occupancy bathrooms. The stated purpose here was so as to make things easier for transgenders. There's not been much public reaction to it. The cultural norm here is live and let live and bathrooms are not an issue folks are going to get worked up over.

Being the impetus in California is different than it was here in Vermont, it will be interesting to see if they view men as the equal of women in the context of patient privacy/modesty, or does he see gender equal as meaning female nurses/techs can equally serve male and female patients.

 
At Thursday, May 18, 2017 10:03:00 PM, Blogger Maurice Bernstein, M.D. said...

Promoting more follow-through on the concept of the California law regarding single-user toilet facility being neutral to the two genders (or better should I say "all sorts of genders", a more diverse term)---how about getting rid of the urinal itself. Wouldn't that create a better environment for either gender to enter one room with multiple closed-door water closet compartments--also less expensive for businesses or places of public accommodation?

You may wonder why I am belaboring this topic but I see this toilet issue a way the government could demonstrate an intent to follow up even further in providing gender equality both to toiletries but might extend, as a first step, to the concept and laws seeking full gender equality for all the other issues of modesty and dignity that have been long discussed here. ..Maurice.

 
At Friday, May 19, 2017 12:56:00 PM, Anonymous Anonymous said...

Maurice

The bathroom issue has always been about transgendered people and no way ever will that rabbit be pulled out
of the hat. For any hospital that provides mammography services and or L&D any male patient that is not provided
an equivalent privacy for intimate procedures is guilty of discrimination. It is not about embarrassment nor humiliation
but rather being treated the same as any other patient. It's worse than being told to sit at the back of the bus, worse
than using a bathroom being labeled as for colored only, I put it almost as bad as slavery, you are treated as a 3rd class
citizen. State nursing boards have as their bylaws that any patient that is left exposed or inadequately draped is considered
sexual misconduct and subject to license revocation. We know this happens to most male patients. I can tell you for certain
it happens to ALL male level 1 trauma patients and most patients in icu's as well as ER and floor patients. Therefore not only
are you mistreated due to your gender but the rules they set aside for patients don't apply to male patients, not applicable.

PT


 
At Friday, May 19, 2017 1:27:00 PM, Anonymous Anonymous said...

Mammography has been around since the 1950's and has always been performed by women in the United States. It is the only
occupation in this country that is held exclusively by women. As a male in this country you will not be allowed to train nor perform
in that occupation. If you are a male who had the unfortunate luck with hereditary and environment factors that led you to have
cancer in your breasts be aware that many imaging centers prefer that you not be a patient there. There are many Women centers
for Radiology that employ only women radiologists and they prefer you not be a patient there. Your best option would be to choose
a somewhat lower socioeconomic area that has an imaging center where you would fit in better for your imaging study.

PT

 
At Friday, May 19, 2017 9:27:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, your statement " As a male in this country you will not be allowed to train nor perform in that occupation" is not supported by the Joint
Review Committee on Education in Radiologic
Technology (JRCERT)
http://www.jrcert.org/sites/jrcert/uploads/documents/MammographyRotationsforAllStudents.pdf

So if a radiologic teaching program for techs wants certification of the program to continue the program must follow the Objective 1.2. ..Maurice.

 
At Friday, May 19, 2017 9:31:00 PM, Blogger Maurice Bernstein, M.D. said...

Oops! The Objective 1.2 was not posted in my last post. Here it is. ..Maurice.
-------------------------------------
JRCERT Objective Addressing Equitable Learning1
Objective 1.2 Provides equitable learning opportunities
for all students.
The provision of equitable learning activities
promotes a fair and impartial education and
reduces institutional and/or program liability.
The program must provide equitable learning
opportunities for all students regarding learning
activities and clinical assignments. For
example, if an opportunity exists for students
to observe or perform breast imaging, then all
students must be provided the same opportunity.
If evening and/or weekend rotations
are utilized, this opportunity must be equitably
provided for all students.

 
At Friday, May 19, 2017 10:30:00 PM, Anonymous Anonymous said...

Maurice

I'm fully aware of JRCERT and just like the joint commission it means nothing. Absolutely nothing! There are no male mammographers
in this country, period. As I said, mammography is on the job training only and males are not given the opportunity to train. Male cna'a
on the one hand can train but do you see them employed in urology offices. Do you see any male medical assistants or an Lpn, Rn
at any urology clinics.

Do you believe me when I tell you that I know of several males with suspicion of breast cancer but were turned away from a
mammography clinic. They had 1) health insurance 2) a valid physicians order for a mammogram. The mammo clinic told them to
seek out their mammogram in nice words another mammo clinic that's not too upscale. Why? The center they initially sought gave
their female patients a pink robe to wear while they waited for their mammogram.

Ask some male nurses what their opportunities were when or if they were expected to do rotation through L&D, not! Regarding
mammography the ARRT in Minnesota regulates the licensure as well as each states radiation regulatory agency. Ask them if
they have any male mammographers employed or licensed. They can tell you. If you want the real lowdown on this practice
you can call the ASRT in New Mexico.

PT







 
At Saturday, May 20, 2017 8:30:00 AM, Anonymous Anonymous said...

Maurice

Forgive me let me explain.

JRCERT only is concerned about the educational programs in radiography, or I should say medical imaging. Which would be
radiography, nuclear medicine and radiation therapy. ( At the educational level). JRCERT has no control once a student has
graduated and receives on the job training. This is what mammography is , strictly on the job training.

Therefore as I have said JRCERT means absolutely nothing in this regard. As you know I've mentioned some years ago that
I researched this subject thoroughly for 6 months calling every licensing agency in the U.S. From the state level to the national
Licensing agency. At every state licensing agency I'm told there are no male mammographers. I looked into the educational
requirements with the ARRT, ASRT. They too have no control when a discipline such as mammography is taught as on the
job training at a hospital or mammography clinic. But that those who receive the on the job training must be a licensed
radiographer registered with the ARRT. Male radiographers are never give the opportunity to perform on the job training.

In conclusion, if someone at a hospital is able to recite the core values of that institution and one of those core values states
" we respect your dignity" and some core values state that. If that hospital has a mammography suite and an L&D suite what
exactly does that core value mean, who does it apply to? How does it apply to the male patient?

Maurice, can you answer this question. I'll let you know that I have already researched this ahead of time by calling the
administration of one hospital and posed this very question. They were speechless at first and could not answer the question!

PT





 
At Saturday, May 20, 2017 6:02:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, thanks for your response and no I cannot fully answer your institutional "core values" question unless it applies to "patient gender specificity" and some of the values are set by and benefit to the institution itself. If a mammography service (which in reality serves only women and very rarely men) of an institution wants more "customers" certainly, the institution would would look to servicing patients with male mammographers as a possible potential hindrance to maximum "business interests". On the other hand, for men needing general nursing care for significant illness, which would be the most common scenario, there is less statistical risk of "losing business" if the nursing of the male patient is by a female. Of course, some may say my above answer is cynical but I truly believe that financing the institution to be a reasonably considered "hidden core value".

What I would like to know from any women visitors here is whether there is a difference between a male physician performing a female breast exam with (as we teach our med students) a careful and systematic palpation (hand on and "manipulation" the one exposed breast after breast inspection.) Surely, there is less discreet palpation and inspection by a male mammographer. Is the difference related to the more professionally developed relationship in terms of the duration and the prior and current professional interaction of the male physician compared with the brief anonymity and relationship to the male mammographer? The probable major consideration of the woman undergoing mammography is "who is this man? I know my male doctor but who is this man?"
By the way, another factor may be the anticipation of physical discomfort (pain) superimposed on the uncertainties of the character of the male tech. ..Maurice.

 
At Sunday, May 21, 2017 3:26:00 PM, Anonymous Anonymous said...

Maurice


This is what is wrong with healthcare today, secret core values, semi-private core values, people who don't know what their own
core values are and " hidden core values". Now I have to admit I've never heard of that one before, that's a new one on me. So
where is the transparency in all of this? I would say there would be a statistical risk of losing business if medical facilities were
transparent and promptly reported to the news media any case of immpropriety, such would be the case of the female ent in New
Mexico. Do we know what her total financial risk was? What about the hospital?

Since the inception of mammography there has never been a male mammographer and therefore no cases of sexual impropriety
and as I mentioned the strict implement of female techs was always at the discretion of female hospital administration. Thus, posing
your question to our female readers is about 68 years too late.

Now on the other hand I could say that the more professionally developed relationship say between myself and the urologist I
chose compared to a brief interaction with his medical assistant. " I know my doctor but who are these women". Yes, there are
statistical and real risks of losing business and this should not be the basis upon how patients are treated!

How many physicians are arrested, prosecuted and undergo license revocation each year due to sexual impropriety and what
are the statistical risks there. What about nursing and sexual impropriety, it happens every day I assure you. Do you see this
impacting the type and quality of care patients receive. Has a secret core value ever been implemented in any of these cases.

PT





 
At Monday, May 22, 2017 3:47:00 AM, Blogger Biker in Vermont said...

PT, part of the difference with managing risk as concerns male vs female matters is that the media, courts, and public opinion is far harsher when females are abused or otherwise poorly treated by males than occurs in the opposite scenario. Hospitals know this. Hospitals also know that females will be quicker to complain and that there are well organized women's groups that will support those women.

Risk manager focus more on women's issues because that is where the risk is greatest. They know that few men will speak up to ask for same gender care and even fewer will pursue a complaint.

Those men who vote with their feet do not necessarily cost the hospital any revenue either if ultimately they present with more advanced and costly conditions.

Until such point as men organize in the manner that women have and press court cases against the medical system, the risk management structure is not going to change. Forcing men to have intimate care by female nurses & techs does not currently pose a risk to hospitals.

I would add to the other part of this discussion that it likely does make a difference to patients that they know and trust their opposite gender physician but are apprehensive about that nurse or tech they've never met before. I can't speak to this myself because I've never gone to a female physician for anything that involved intimate exposure. However I can speak to having learned to be apprehensive about female nurses & techs that I've never met before.

 
At Monday, May 22, 2017 9:34:00 AM, Anonymous Anonymous said...

Biker in Vermont said

" Risk manager focus more on women's issues because that is where the risk is greatest"

Why would you think the risk is greatest with women's issues and define those issues. Risk managers spend virtually all of their
time investigating poor patient outcomes. Wrong medication given, wrong surgery, wrong site surgery, nursing error, physician
error. Patient falls, and my favorite, joint commission surveys. Deaths in the operating room etc.

There is no risk with female related gender issues. I've never heard one presented. Why would there be when 95% of all nurses
are female. You won't see female gender issues in the neuro intensive care units. Those are all female nurses there. All female
nurses in L&D, The ICU's in general are all female. All the cna'a on the nursing floors are female. The operating rooms are all
females as well as the scrub techs.

Biker, do you or have you ever worked in a hospital before. You need a tour, but then a risk manager would never sit down with
you and tell you all the problems that occur in hospitals because they don't want you a potential patient to know that. That's why
they are called risk, to reduce the risk. Their real and correct titles are called Quality assurance managers by the way.

The last headline I've read within the last year or so ago regarding privacy issues was a female nurse who took a cell phone pic
of her male patients genitals at a hospital in upstate Ney York. She sent that pic along with a text to all her colleagues. I can only
imagine the nightmare was to that Quality assurance manager investigating that incident. Those employees by the way are all
females too. Why? Because they start out usually as nurses!

PT








 
At Monday, May 22, 2017 2:38:00 PM, Blogger Biker in Vermont said...

PT, I'm not talking medical risks or outcomes. I'm talking the risk of a female patient making a claim against a male employee. This is why male staff often must have a witness present if doing an intimate exam or procedure with a female patient. Male patients are far less apt to make claims against female employees, hence a win/win for the hospital in primarily hiring female staff. Fewer male employees reduces the risk of claims against them, while more female employees carries with it little to no risk of impropriety claims.

Hospitals as well reduce their financial risk in catering to female patients in this regard. Women will go somewhere else if faced with male staff for certain matters such as mammograms, whereas men just quietly accept female staff for intimate procedures in urology and elsewhere.

Why do men quietly accept it? It is only in the past few decades that the medical world and society as a whole have begun to recognize men as being deserving of any respect as concerns their exposure. Older people dominate the patient population and older men know they are being treated better than they ever were, thus being less apt to complain. The medical world knows this.

Older guys grew up accepting as normal that which is unthinkable today. For example in the mid-60's in Middle School all us boys were told to strip down to only our tighty whities in the boys locker room, then marched single file up the stairs and down the main hallway of the school where we stayed in line waiting our turn as the line slowly made its way into the nurses office for what included an intimate exam by a female nurse with a female asst. That office was separated from the main office by a half glass wall and an open door right into the main office. It was in front of that open doorway that we were told to drop our underwear. There was no shielding us from view by whoever happened by while standing single file in the hallway in our underwear, nor any concern about the women in the main office seeing us as our underwear was dropped, or any other female (parent, student, or teacher) that happened to come by the office. All those boys are in their 60's now and hospitals know they aren't going to complain about how they're treated.

Conversely, the girls did not have public intimate exams back then and generally have much higher expectations of how they are treated in the medical world.


 
At Monday, May 22, 2017 4:40:00 PM, Anonymous Anonymous said...

As I have said in the past the only way to effect change in healthcare is through legal intervention. You can't effect
change from the outside in. Rather from the inside out and medical institutions currently benefit current gender staffing. I
always get the impression some on this blog I believe enjoy the current staffing, that some enjoy reading about the
dismay many male patients have in this regard. It's my opinion that it would only take a change at one hospital for
a legal precedent to be set. That a hospital in question would need to have a mammography suite and a L&D suite.
Furthermore, there are enough examples on the web that indicate male patients experience unprofessional behavior
in every medical setting and unsettling as it is will never in itself effect change. In fact complaining will do nothing on a broad
scale as this volume implies. Patients may realize that patient satisfaction scores are important and becoming a
relevant factor in reimbursements but probably won't have the broad impetus to do any good in this regard.

PT

 
At Tuesday, May 23, 2017 4:00:00 AM, Blogger Biker in Vermont said...

PT, I agree that legal action is the most likely way to get meaningful change that gives men gender choice at the nursing and tech level. At issue is the right case materializing, and that case not quietly being settled out of court. I think it would need to be a class action type case.

I do differ on the impact of complaining though. I doubt the kinds of changes that brought us to where we are today versus the old days such as I described in my last post did not entirely come from the goodness of their hearts. At some point either boys starting complaining in school settings or their parents did. When I was a kid no boy dared complain and if he did the school staff and their parents would have called him a sissy.

Somewhere along the way the small minority of men that did speak up did nudge the medical world into the many small changes that were made which cumulatively resulted in men today generally being treated in a respectful manner, even if it remains undignified and embarrassing. The mantra that maintains a system of undignified and embarrassing care is that medicine is gender neutral.

I doubt anyone that posts here enjoys the current staffing scenario. The point I have tried to make is that older men who represent the majority of patients, especially in urology, remember the old days and know that they are generally treated in a respectful manner, albeit to many of us undignified and embarrassing. Older men as well were raised to believe that stoically suffering indignities is what a man is supposed to do. It is hard to shake that which was ingrained from a young age. It took me far too long to find my own voice and say enough is enough, I want same gender nursing & tech care for intimate matters. Our hope for change likely lies with younger men who don't carry the deeply ingrained stoic mindset.

I will add another example of the mindset we grew up with. I recall a family picnic when I was 9. It was a hot day. My father was barefoot wearing only shorts. My brothers and I were dressed the same as him but I noticed my 3 year old sister fully dressed. I asked my mother why my sister didn't take her shirt off too. The reply was that she was a girl and girls had to remain covered, but boys didn't. Fast forward a couple decades and it never occurred to me to let my own daughter play outside without a shirt on whereas my son was free to wear as little as he wanted. This speaks to how ingrained the differing standards were.

 
At Tuesday, May 23, 2017 5:44:00 PM, Anonymous Anonymous said...

Hello,
I understand that the UK's health care system is a tiny speck compared to the US leviathan; nevertheless, the following quote (albeit 3 yrs old) is rather instructive. It begs the question, "Why not here?" I've attached the URL so that you might read the entire article.

Promoting a Patient's Right to Dignity · January 2014
https://www.researchgate.net/publication/272472522_Promoting_a_patient%27s_right_to_dignity

“Measures to help promote patient dignity are evident in some NHS Trusts [i.e. hospitals]. For example, some operating departments try to arrange female staff for female patients, with the justification that this is good practice for certain intimate procedures. This can also help to prevent potential accusations against male members of staff when performing intimate care. However, it could be argued that men coming for urological surgery are not offered any choice between having male or female staff [Surely, there's a male nurse, tech somewhere]. Clearly, it is important to manage each situation based on individual circumstances. The key to managing such situations may commence by asking the patient if they have a preference….” [ ] are my insertions.

Reginald

 
At Tuesday, May 23, 2017 8:17:00 PM, Blogger Maurice Bernstein, M.D. said...

Reginald, thanks for the linked article which is most appropriate in the continuing discussion here.

Looking back to earlier Volumes of Patient Modesty I think is very informative. I mean "way back"...how about for example 2009, Volume 16?

http://bioethicsdiscussion.blogspot.com/2009/05/patient-modesty-volume-16.html

Much more "moaning and groaning" and less discussion of approaches to resolutions. Many more women writers to our thread then presenting their personal modesty experiences as patients but not supporting men patients and men's concerns. Oh, and PT was there to provide us with the ins and outs of what goes on behind the curtains. Thanks PT. Where did all the women go? Or are they all are now satisfied with the approach to the current female gender medical system attention in 2017. (To all current female visitors here, please be welcome to resume participation by writing.)

It is interesting to go back in time to the early versions of this thread and compare. Do all my current visitors agree with my above comparisons of 2009 and 8 years later? ..Maurice.

 
At Wednesday, May 24, 2017 3:34:00 PM, Blogger NTT said...

Hello:

Pt. 1

Why Not Here?

Like women, men pay their healthcare premiums. Why shouldn’t they get same gender care for intimate care, tests, or procedures? Guys are paying for the use of same gender nurses and techs. Maybe they should get a refund om part of their premium since the providers aren’t providing the service.

Because the Healthcare Industry doesn’t want to change their ways. They hate change when it comes to their way of thinking or it’s going to cost them money.

Their way of thinking right now is that men are these strong, heartless, emotionless warriors expected to put up, shut up, and take anything thrown their way by the healthcare industry. The medical community figures if they shame and humiliate men enough, they can do what they want with men, and when men get tired of being embarrassed and humiliated they will just stay completely away from care. Hence they trade men’s lives for dollars.

The cost to the industry for respecting a man’s dignity and his right to privacy, would be female jobs and/or money they don’t want to spend.

Because many of the personnel decisions are made by women who are influenced by their female subordinates throughout the system, that would leave a foul taste in their mouth and start rumblings through the mostly female rank & file.

Unless they are persuaded to, a female personnel director will always hire a female tech or nurse over a fully qualified male every time because they (like men who won’t open their mouth & just say no), want to go with the status quo.

The current staffing scenario is the way it is simply because men are afraid to say something. Men are scared to rock the boat and look weak for a minute. Even if in that one minute of perceived weakness he might just gain some respect and protect his own dignity at the same time.

Maybe it’s because of repercussions they fear will come their way during their visit for opening their mouth & saying no, this isn’t right.

Men won’t speak up when they should which in turn hurts the rest of us that are talking until we’re blue in the face and pushing back at the system in place.

If something is happening and you are not comfortable with it, you have the right and the duty to speak up and stop what it going on. For instance, if you’re unnecessarily exposed in an uncomfortable manner and you don’t want to be, SPEAK UP & say NO.

Women found their voice mostly I would think without the use of lawsuits.

They didn’t like what was happening so they spoke up. They kept speaking up until they were heard.

 
At Wednesday, May 24, 2017 3:35:00 PM, Blogger NTT said...

Hello:

Pt. 2

Why Not Here?

If men feel they have to wait for a male healthcare worker who feels his talents are being wasted to file a lawsuit to change the way things are done, then men have a long road ahead simply because the medical community will buy whoever’s silence they have to, to keep this issue from going mainstream.

The only way this will go mainstream is if men who don’t like the system as it is today stand up for themselves and put a stop to it.

If men are going to stay silent, then the medical community has no reason to change their ways. Is that what you really want? I don’t.

Men just want their privacy protected and their dignity kept intact.

Nobody’s asking for the moon here.

Lawsuit or no lawsuit, men don’t deserve to be treated the way we are being treated. Look at how they treat male patients in the urology dept. of your local hospital.

It’s time to stand up and JUST SAY ENOUGH is ENOUGH. Time to change your ways.

Just like the women, if men keep up the pressure as a GROUP, they WILL have to listen and make changes.

Start asking question like why doesn’t your facility destroy some men emotionally and psychologically by embarrassing and humiliating them for an intimate test or procedure that could be done by another man?

Ask if they let male techs and nurses do mammograms and work in L&D. If not, why not? They claim to be gender neutral. They let female techs do male related intimate tests.

Why aren’t you protecting a man’s dignity and giving him a Choice by asking him first and foremost does he wants same gender care for intimate care, tests, and procedures rather than forcing opposite gender care on them all the time?

Tell them that forcing female attendants on men for male related issues is simply wrong and it’s GOT TO STOP.

Tell them how you are gonna let everyone you know how wrong they treat their male patients. Then they will tell everyone they know and so on and so forth.

WE cannot wait for a lawsuit that may never come to fruition.

WE have to take the bull by the horns on this issue and ram it back down the throats of the same people that have been ramming it down our throats for years on how men have to hand over their dignity and privacy at the door as the cost of admission.

Men are human beings and they just like their female counterparts have rights.

It’s time to see if men have it within themselves to stand up, reclaim their dignity, privacy and respect.

I’ve written to many legislators and spoken to many ordinary men and women. Many don’t think this is happening to men.

I just tell them, you don’t believe me. Okay, wait until it’s your or your loved ones turn then you’ll see what I and others have been saying is really happening.

They you’ll be the one embarrassed and totally humiliated by the very system you thought was protecting you and your loved ones.

The system is broke. Are we going to fix it for everyone? It starts with one patient in one hospital saying NO. From there it goes to another facility, then another, until the push for change is so strong, the healthcare system can no longer deny men their well-deserved changes.

Men and women have been embarrassed and humiliated long enough.

Regard to all,
NTT

 
At Wednesday, May 24, 2017 4:47:00 PM, Anonymous Anonymous said...

Hello Dr. Bernstein,
You're right. There seem to have been many more female posters in 2009. Many also seemed to post re "very serious" modesty violations. It would be interesting to be informed why few women are not presently posting. You may be right again when you say that women's complaints seem to have been heard; whereas, men's modesty issues have still not been recognized. However, I'm really puzzled that after hosting this blog for 13 years, you haven't seen some resolution to the issues raised. The same suffering continues. The same trite responses are given ("You don't have anything I haven't seen, etc.,etc.) Medical personnel still don't seem to realize that there's even an issue with male modesty. The "speak up" mantra is about the only progress that seem to have been made. If this works to procure the necessary modesty for the individual male, that's great. Nevertheless, this leaves each individual to confront the issue alone, often without the knowledge that he has a voice in the matter. It would be so nice to enter a medical facility and be asked if one preferred same-gender care, instead of expecting to be scoffed at, ridiculed or dismissed when one presents with the request. Possibly, the medical system is too entrenched to accommodate something as "trivial" as male modesty. This is sad, since many of us are "broken" physically and we eschew health care because we fear being broken emotionally, spiritually or psychologically.
Reginald

 
At Thursday, May 25, 2017 2:27:00 PM, Blogger Maurice Bernstein, M.D. said...

To All My Current Readers and Writers to this blog thread: I really do appreciate all your ongoing support of now looking for and writing about approaches to change the behavior of the medical system so that the system will pay equal attention to the modesty and dignity aspects of ALL genders (and that means also LGBTQ).

I have been aware, as you have also, that there has been commentaries currently mainly from apparently male writers (for example as compared with Volume 16) and so I wanted to publicize this blog thread a bit more to the world. Therefore, in the past week, for the first time, I put up my first such messages to Facebook with the link and the with the associated current thread display on 2 days. I clicked on "public" which I assumed went out beyond my "friends". However, as I screen my responses to this act on a statistic site, I see only one individual actually came to our thread.

I am, therefore, asking for the first time, assistance from my current participants who may be more familiar with the operations of Facebook and even Twitter, if you could, through these and any other media you are familiar with, help publicize this Patient Modesty Volume 79 thread. In all these 12 years of this thread, I have never asked this of my participants previously.. maybe I should have.

Of course, my request is based on my assumption that all the participants here recognize the need for more and continued constructive input.

Any help that you can provide for our important blog thread will be most appreciated by me and hopefully by the others here.. (and as you known this is not in any way a commercial blog and that is not a factor in my request).

So feel free to disseminate our interest here by means you are familiar with and let's see if some constructive ethical good can be further developed. ..Maurice.

 
At Thursday, May 25, 2017 6:33:00 PM, Blogger Biker in Vermont said...

A few things.

Reginald, that UK article you posted a couple days ago indicating some awareness that maybe even men might want some gender choice is encouraging. It is at the same time discouraging in that while they know it is an issue for women they are only speculating with men.

Dr. Bernstein, though I wasn't with you back in 2009, I have read some of the old material and do see some shift towards solutions versus just grousing. Grousing is a very necessary first step though if for no reason to validate one's feelings with others who will understand where you are coming from. It can be therapeutic.

I too would like to see more female voices, and very much would like to see some nurses & techs join in the discussion.

I am not on Facebook or any of the others and can't help there but do encourage those who can.

A small non-modesty but speaking up for oneself tangent here. Yesterday I had a follow up colonoscopy, but at a large teaching hospital vs the small regional one that did it last year. I had pre-arranged for it to be without sedation and nobody hassled me at all, yet had I not spoken up I would have automatically been sedated. More pertinent to the discussion, as noted at the time when I was there a couple months ago for a cystoscopy, when I stated I wanted a male nurse for the prep, I got one no questions asked. Had I not spoken up, odds are I'd of gotten a female nurse given most of the urology nurses are female. I wish I had started speaking up long ago.

As a follow-up to a discussion a few months back, I checked the website for the local college nursing program, and there is now a photo with a male student. Just one but that's one more than they used to have. A small step but a step nonetheless.

 
At Thursday, May 25, 2017 8:54:00 PM, Anonymous Anonymous said...

Hello again,

I recently reviewed an article from the UK's Nursing Times titled, "Design agency and trust apologise for error over ‘sexist’ nurse job adverts", 24 May 2017. I would attach the url; however, I don't think it can be read w/o a subscription. The full article may be available somewhere on the internet. I've attached an edited excerpt below. In light of the my previous post re deference to UK females requesting same-gender care, this article is "interesting". It decries sexist, unenlightened views of nursing but, seems to miss the sexist (male) prejudices alluded to in the previous post. Additionally, the UK's protection of nurses as NOT playthings seems something that isn't even considered in the US. The edited article follows:

Design agency and trust apologise for error over ‘sexist’ nurse job adverts

A design agency and hospital trust have apologised after two nursing recruitment adverts were used in error that went on to attract heavy criticism on social media for being sexist. The two adverts were developed by Strawberry Design for Hull and East Yorkshire Hospitals NHS Trust, as part of its “remarkable people” nurse recruitment campaign. They featured two of the trust’s current emergency department staff, newly-qualified nurses Emma Gray and Izzy Davis. However, the trust noted that what had “caught the attention of social media users, print and broadcast media over the past few days” were the captions accompanying the pictures. One caption stated: “As soon as Emma looked at John she knew it was serious. A full fracture of the tibia.” And the other said: “Before lunch, Izzy made Roy’s heart flutter. It’d stopped for 10 minutes.” The adverts, which appeared in the healthcare management publication Health Service Journal on 16 May, were greeted by a torrent of criticism on the social media site Twitter. Regarding the new adverts, Victoria Daley, deputy chief nurse Surrey and Sussex Healthcare NHS Trust, said: “Oh dear, have we gone back half a century? Will it be Carry On Nurse characters next?” Picking up a similar theme, Dr Iain Beardsell, a consultant in emergency medicine at University Hospital Southampton NHS Foundation Trust, said: “Seriously? Where are they hoping they’ll work? The 1970s? Are we not in more enlightened times?” Elaine Maxwell, associate professor in leadership at London South Bank University, questioned whether the Yorkshire trust used “Mills & Boon style ads for other staff”, and whether it only wanted to employ “young blonde female nurses”. Dr Lynne Stobbart, a nurse and senior research associate at Newcastle University, described the adverts as “patronizing, demeaning, insulting and offensive”. In it she noted: “Gender prejudices are alive and well in public images of nursing, and these prejudices are evidenced in portrayals of nurses characterised as sexual playthings, beautiful young and sexy, defying danger to find romance. “It’s one of nursing’s biggest issues professionally and it is deeply troubling that employers should exploit this as a recruitment tactic,” she said. In the statement, the trust’s executive chief nurse, Mike Wright, described the incident as “deeply regrettable”.
[PS Please note that the executive chief nurse, Mike Wright, is apparently male.]

Reginald

 
At Friday, May 26, 2017 10:11:00 AM, Anonymous Anonymous said...

Hello again,

Please excuse my repetitive posting. I'm somewhat flabbergasted at the article below from UK's Nursing Times titled "Do We Need More Men In General Practice Nursing?" Q - How fast can this idea cross the pond?
http://lp.plexusnetwork.com/index.php/email/emailWebview?mkt_tok=eyJpIjoiTVRJMlpETTFZemN3WVRrNCIsInQiOiJWelRDa3FjbUdHdUpvRzhldkpLM0xzUk01aG0wbTkrTFhlQ3dkNG1odU40QUpkZlV4M2ZZYWt0VU5SdGVSQXQrc2pzaU9xZUVoSTErODJLNWQ3R1U4U1JSaEUxZjNJN1wvV2kyOVZtV3d2ZE1CTXVZeVYzTTV1ZHBZWWM3d1MyOVkifQ%3D%3D

Reginald

 
At Friday, May 26, 2017 3:25:00 PM, Blogger Maurice Bernstein, M.D. said...

Again, thanks Reginald.

You know, in attempting to dissect the issue presented by the visitors to this blog thread "Patient Modesty", like all investigative work both forensic or medical, everything should be looked at and decided whether to be further investigated.

Based on this premise and with the slant of the explanation of the experiences of the patients writing to this thread, I looked back on my blog to an August 5 2004 posting which presents a different view of the patient-doctor relationship as written by a physician ethicist, perhaps tongue-in-cheek or perhaps not. Is there anything in this poem which helps us better understand what is going on with our patient modesty-dignity issue? Here is the link but a reproduction of the posting follows.
http://bioethicsdiscussion.blogspot.com/2004/08/why-cant-patient-be-more-like-doc.html
================================================
Why Can't a Patient Be More Like a Doc?

Continuing with the consideration of the ideal physician and ideal patient…
Here is a satirical takeoff by Steven Miles, MD,Professor of Medicine and Geriatrics,Center for Bioethics,University of Minnesota on a familiar My Fair Lady lyric.

Thanks Steve.

A HYMN TO HIM


Why can't a patient be more like a doc?
Docs are so honest, so thoroughly square;
Eternally noble, historic'ly fair;
Who, when you win, will always give your back a pat.
Well, why can't a patient be like that?
Why does ev'ryone do what the others do?
Can't a patient learn to use her head?
Why do they do ev'rything other patients do?
Why don't they grow up- well, like their doctor instead?

Why can't a patient take after a doc?
Docs are so pleasant, so easy to please;
Whenever you are with them, you're always at ease.

One doc in a million may shout a bit.
Now and then there's one with slight defects;
One, perhaps, whose truthfulness you doubt a bit.
But by and large we are a marvelous lot!

Why can't a patient take after a doc?
Cause docs are so friendly, good natured and kind.
A better companion you never will find.

Why can't a patient be more like a doc?
Docs are so decent, such regular chaps.
Ready to help you through any mishaps.
Ready to buck you up whenever you are glum.
Why can't a patient be a chum?

Why is thinking something patients never do?
Why is logic never even tried?
Questioning me is all that they do.
Why don't they straighten up the mess that's inside?

Why can't a patient behave like a doc?
If I was a patient who'd been offered a cure,
Hailed as a miracle by one and by all;
Would I start weeping like a bathtub overflowing?
And carry on as if my home were in a tree?
Would I run off and never tell where I'm going?
Why can't a patient be like me?
==============================================

So.. does anything in this expression of the relationship between patients and their physicians or even their nursing staff help us to understand anything about the topic and the approach to mediation of the issues long presented here? ..Maurice.

 
At Friday, May 26, 2017 6:06:00 PM, Blogger Biker in Vermont said...

Dr. Bernstein,the poem is surely tongue in cheek, though humor typically seeks to amplify stereotypes and prejudices. If so, then the link to our modesty discussion is that when a doctor says medicine is gender neutral we're supposed to agree that it is gender neutral.

The primary problem with doctors is the extent to which they influence staffing mix decisions rather than their own behavior. Except for certain OR & ER scenarios, we all generally get to pick the gender of our physicians. Yes that is harder in rural areas, but those who feel strongly about gender choice do generally have the option of traveling to where their needs can be met.

For men the issue is far more at the nursing and tech level as has been discussed many times. Its not the doctors. So long as the nurses & techs conduct themselves in a clinical and professional manner, including not bullying or being dismissive of patients who express a gender choice, it isn't their fault that they are who was assigned to us as patients. They were hired to do the job and they are doing it.

The problem then are the people, be they physicians staffing their practice or hospital administrators staffing their facilities. Neither can hide behind the "we don't get male applicants" excuse if they don't convey their needs to nursing schools. If nursing programs were told that the local hospitals and private practices will be prioritizing the hiring of male nurses in order to meet the needs of their patients, and that if they can't get them from that nursing program they will seek them elsewhere, you can bet that nursing school will start promoting nursing careers to boys at the area high schools. Yet physicians and hospital administrators don't make requests. That is where the problem lies.

Neither physicians nor hospital administrators can truly believe the medicine is gender neutral mantra so long as the very concept of male mammographers is unthinkable. They know gender matters.

 
At Saturday, May 27, 2017 4:26:00 AM, Blogger Biker in Vermont said...

Just a piece of positive trivia from today's paper. The local hospital has two employees of the year each year, one clinical and the other non-clinical. The clinical employee of the year is a male RN who works in the OR, and with his photo in the paper to go along with the article. Hopefully local high school boys see this.

 
At Saturday, May 27, 2017 11:48:00 AM, Blogger Maurice Bernstein, M.D. said...

I found an excellent article about the issues involved in the nursing education of male students. Although it was published in 2004, I suspect, unfortunately, it is still "up to date" 2017. The article was published in the Nurse Educator
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.473.9065&rep=rep1&type=pdf

The Introduction reads:
Contemporary nursing literature,
both research-based and popular
press, is replete with examples of gender
bias and its impact on males seeking
to pursue a nursing career. The
outcomes of gender bias are harmful
to the profession and create a cycle
that perpetuates bias and limits the
role of male nurses. This cycle results
in different learning experiences for
males and females as nursing students,
limits recruitment and retention
of males into the professions and
perpetuates traditional male/female
stereotypes that make the profession
irrelevant to the diverse population
that the profession claims to represent
and serve.


Unfortunately, male nursing students and then as male nurses in practice are bucking against the very concept begun "150 years ago as the profession began to be organized around principles espoused by Florence Nightingale and concurrently became accepted as a legitimate option for unmarried Victorian women who sought employment."

Worthy reading even though the RN writing this encouraging article is a female. (By the way, in the article she does encourage male nursing students to be educated by male nursing instructors... and I would agree, wouldn't you?

What we need to encourage men io enter the nursing profession is for men, as patients, to ask, request or even demand care also by male nurses. This gender inequality with regard to education and public demand must change and if it ever does, a blog thread such as this one may end up becoming moot. ..Maurice.

 

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