Bioethics Discussion Blog: Patient Dignity (Formerly:Patient Modesty):Volume 99

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Monday, May 13, 2019

Patient Dignity (Formerly:Patient Modesty):Volume 99






















Does  the above animation tell us anything about the
patient-doctor relationships which has been amply described
and detailed on this blog thread?  Could any of the patient
reactions to the actions of the physician or the medical system
simply be a natural reflex to some actions by the profession which
were not intended to be traumatic? Could some actions of the
professionals be well intended (in this example to test for neurologic
reflex impairment) and  yet turn out to appear that it was not fully
 considered?

In this analogy, by working together, could the patient have reminded
the physician, based on the patient's previous experience that the doctor
may be sitting too close for the test?  Usually, patients know more about
themselves and their reactions (both emotional and physical) and the
physician deserves to be informed in advance. So..the message again
to the patient: "Speak up".
 ..Maurice.


Graphic: From https://gifimage.net/interrogatorio-medico-gif-3/
via Google Images


NO FURTHER COMMENTS WILL BE PUBLISHED ON VOLUME 99.
NEW COMMENTS CAN NOW BE WRITTEN TO VOLUME 100.

169 Comments:

At Monday, May 13, 2019 3:30:00 PM, Anonymous F68.10 said...

Hi all.

I'm having a "debate" on another blog when it comes to the term "medical kidnapping".

While I'm the first who would claim that "medical kidnapping" can be a very legitimate practice to protect a child, I also acknowledge that the practice of removing a child from his parents can be a traumatic experience.

I therefore provocatively argued the following.

1. These practices can technically be kidnapping, as it is indeed a forceful removal of a child from his parents.

2. It is indeed done for medical reasons, reasons that can be fully justified.

Therefore I argued that we should not shy away from calling this practice "medical kidnapping" in its own right. I argued it a bit differently on the other completely pro-medicine blog, but essentially the reason would be the following: when such things happen, and a kid is removed from his parents, I believe it would be best that the State states things rather bluntly and not cower away in technical jargon. Technical jargon seems to rhetorically forbid parents their feelings/beliefs that they have been wronged in some way. Naming a cat a cat would have the effect of making explicit to the parents what the situation really is, and it would push the medical establishment to make more or less publicly a case that their move is justified. If the issue is couched in technical jargon, then everything seems intrinsically fine, the medical establishment can simply claim it's in its own good right and dismiss the parents as cranks or deluded nuts.

So calling a cat a cat, IMO, would have the beneficial effect of making the debate more open, and both sides could come with their ethical arguments.

Of course, most of the time, the parents would lose their arguments. I'm fully aware of that. But I do not think we should deny them the recognition that they have been wronged in some way. Even if they are dangerous deluded nuts.

It's not exactly a question of "patient dignity", but to me it still is a question of "dignity".

And do not get me wrong: as far as I can judge things, I'm all for "medical kidnapping". I'd simply wish we called it by a name that properly reflects what it is.

What's your thoughts?

 
At Monday, May 13, 2019 9:40:00 PM, Blogger Maurice Bernstein, M.D. said...

Before I go into the topic of "medical kidnapping", I would like to first go back to the "nitty-gritty" of "good doctor" vs "bad doctor". Here is what a participant on the medical education listserv wrote today on that topic.


I would like to add to the conversation about the “bad doctor.” I suggest that we discourage the use of language that reinforces a binary stereotype of “the good doctor” and “the bad doctor.” Using this language puts us all at risk.

It’s likely that none of us are quite as “good” as we could be, i.e., we are all always “works in progress,” Labelling someone as “bad” removes the possibility of improving through advanced training, rehabilitation or remediation, or ... generally achieving growth as a physician and as a human being.”

Egregious behavior is likely criminal behavior, and it is up to the courts and our medical licensing boards to decide when someone needs to be removed from society, or from the practice of medicine, respectively.


What do you all think of the pros and cons of defining doctors that way?

With regard to "medical kidnapping", I think it is a matter of "patient dignity". Who is the patient? The child.

And the child deserves caring parents if the behavior or ignorance of the parents demonstrate uncaring and who indeed are the cause of the transfer of the child away from them.

Or is the term "kidnapping" a slap on the reviewing physician or the protective societal system.

Fortunately, I never was involved with a pediatric issue. My medical responsibilities, however included screening for "elder abuse". ..Maurice.

 
At Monday, May 13, 2019 10:49:00 PM, Anonymous Anonymous said...

I think what might turn any good person into a not so good person ( Dr or otherwise ) is long hours. Delayed meals. Not taking care of their own needs.
All those volumes ago when Giftbearer's doctor flipped out and treated her like dirt and did all in his power to block her from getting care in the future. My bet is that he'd been pushing himself beyond his strength. A series of 12 or more hours a shift. No days off for x amount of days. Missing family events that he really didn't want to miss or maybe he attended but was too whipped to enjoy it. I don't know how often that kind of thing turns into violence but it definitely COULD! JF

 
At Tuesday, May 14, 2019 6:51:00 AM, Anonymous Anonymous said...

JR said:

That is just it--there is not a competent or reliable means of disciplining or removing doctors. Here in central Indiana, most doctors are part of a large practice that labels them as independent practice from a hospital buy in reality they are actually hospital employees. The hospital carries the malpractice insurance on them as the hospitals are mostly self-insured. Of course, for drs. & nurses when there is an investigation, the first thing that is looked at are the EHR which of course in the overwhelming majority of cases to do not say "I abused or did wrong" so the investigation is dropped. The EHR allows for very little evidence to point to any wrongdoing thus allowing these sociopaths to continue business as usual for years. Oftentimes, the if they are caught they receive very little in disciplinary actions & rarely lose their licenses. So the thought that boards or government oversight controls or even oversees the issues would be laughable except for the harm done by these criminals. Also, why not label them as bad. There are some offenses that they cannot recover from nor should they be able to continue to practice. Once disgraced or caught, why should they be so special to be allowed to continue practicing? If a teacher is criminally convicted of say child molesting, they loose their license & are put on the child molesting list. Since what the medical community does is so vital to people's well-being shouldn't their offenses be treated equally important?

During our walk last night and through most of the ensuing night, my husband & I were discussing why he was the chosen victim? If any investigative team cared, his MRs point to the fact the nurse falsified or outright lied about many major areas of care. Should that not be a signal to them that she has issues? She is willing to lie about care so would that not point to she may be willing to lie about other things? The fact she lied about many other issues in the MRs points to the fact that she was concise & knew what she was doing. What about him made her pick him as her victim? How often does she do this? Why do others remain silent when someone who saw him exposed should know right from wrong? What makes a dr. think they have the right to take away a patient's right to choose what treatment they receive? What prompts them to lie? Why is this not thought of as being wrong? JR

 
At Tuesday, May 14, 2019 10:21:00 AM, Blogger A. Banterings said...

JR,

The whole independent contractor thing for doctors is BS! Read the IRS page: "Independent Contractor (Self-Employed) or Employee?"

A simplified version is the IRS 20 Factor Test – Independent Contractor or Employee?

The fact that the hospital has so much control over them, they are employees. California has even stricter regulations, see The new ABCs of worker classification in California.




-- Banterings



 
At Tuesday, May 14, 2019 2:49:00 PM, Blogger Maurice Bernstein, M.D. said...

So far, I have had no specific response to my assumption related to the animated graphic for this Volume: Usually, patients know more about themselves and their reactions (both emotional and physical) and the
physician deserves to be informed in advance.
Do you think that is a valid generalization? Or do you think "speaking up" is worthless because the physician and the medical system is just plain "deaf"? (...and it takes a "kick in the face" to provoke attention?) ..Maurice.

 
At Tuesday, May 14, 2019 3:26:00 PM, Blogger A. Banterings said...

Dignity is a human right and is important to every individual but can become compromised during healthcare. Being treated with dignity and involved in decision-making is associated with positive outcomes, such as high patient satisfaction (Beach et al, 2005). In a review of the World Health Organisation (WHO)’s general population surveys in 41 countries, most participants selected dignity as the second most important domain in care - only ‘promptness of care’ was more highly rated (Valentine et al, 2008). The Amsterdam Declaration recognised dignity as one of the main rights for patients (World Health Organisation [WHO], 1994).


Read more about Dignity, Privacy and Confidentiality.



-- Banterings


 
At Tuesday, May 14, 2019 3:26:00 PM, Anonymous Anonymous said...

Dr B.
A kick in the face might work for that one doctor but for the whole system it would more likely take a serial killer leaving lots of notes behind and posting messages from his victims cellphones. JF

 
At Tuesday, May 14, 2019 3:37:00 PM, Blogger Biker said...

Dr. Bernstein, I think the graphic is appropriate. Given they aren't likely to even ask, we need to tell them of specific needs or preferences that we have. Whether they listen to what we say is a different matter.

One of the things I learned in my long corporate career as a manager is that for some people one need only hint as to what you want. For others you need to hit them in the head with a 2X4 in order to get their attention. As a manager I'd tried the gentle approach first and only ramped up to the 2X4 as needed. Healthcare is no different. No need to start out confrontational if a polite request will address the issue. If you start with the 2X4 approach when it wasn't really needed you may find yourself needlessly labeled a problem patient. If anyone is going to be fired, best you be the one firing the doctor rather than the doctor firing you.

 
At Tuesday, May 14, 2019 4:42:00 PM, Anonymous Anonymous said...

Dr B
I hope you know my last comment was mostly a joke. Or sarcasm. The reflex test isn't likely what any of us are taking about anyway.
I do blame my former family doctor for how long I had to suffer with my gallbladder systems because I told him on my first visit I thought it was my gallbladder.
I had taken care of my grandmother at home when she was having gallbladder symptoms. He was her doctor also.
Because he was ready willing and able to string me along ( more appointments equals more money ) I lost the best paying job I ever had. Before that I'd never even received a write up over attendance.
My surgeon doctor I love him to the moon and back. THAT doctor saved me. Maybe he wouldn't have had to if my family doctor wouldn't have been such a selfish #!@$&€hole! JF

 
At Tuesday, May 14, 2019 5:18:00 PM, Anonymous F68.10 said...

"Or is the term "kidnapping" a slap on the reviewing physician or the protective societal system."

I do not know. I reflect on my past, and I thought to myself that I would have liked to be medically kidnapped at one point in time. The term "kidnapping" feels right for me. So I wonder why all the hysteria about the term by parents of "medically kidnapped" kids and doctors saying "no it's rescue". This way words are twisted to fit an agenda doesn't resonate with me at all. I do not see (any more) any negative connotation to the term "kidnapping". Seems like everyone is walking on eggshells here, where we should indeed be upfront about what the procedure entails.

I acknowledge my subjectivity could entirely be warping my view of the issue.

 
At Tuesday, May 14, 2019 5:30:00 PM, Anonymous F68.10 said...

I opted for the kick in the face solution, ultimately. The medical establishment is stone deaf. That's a fact. I really tried to negotiate and explain things out. Pointless.

I had diverse luck with MDs on a more personal basis. One apologised to me, now that I think about it. He was stone deaf too initially, or rather flabbergasted and in a state of sideration at my story, and acted very coercively. But he apologised in the end. I'm really grateful for the apology.

Apologies are something MDs need to learn how to do! It's no big deal saying you are sorry about the things went down! Moreover, that's what they think, so why can't they just say it???

MDs I chose where mostly fine people where you could try to sort things out. MDs I didn't choose where much more problematic people, always wary paranoiac mind-readers, highly susceptible. There wasn't any point trying to put boundaries with them: they weren't really there to respect my boundaries. Some did try though.

 
At Tuesday, May 14, 2019 7:34:00 PM, Anonymous Anonymous said...

Maurice

The depiction although it is a reflex certainly dosen’t suggest physical violence against any healthcare worker as that is
a felony in most states. But look, are there two sets of standards? One set for the physician and another set for the other
medical staff, nurses, techs etc. Apparently, it appears neither of these two are on the same page. Let’s hold a quiz for
everyone in healthcare. Let’s see if any physician working at a hospital can recite one (1) core value of that institution
or would you think that don’t need to know any because of their training? Let’s see if any of the nurses, medical staff
can recite one (1) core value of the institution for which they are employed.

I’d be willing to bet not one can get any correct. I’d be further willing to bet most nurses, if not all can recite any requirements
from the nurse practice act. There needs to be a paradigm shift in how privacy and dignity are intertwined in the aspect of
healthcare delivery.

PT

 
At Tuesday, May 14, 2019 9:14:00 PM, Blogger Maurice Bernstein, M.D. said...

I want all my visitors to dip their toes into a graduation ceremony of "192 new doctors" who graduated a few days ago with their MD degrees from the school where I teach (USC Keck School of Medicine). Jimmy Kimmel was the commencement speaker at the school's 134th (!) ceremony. Here is the link to the USC news:
https://hscnews.usc.edu/commencement-2019-laughter-rings-out-at-ceremony-for-class-of-new-physicians/
Of course, Kimmel in recent times on TV is known for his engagement in medicine with his publicized newly born son who had a congenital heart defect.

The current (finally a female) USC medical school dean also spoke. Read what she told the class and let us know whether you think her words will mean anything substantial to these "new doctors". ..Maurice.

 
At Tuesday, May 14, 2019 10:48:00 PM, Anonymous Anonymous said...

The long hours... That's a huge part of the problems. Sometimes like when mass shootings or natural disasters or circumstances happen , many people have to be treated at once. In that case there's probably no way around working long hours.
In general though, working long hours is a walking time bomb. Tired people don't do their best and closely resemble demons from Hell
I said 12 hour shifts but I strongly suspect that many doctors work longer shifts than that. Also it very much matters the conditions people work under. If I'm working slavishly hard or if I'm working on Easy Street , that makes a difference in how hard/easy it's gonna be on me and the quality of work I'm able to do.
Workplace bullying in medicine has a sabotaging effect.
What I would like to see happen is for students to prove they have good studying skills. Prove early on that they CAN work an extra long shift. And after that they get paid $10 dollars an hour to study to become doctors. Once they become doctors, they receive doctors wages, minus $10 dollars an hour until they pay back what they owe.
Also it would be good to only learn what is actually going to be needed.
Probably someone might say that's unsafe. But it's unsafe to put deterrents in front of students who would/could make wonderful doctors.
JF

 
At Wednesday, May 15, 2019 4:29:00 AM, Anonymous Anonymous said...

JR said:

What is amazing that even KEPRO doesn't think if MRs are falsified that it is a problem. They only investigate what is in the record as it is a legal document. So it is no wonder there is so much fraud and misdeeds in medicine. They know if they put it as being so in a MR it is written in granite. There is absolutely no incentive for honesty. If a medical provider (dr. or nurse) wants to do harm they can bc all they have to say in the MR is they followed whatever procedure. Of course, as w/ most criminals rarely do they advertise they have committed a crime so the in the MRs the dr. isn't going to say he did not get consent or the nurse is not going to say that she chose this patient to sexually abuse. The electronic systems make their coverup too easy. They literally just have to pick & click. This just reconfirms in our minds that it is not safe to seek hospital care where there is a chance they can use drugs to control & manipulate. Bc once they use drugs all the things you have done to maintain dignity & respect no longer matter to them.

No, I do not think that any commencement speeches will make any difference. They are just ready to leave the university behind, celebrate, & get started. Most already have in them what they are going to do. There probably are signs but they do go undetected just as those signs oftentimes go undetected for other types of criminals. It is usually not until something happens that someone then says they saw something strange in that person. The Jimmy guy might inspire someone who actually is star-struck but the school person probably wouldn't make a difference. JR

 
At Wednesday, May 15, 2019 5:07:00 AM, Blogger Biker said...

Dr. Bernstein, it looks to have been a wonderful graduation ceremony. Congratulations to one and all. Given the sexual abuse scandals the school endured during their years there, I wonder to what extent it had an impact on them. Will they look the other way when they see their peers abusing patients, potentially letting it go on for years and the victims then numbering in the hundreds or thousands, or will they act?

Just based on the photos it appears that the class was majority-female. With the new Dean also being a woman, I wonder what the impact will be of the slow but ongoing shift at the physician level to what will eventually become a female majority. Will things get worse for male patients rather than better? Or are schools such as yours instilling in the students the concept that male patients are equally deserving of the privacy, respect, and dignity generally afforded to female patients?

To make it real, would any of the female graduates have allowed JR's husband to be left there fully exposed had they been present? Assuming they'd of covered him, would they have reported those nurses for having left him lying there the way they did? You've been clear as to what you've taught students, my question being did they take those lessons to heart? I know we can't know the answers to these question, but I wonder nonetheless.

In fairness to female physicians, I will note that the males who have long dominated physician ranks and that of medical schools and hospitals did little to nothing towards ensuring male patients are treated as the equal of female patients. They instead allowed the nursing and allied ranks that were dominated by women to perpetuate the males as 2nd class patients standard. The problems most men face come at the nursing and other non-physician levels, not the physician level. The question that follows then is will a female physician dominated society give the female non-physicians even more latitude to do as they will with male patients?

 
At Wednesday, May 15, 2019 7:31:00 AM, Anonymous Anonymous said...

JR said:

We received our CMS response. Of course, they found no wrongdoing. Even though I received letters saying both hospital investigations were over, I received a phone call yesterday saying they are still investigating both. However, based on how they investigate I know the hospitals will get away with what they did.

For those of you interested, how they investigate is to review the medical records. If the medical records have been falsified like my husbands were, there will not be any entries to confirm abuse like the nurse saying, "I chose to sexually abuse this patient by exposing him in a room full of people for entertain purposes." Of course, she was smart enough to cover her tracks as the fully automated system with pre-selected phrases work to only their advantage. I would imagine that many medical records are not actual facts but rather made up lies as to what should have been done. CMS is stupid and/or ignorant if they think medical records will list abuse. As for the consent, the 2 heifer-hags signed it so it must be so. The dr. did not put into the MRs that he had been drugged 10 minutes before arrival w/ 100mcg of fentanyl so therefore he was incapable of understanding what was going on--even less capable of making a decision. He does not remember being given the whole consent speech along w/ optional treatments, lifestyle changes, rx medicines, and why he was bad to have a heart attack. They also ask those involved if they abused. There again, like any smart criminal they will deny wrongdoing. They do know how things are supposed to be done and will absolutely attest that is the way they did it. They also follow them around to observe as if they would sexually molest if their presence. The Medicare investigation is a joke. They only add to fire fuel that will make it grow. They shouldn't even bother to have such an oversight dept as it is totally useless. I doubt if they would recognize abuse even if it did happen in front of them. So what I have further instilled is that patients have no rights and no one will help them if they have been abused or violated. Absolutely no on cares! This further reinforces that we will not seek any hospitalization or emergency care. Our fears are not groundless and our realization that abuse is allowed to happen and thrive is also very real and confirmed by CMS. JR

 
At Wednesday, May 15, 2019 9:22:00 AM, Blogger Maurice Bernstein, M.D. said...

Another comment from a medical school dean regarding separating "good" and "bad" medical students and residents as published in the medical education listserv. If you have a clearly expressed and rational argument or support to this presentation, I may have it published on that listserv. I think it is important to have constructive comments from the public, from patients to present support or arguments to those who are in charge of medical school and residency education. ..Maurice.


I would like to add to the conversation about the “bad doctor.” I suggest that we discourage the use of language that reinforces a binary stereotype of “the good doctor” and “the bad doctor.” Using this language puts us all at risk.



It’s likely that none of us are quite as “good” as we could be, i.e., we are all always “works in progress,” Labelling someone as “bad” removes the possibility of improving through advanced training, rehabilitation or remediation, or ... generally achieving growth as a physician and as a human being.”



Egregious behavior is likely criminal behavior, and it is up to the courts and our medical licensing boards to decide when someone needs to be removed from society, or from the practice of medicine, respectively.



The desire to have some sort of character-predictive tool as a part of the admissions process sounds reasonable, but it is unattainable unless we want to implement FBI-type of clearance procedures to attempt to definitively determine character traits before hire(admission) by in-person interviewing of extended family members, grade school teachers and neighbors. There may be additional criteria that we could include in the admissions process to assess character, but this needs to be done carefully. We do not have a crystal ball that can allow us to predict a 21-year-old’s entire future. Medical school applicants are usually in their early 20s, and their brains, neuroscience tells us, do not reach adult maturity until age 25. It is inconceivable that we would have any grounds that would allow us to sort medical school applicants, at 21-years of age, into “good” and “bad” piles based on their inherent character as human beings. The admissions processes at the medical schools that I am familiar with, do a pretty good job of looking at the available data and using it appropriately. We must be aware that those of us on admissions committees have our own implicit biases, and conscientiously work to prevent our own implicit biases from adversely affecting the admissions process. It could become temptingly easy to assign a “bad character” label to applicants in groups other than the identity group that we identify with most closely. This could potentially exacerbate the disparity and social justice issues in the medical school admissions process.



There are opportunities, though, for us to recognize unprofessional behavior and intervene after a student has matriculated into medical school. Often, those of us in positions to do so, do not intervene swiftly enough, or definitively enough when unprofessional behavior is demonstrated by a medical student or resident. This is a failure on our part, as medical educators and academic physicians. Recognizing and accepting the obligation to respond when a professionalism problem is identified while a medical student or resident is in our course, or on our service, seems to me to be the best time and place for these difficult conversations to take place, and appropriate actions to be taken. Taking advantage of these opportunities to intervene and address the professionalism issue, no matter how difficult it may be to do so, is the best way to improve our own performance as guardians of the profession.


 
At Wednesday, May 15, 2019 10:41:00 AM, Blogger Biker said...

Dr. Bernstein, I can understand the difficulty in fully vetting med school applicants into good vs bad columns but once they are in med school the question becomes how much effort is given over to weeding out the bad ones. It is pretty tough to hide fatal character flaws throughout 4 years of schooling.

Likening it again to my corporate experience, the bad apples may make it through the interview and reference checking process but once on the payroll for a couple months you know whether they're going to work out or not. Every time we let our emotions get in the way by giving the new hire that is a bad fit more time to come around, it would just prove to be more difficult and more costly to get rid of them later. In the case of flawed med students, it ultimately is the patient that pays the price though, and perhaps that is why not much effort goes into weeding out the bad apples. It isn't the school that pays the price.

 
At Wednesday, May 15, 2019 12:38:00 PM, Blogger Maurice Bernstein, M.D. said...

I wrote the following to the medical education listserv. Thanks Biker. ..Maurice.



One of the visitor and writer of comments to my blog thread has been a long time corporate manager.
He wrote the following today:
=========================================
=========================================
Dr. Bernstein, I can understand the difficulty in fully vetting med school applicants into good vs bad columns but once they are in med school the question becomes how much effort is given over to weeding out the bad ones. It is pretty tough to hide fatal character flaws throughout 4 years of schooling.

Likening it again to my corporate experience, the bad apples may make it through the interview and reference checking process but once on the payroll for a couple months you know whether they're going to work out or not. Every time we let our emotions get in the way by giving the new hire that is a bad fit more time to come around, it would just prove to be more difficult and more costly to get rid of them later. In the case of flawed med students, it ultimately is the patient that pays the price though, and perhaps that is why not much effort goes into weeding out the bad apples. It isn't the school that pays the price.

==========================================
==========================================
So my question to this listserv is in all
of the published cases of physician "misbehavior" or even legally worse, how often does the public and particularly the medical profession will be informed from what medical school that physician was trained. Yes, the hospital or other institution where the physician worked is named but where is the name of the medical school of training? If the name of the school is not published, do all medical boards and schools who read the stories have the routine practice of actually begin scanning their, perhaps many years old, student records in order to determine the origins and "pathophysiology" of what has occurred?

By the way (and I really don't know), in the long run, in the expression of my blog visitor, "does the medical school pay the price"?

 
At Wednesday, May 15, 2019 2:54:00 PM, Anonymous Anonymous said...

I would like to respond to what JR said about how the investigations aren't really investigations after all.
From what I have seen at the nursing homes I have worked at, I'd have to say I agree with her.
One instance of this being the case: we had a relatively young patient/resident at one of my Ohio nursing home jobs. She had suffered brain damage from injury.
When wearing a brief ( adult diaper taped on the side her pants would fall down. Some of the nurses even seen it happen.
We CNA's started trading her briefs with another patients pull ups because the other woman was in a wheelchair and briefs work fine for wheelchair patients or patients in bed. Management stopped us even though they were told why.
After this poor girls pants fell down in front of an appreciative male resident, it was reported to the state.
Their investigation was somebody showed up. Her pants didn't fall down in front of the investigator. Case closed
Nobody asked around. I already told about the elderly woman falling out an upstairs window while the state inspectors were in the building.
Also what JR saying about care being documented being equivalent to care being delivered in the eyes of the law. It's true.
The nursing home I first mentioned in this post got caught red handed though when they made staff document one certain lady was faithfully attended to every 2 hours. She sat in a gerry chair and was particular about her did her. Didn't sleep in bed. And sometimes went 24 hours without being changed. More investigations should include hidden tape recorders in break areas and other areas where staff cluster to talk. JF

 
At Wednesday, May 15, 2019 11:37:00 PM, Blogger 58flyer said...

I had my prostate ultrasound/biopsy done today. At 0845 I did the Cirpo and Fleet enema. Then at 0945 I took the Valium. At 1045 I arrived at the center. I was very keyed up and I did not feel any different with the Valium than without. My neighbor drove me to the medical office but I could have driven myself as it turned out as I had no effect from the Valium. My heartbeat was about 125 which told the LPN I was very nervous. BP was 160 over 98. I brought along a sample pack of colonoscopy shorts and asked if there would be a problem with me wearing these. The LPN said she had never heard of this and thought it was a great idea. She took them to the doctor to inquire if this was OK for my procedure. The doctor approved them and I was allowed to put them on. I was determined to wear them anyway regardless.

The procedure went well. The LPN came into the room with the male ARNP. I was too close to the edge of the exam table and she had me move more to my left so I wouldn't fall off the table. I felt comfortable with the procedure shorts on. The doctor came in and got to work, first with a DRE. I noted the position of all in the room and the female LPN was positioned directly behind me facing away from me. Her job was to put the samples of the biopsy into the proper containers for submission to the lab for analysis. The male ARNP stood in front of me to monitor my signs of comfort or discomfort.

The doctor first began with a DRE. That went just fine. It told me that the colonoscopy shorts weren't a problem for the doctor. When he introduced the rectal ultrasound probe that really hurt. Once inserted the pain went away and he did the US. Upon finding that a suspicious area needed biopsy he announced such. He then proceeded to administer the lidocaine, and that was fine as I barely felt it. He then proceeded with taking 12 samples. Again, I barely felt it. Just a pop. 12 times. Nothing to it.

With the procedure over I got dressed. My only complaint was that the LPN came back into the room as I was still zipping up. At one point I was laying on the table and the door was fully open. I will address this at the next procedure which will be the cystoscope next week. I think I educated the LPN about the colonoscopy shorts and she thought it was a great enhancement to patient comfort. I asked the front office to make a copy of the information packet to give to the LPN. Perhaps she will use this in her future patient encounters.

Other than what appeared to be a casualness about male modesty needs, I think it all went well. I will address my concerns next week with the cystoscope. Hopefully, that will go well.

58flyer

 
At Thursday, May 16, 2019 5:16:00 AM, Anonymous Anonymous said...

JR said:

I think there are going to have be cameras and recording devices. However, that is certainly an invasion of privacy of the patient. When most are observed, they put on their best face. There maybe could be a pre-test and post-test about patient dignity and respect. It should probably be its own course and use patients who have been violated to tell their story. Your university could pilot this program. You could follow these students to see if it does makes a difference.

There is another issue. There are a lot of drs. from foreign countries. They are educated in the foreign countries. Their cultures are very different from ours. The ER dr. at the hospital from hell was one of these drs. He went to G____ School of Dentistry for his medical degree. The country he is from is very different from his native country and has different beliefs. I think there is a certain amount of prejudice and downright hate already built in for Americans especially older, white males.

I think the politically charged climate in this country has made the older, white male the target of hatred as they infer that everything that has gone wrong is their fault. There are even companies in their advertising pointing to males needing to change their attitudes toward women. I know from social media profiles that some of the nurses are very active in these attitudes. I think the opportunity of my husband, an older, blonde-hair, blue-eyed, DRUGGED male presented, they took the opportunity along w/ the dr. to get even for all they think this class of males is guilty of committing. Not to mention, he was also labeled an older gay male w/ a husband which would have been our son bc he was the one addressed.

Certainly the dr. should have known better than to have a naked, drugged patient lying there for 30 minutes before the procedure. He should have known that he was using coercion in the "Medical Decision Making" as a patient cannot be drugged beforehand, cannot be lying on the procedure table being readied for a procedure while he is coercing consent, be totally naked, and ignore the family in the "discussion". So why did he do this? Is he stupid? uneducated? didn't care about patient's legal rights? just like committing medical & sexual assault? What about the nurses? They do are as culpable as they knew it was wrong but did it anyhow. The Cardiac ccu nurse is just a sociopath. She will continue as now she knows she got away w/ it so she has more confidence in the system to protect her.

I think having more females in the medical profession as drs. or administers will only lead to more abuse of male patients. As it is now, what is happening is very protected and the patient who has been abused has very little recourse. The investigations are just as big of a sham as the Patient Bill of Rights these hospitals kill trees over to print it on. What we need are medical people who recognize that patients are actually people and all people have rights and we are not things for them to control and manipulate. They are actually do harm with their attitudes rather than helping us as they make it so many do not seek medical care. JR

 
At Thursday, May 16, 2019 12:20:00 PM, Blogger Biker said...

Good report 58flyer. The LPN, doctor, and everyone else involved likely learned something valuable yesterday.

I had a non-intimate ultrasound this morning and was assigned a male sonographer. We talked about the training involved to do his job and I inquired about whether sonographers specialize. He then starts naming a few specialty areas and I chimed in "and the dreaded urology ultrasounds". He says he does many "male ultrasounds". I said having had a female do an embarrassing testicular ultrasound on me I am glad to know this hospital has a male for such things. He said "that's why they hired me".

 
At Thursday, May 16, 2019 1:59:00 PM, Blogger NTT said...

Good Afternoon:

System on Life Support

Let me start by saying, the empathetic & ethically moral healthcare worker is on the verge of extinction in the American healthcare system today.

Today’s healthcare environment is infected with a disease as powerful and lethal as the MRSA super bug. The disease is called Voyeurism, Perversion, & Greed VPG for short. If this disease is not met head on & totally eradicated from the system those few empathetic, ethically moral healthcare workers left will be extinct and the system will be unsafe for all.

We have doctors going around taking sexual advantage of their patients. Next, we have nurses going around leaving patients unnecessarily exposed at length for them and their colleague’s entertainment and picture taking along with stealing drugs earmarked for patients. Then finally you have corporate greed taking each and every cent possible from patients any way they can. The disease is running like wildfire through the system currently. You see, read, and hear about it daily in the media.

The ONLY way the American healthcare system will survive, is if the VPG super bug is totally eradicated.

To completely eradicate this infection, there has to be a fundamental change in thinking within the healthcare community.

To begin to rebuild a world class organization, first thing the medical community must do, is really deep soul searching & find that empathetic, moral and ethical person that used to be there as they went MIA decades ago. You can’t operate a system the likes of which hasn’t been seen since the days when Florence Nightingale organized care for wounded soldiers back in the Crimean War without these essential traits.

As healthcare workers have readily shown for decades, they don’t like “snitches”. Snitches have for the most part always had to face retaliation; bullying, & being blackballed by other staff. And if the person being snitched one had any pull, the snitch also faces the real possibility of being fired. Case in point the CRNA in the Twana Sparks case was fired for snitching on her. She had integrity and was fired for it.

Remember Do No Harm & Choice, Privacy, & Respect (CPR) go hand in hand. You can’t have one without the other & expect to build a world class healthcare organization.

Now, management must make it univocally clear throughout the entire organization; There will be NO repercussions towards anyone in the organization who snitches because “there’s no such thing as snitching because there is no such thing as a snitch anymore.”

Using your new found empathetic, moral and ethical sense of judgement, if you see something at any time or place while on the job that isn’t morally, ethically, or legally right, speak up and say something, so the organization can correct it.

By speaking up you help eliminate the weak links in the frame work whereby making the organization as a whole, stronger & safer for all in the long run.

It’s time the medical community got back to putting the patient first. The needs of the patient outweigh anything else so that each patient, can get the best possible outcome from their medical encounter.

Finally, the healthcare industry MUST ELIMINATE GREED.

Greed will kill us all if we don’t tag it, bag it, then permanently eliminate it!

The new healthcare theme must be patients BEFORE profits.

Without this course of action, you will never kill the VPG super bug which will leave America with an unsafe healthcare system that NOBODY will be able to afford nor want to use.

That then begs the question. Are the American people ready and willing to work TOGETHER to eradicate the super bug and build a healthcare system built on the foundation of Do No Harm & (CPR) that will have the rest of the world in awe of what America can really do when She puts her mind to it and Her people show how they worked TOGETHER and MADE IT HAPPEN?

That’s it for now.

Regards to all,
NTT

 
At Thursday, May 16, 2019 2:00:00 PM, Blogger NTT said...

Good evening:
Good Evening:

On another note.

Last month I sent out that letter I previewed here to the editor of to the top 100 newspapers by circulation for publication. Since then, I have monitored the sites and through today, not one newspaper has seen fit to publish the letter. Letters to the editor is a bust. Will need to find another way to get this issue before the public.

That’s it for now.

Regards to all,
NTT

 
At Thursday, May 16, 2019 6:26:00 PM, Anonymous Anonymous said...

Sending private messages to a large number of people might work.
Also a large number of people complaining that their concerns are being ignored. Maybe when we make complaints, we should require a type of receipt so it can be traced who is stopping the communications. That doesn't apply to newspapers but hospital complaints.
In addition to voyeurism and greed are HUGE part of the problem is cowardice. Everybody's afraid of making waves. Endangering their own jobs. Making coworkers angry...
JF

 
At Thursday, May 16, 2019 7:55:00 PM, Anonymous Anonymous said...

NTT

Excellent comments. I don’t think our healthcare system is on life support, it’s DOA (dead on arrival). I want to mention
something that our readers need to appreciate and that is this. In my 40 years in healthcare I’ve noticed that nurses only
snitch on other nurses when their is something to be gained. Now they constantly stab other members of the team in the
back constantly, physicians, techs etc and yes even patients. Nurses will tell the patient’s physician lies if the patient’s family
feels that their loved one’s nurse is not doing their job etc.

Nurses stab other nurses in the backs to make theirselves look good in the eyes of their director. This backstabbing, blood
slinging contest which rages constantly has its own collateral damage on patient care. They hate their job, hate their patients
and hate their life. Now, back to Dr Twana Sparks and the Crna. That Crna is just as guilty as everyone else in that room. She
knew and saw this go on for years but decided at one moment in time to complain,why? Her job was on the line. It’s been
mentioned that there was some relationship issues that went sour between her and Dr Sparks but we won’t know the truth.

I’ll say this, a Crna is a Certified registered nurse anesthetist has an equal if not greater responsibility to the patient not only
as an advocate for to a higher standard of patient care. She knew these male patients were being groped and assaulted, there
are no other words other than these to describe this. The law says you must report sexual assault immediately, not 2 years
later when it suits you when as you know she is a nurse, thus she pulled her knives out to see how much blood she could
spill. All those people need to be in the same cell as Dr Nassar. It just makes you want to puke your guts out.

Does it seem to you that people in healthcare get away with this Crap. If it happened in a daycare or at the grocery store
or at Walmart people get cuffed and thrown in the slammer like, right now. Why is this subject matter not debated more
often by those in healthcare. This issue should be the highest priority among hospital administrators, Chief nursing officers
and ethicists. Instead there seems to be more attention spent on wether some adult can take their out of the hospital or
some gay man should or should not be entitled to any surgery he or she wants.

The priority is how patients who drop $4 Trillion dollars into an industry have to pay to be assaulted, sexually assaulted,groped
and leered at. Verbally abused, neglected, laughed at, given a super bug, the wrong medication, wrong surgery, judged,
murdered, stolen from, steal the patient’s identity, slept with ( boundary violations) and raped. We spend more money towards
healthcare than we do on our automobiles and in some cases our homes. Does this SHIT happen to us( listed above) when
we make other purchases, NO. Why does it happen when we as human beings are at the lowest point in our lives, we we are
I’ll. Well, you know, some people just like to KICK you when you are down!

PT

 
At Thursday, May 16, 2019 11:35:00 PM, Blogger 58flyer said...

Biker, Thanks, good to know you had the right conversation with the male sonographer. They need to hear positive feedback. Picture a fast moving freight train. Lots of tonnage moving in a certain direction. If you want to move that freight train along a different course, you have to do it incrementally, an inch at time. It's not going to happen all at once. Just too much energy going along the intended path. Each time we have the conversation with the conductor, or engineer, we can move that train a little more towards the right path. Over time we can move that medical care freight train to something we men can live comfortably with. But, it will take a LONG time to do that. I only hope my son will live to see the day when he will be finally regarded as a real human being by the medical community. For me, at this point in time, it is a constant uphill battle.

PT, some really great points. I am just wondering when you are going to write the book on the real reason men avoid healthcare. Maybe you can derail the current healthcare freight train.

58Flyer

 
At Friday, May 17, 2019 6:32:00 AM, Anonymous Anonymous said...

JR said:

Why is this stuff allowed to happen? That is the question. Apparently, the medical community is like a sacred cow who is allowed to eat your prized orchid, crap on your lawn, etc. It seems there is nothing in place to oversee them and furthermore, they know it. If a patient tells the investigators that medical records were falsified, why would they use the records as if they were gospel? How stupid! Why would they only go by what the medical records say as if a nurse is going to note I molested that patient? Again, how stupid! Why even have "investigators" when the outcome is known before they even investigate?

PT is right, any nurse or staff member that witnesses abuse and does nothing to stop it while it is happening and doesn't report it immediately is as guilty as the actual perpetrator. Most of the time when abuse is happening, the patient is drugged and unable to protect himself/herself. Part of a nurse's duty is to protect the patient and to be their advocate when the patient is unable to.

My husband will continue to see a doctor in an office setting and get tests as long as I am present but he will not seek emergency or hospital care. We can control what happens in an office setting but the really large issue is when there are drugs administered and that is when patients loose total control. There is no way of preventing what happened previously or even predicting which nurse or dr. will be more likely to do it. It has been a double whammy to have a procedure done that he did not want, know about, or consent to and then to be sexually abused. In order to avoid being raped, women know not to walk in secluded, dark places at night and kids know not to take candy from strangers so the only conclusion we know is to avoid the places where he was criminally assaulted. No amount of therapy will ever make these places safe for us. The only thing that will make these places safe is change and for those who commit the crimes to be in jail and lose their licenses to practice anywhere.

My hope for those who had a part in his/my abuse from the first hospital to the hospital from hell is that they have a life full of pain and suffering. I hope they find no peace bc they have destroyed our lives and probably lives of other silent victims. I hope their God or fate will take care to see they get what they deserve. I hope that not only will they suffer here on earth but on judgment day, they will also answer. For those who gave him the drugs, I hope their lives become full of drug addictions as it would be cosmic payback. Maybe they already have an addiction and that is why they harmed him. But in any case, here's hoping. I also have these same hopes for all others who abuse victims such as in nursing homes. Whenever I see a news article where someone has victimized a dog or cat I also wish the same for them. Take for instance the man who baked a small dog in an over should also be roasted. This is where I am in agreement w/ the old testament. Punishment should fit the crime. However, this country turns a blind to patient abuse bc most are afraid of them and put them on a pedestal. They don't understand that medical people are just people and have their flaws and the ability in them to commit horrendous crimes and are more likely to get away from it bc they are protected by the law and regulations. If only patients had such protection. JR

 
At Friday, May 17, 2019 7:31:00 AM, Anonymous Anonymous said...

PT
I agree that Twana Sparks x flame reported her for her own personal reasons and not because she cared about the patients.
But there's no possible way all the staff that witnessed/laughed about the abuse could be fired and put in prison.
Making such a threat would likely backfire because those nurses would swear up and down THEY never witnessed anything.
Also how could any patient care happen with 75 percent of the nurses missing?
Don't you think a better plan would be to call them out but give them the chance to name the worst of them. Sort of like plea deals?
Also, so they just don't throw under the bus whoever else they don't like, secretly tape record them. I know that is inadmissible in court but jobs can fire for just about anything. Often the reason stated on the termination papers are completely different from the real reason.
JF

 
At Friday, May 17, 2019 1:11:00 PM, Blogger NTT said...

Good Afternoon:

JR, you asked “Why is this stuff allowed to happen?”

There are many reasons some of which I will go into here.

It starts with the caliber of the people. As I said earlier, there are very few empathetic, ethically moral healthcare workers left today. Most are there for the paycheck not the welfare of the patient.

Next, you have to look at who’s supervising these people. What kind of character is in their makeup? Are they morally & ethically sound or are they too just in it for the paycheck and maybe a laugh now & then? If they’re in it just for the paycheck and the laughs, then the subordinates under them will have free reign unless a manager who puts the patient’s welfare first, gets wind that patients are being abused for workers entertainment.

Then you take a look at facility management. Are they hands on kind of people that lookout for the welfare of both the patients and employees? Are they making sure they are staffed with the best caliber people and levels are sufficient enough that no patients are neglected? Or is the management team one of those that places profits before patient welfare? It that’s the case, I don’t want to go there.

Then finally you have what I consider to be the biggest reason this crap is allowed to continue.

For decades now the United States healthcare system has been allowed to run under a veil of secrecy and police itself. They want NO outside interference in their matters. Proof of that lies in how Yale New Haven Hospital (the biggest employer in the State of CT), recently used its influence to keep the CT legislature from requiring that women undergoing gynecological surgeries give explicit approval to a pelvic exam beforehand.

The time has come for the veil of secrecy to be permanently removed and all healthcare institutions start being totally transparent with the public.

The way things are right now, when someone violates a patient, the facility goes into what I call “damage control mode.” They will do EVERYTHING in their power to keep the issue out of the media. They’ve had decades of practice at it and are VERY VERY good at it.

Once the issue is secured in-house, the perpetrator is given time off, maybe take a token class or two, then allowed back into the fold where they can pickup where they left off whereby making it a totally unsafe environment for patients.

This kind of crap has to end. The perpetrator should be handed over to the authorities along with all the evidence to face charges and if serious enough, have their license permanently revoked.

There need to be a national healthcare Do-Not-Hire list available to ALL healthcare institutions to keep these people from going to another state & picking up where they left off.

Finally, both physician and nursing medical boards must be address. All boards MUST have a civilian majority so that the medical members do not just give their medical pals a pass all the time. Case in point the TN nursing board.

The board has 12 members. 11 medical people & ONE token civilian. Guess how the voting is going to go.

There’s a case there whereby Radonda Vaught a former Vanderbilt Hospital nurse was recently charged by authorities there with reckless homicide and patient abuse in the death of a patient she gave the paralyzing drug vecuronium instead of versed to her patient. Evidence shows she made multiple errors along the way to giving her the drug.

When the case was brought before the TN nursing board, they just said she made a mistake that anyone could have made. Live & learn and decided there was NO reason to take her license. There’s no way to know this but maybe if the board had a civilian majority, she might not have her license today.

What we desperately need and don’t have today, are people with influence over the industry that can take what the medical community tells them with a grain of salt and do what’s right for the patient.

That’s the only way, this nightmare will end.

Regards,
NTT

 
At Friday, May 17, 2019 1:12:00 PM, Blogger NTT said...

Good Afternoon:

58Flyer two things.

First.

I like your analogy of the fast-moving freight train. Problem is the physician gender landscape is changing at a quicker pace. Soon there will be more female doctors who will hire female assistants and their male patients will just be told to “suck it up”. We need the male population to put that beer down, get off the couch, and start speaking up on this issue.

Second.

For your recent prostate ultrasound/biopsy you stated you brought along a pair of colonoscopy shorts. Were they from Covr Medical? If so, which garment did you get? Thanks.

That’s it for now, thanks for listening.

Regards,
NTT

 
At Friday, May 17, 2019 1:31:00 PM, Anonymous F68.10 said...

"If a patient tells the investigators that medical records were falsified, why would they use the records as if they were gospel? How stupid! Why would they only go by what the medical records say as if a nurse is going to note I molested that patient? Again, how stupid!"

And that's when there are documents around... when there are no document around, or fully bogus document... That's even tougher.

Check this out:

https://bcombudsperson.ca/sites/default/files/OMB-Committed-to-Change-FINAL-web.pdf

There are copies of medical certificates in this report. I find them "hillarious".

 
At Friday, May 17, 2019 5:00:00 PM, Blogger Biker said...

I agree that healthcare self-regulation more protects the interests of doctors and nurses than it does patients. Civilian oversight is needed for charges involving behavioral matters, but non-medical civilians are not qualified to judge medical issues. Reconciling that is problematic unless we were to have separate boards.

For most of us, the nudging of one provider and one practice at a time is the most effective course of action we can take on a day to day basis. Surely that is how my urologist came to have a male nurse and that hospital having the male sonographer I spoke with yesterday, and my dermatology practice now allowing for full skin exams without female observers.

NTT is right that the demographic shift that is going to result in women becoming the majority at the physician level likely doesn't bode well for men. At the same time women will become the majority in it will hospital and medical school administrations.

The larger problem is that healthcare reflects society as a whole and at present society has little concern for male bodily privacy. The men have no modesty or shouldn't have any modesty mantra is so deeply ingrained in our culture that few give a 2nd thought to what men deal within healthcare settings. Society says the rights of female reporters to have equal access to college and professional athletes in locker rooms outweighs the rights of those men to bodily privacy. Society says the same for prisoners and for teenagers in youth facilities. The rights of the female staff to have those jobs outweighs the rights of the men and boys being forcibly exposed to them. Society says the same for police and in the military. Female staff have the right to their positions and the rights of the males the police interact with and the soldiers the staff interact with are subservient to the rights of the female staff. It is endemic throughout society. That is plays out daily in healthcare settings is generally accepted by society.

 
At Saturday, May 18, 2019 4:04:00 AM, Anonymous Anonymous said...

JR said:

F68.10,

Read through the link you provided. Bc Leslie didn't to leave against medical advice was reason enough to have her committed is unbelievable. Also, the hospital from hell uses the rubber stamp type of medical records as they use the Epic system which delivers boilerplate phrases so entries from like procedures match and they are less likely to give out information that would hurt the facility/staff. This systems makes it easier for them to falsify information. Also, the one dr. who said a patient was put in bc they had disorganized thoughts & speech should come to the US to put most of the candidates running for Pres. in a facility. There is no truth or dignity in medical care.

Biker,

The boards need a civilian majority bc w/o it, things will continue to be swept under the rug. At DDS, where I worked going to college, we had a group of doctors that reviewed the medical & give us their input. We would read their input, ask questions, and review the medical, technical, & regulations. It does not necessarily take a dr. to understand medical procedures. More highly skilled laypersons w/ no ties to the medical community would be fair to all. Of course, these positions should change so as to retain integrity bc as w/ anything corruption happens.

As more and more women enter the physician's field, hospital care is going to worsen for men. With all this talk about abortions becoming tougher, too many women are getting upset that men (especially a certain demographic) are controlling their bodies. So guess what, when a man enters a hospital guess what the female hospital is going to do--control that man's body by any means necessary. There is a climate in this country of punishing men. You can control what happens to you when you visit a doctor's office or even a hospital for a test. The point you lose control is when you are having a procedure and afterwards. Of course, in ER you have no control even though when you are very ill you should expect they would not add to your misery but then is the time they seem to enjoy inflicting misery even more. If there are drugs involved, that is how they control you. As w/ my husband, even though he told them the drugs caused severe harm, they used them anyhow. Their need to control was much greater than their concern for his health & safety. Isn't American healthcare the greatest? It will be even greater when it is socialized bc then they will make no effort to respect any type of individual rights. JR

 
At Saturday, May 18, 2019 1:04:00 PM, Blogger 58flyer said...

NTT,
I agree that the future of men's health looks bleak. I had a friend of mine tell me today that he went to a doctor recently since he has not seen any doctor in 30 years. It was a female doctor and she had a female assistant come in and be present for the hernia exam. He said the assistant didn't look away but instead engaged him in conversation. He assumed she was a nurse.

I've said this before, it's going to take legislation for there to be change. The medical community has long demonstrated their disregard for the dignity and well being of men. How and why this is true can be debated forever. Debate will not change anything. Venting on a blog site will not change anything. The medical community will not suddenly wake up and out of the goodness of their hearts start treating men with the respect they deserve. It's going to have to be legislated.

Let's look at the voting rights of women for example. At one time as we all know, women were not allowed to vote right here in America. There were many female activists who fought for change. In the end, it was MEN who voted in majority to allow women the right to vote. I can only hope that women will join men in the fight to be treated with the appropriate professionalism in healthcare in this country.

To answer your question about the procedure shorts, mine came from Prime Pacific Health Innovations. You can find them online and order them right over the phone. The phone number is 1-800-223-9374. They come in small/medium or large/x-large. I have a 36 waist and the small/medium fit me with room to spare. Even though they are designed with colonoscopies in mind, you can reverse them and have the opening in the front for procedures like a cystoscope or urodynamics.

58Flyer

 
At Saturday, May 18, 2019 3:20:00 PM, Blogger Maurice Bernstein, M.D. said...

In general, as Moderator, I do not accept advertisements on this blog. However, I think the garments described here unique and pertinent to the specific discussion involving patient modesty issues and therefore I am allowing the information to be published.

By the way, you have no idea (or maybe you do) of the number of posters, particularly from foreign countries are writing their ads to this topic or other topics on this blog. Some topics which are selected have no relationship at all with what ads have been submitted read, yet the posting starts with "I love reading this thread". ..Maurice.

 
At Saturday, May 18, 2019 3:48:00 PM, Blogger Biker said...

58flyer, the woman who observed your friend's exam was most likely not a nurse but rather a Medical Asst. Some MA's have had some small amount of schooling to be certified, others have only had on the job training. It doesn't take much training to stand there and stare at male patient genitals.

 
At Saturday, May 18, 2019 7:34:00 PM, Anonymous Anonymous said...

Maurice

You mentioned that you get those who say “ I love reading this thread”. Can you clarify? Are they reading this thread just
for fun or are they contributing? One would think that if you don’t have issues with the healthcare industry you certainly have
better things to do. I’m not a fan of AOC but when she asked big pharma why Americans pay $2,000.00 for a medicine that
Australians pay $8.00 for in front of Congress that should get a lot of people’s attention.

If people read this blog for fun or entertainment then I feel very sorry for them. One day the ugly, evil healthcare industry will
rear it’s ugly head, bite them in the ass. For what I pay in healthcare insurance and out of pocket expenses I should be getting
personalized tailored service. What exactly do I mean by that, I’m not asking a lot am I? I expect to be treated professionally,
refer to me by my name or sir. Not hun, honey etc. A private place to change, I’m done with The interrogations, ie what type
of work do you do, what are the names of all your siblings and what are their occupations.

I especially hate the Dumbass nurses who want to recite verbatim my discharge instructions as if they are lecturing me, just
give me the printed discharge instructions, I can read. Now, for those who just want to read this for entertainment you really
should be spending more time on the blogs that describe nursing and physician malpractice or more specifically all the
unfortunate things that can happen to you while hospitalized, it’s not very entertaining.

PT

 
At Saturday, May 18, 2019 7:41:00 PM, Blogger Biker said...

Just a comment following up on 58flyer's friend having had a chaperone for his exam. If, as everyone who works in healthcare says, there is nothing even remotely sexual about patient exposure, why do they feel the need for chaperones? Why do they need MUTA's & GTA's to train students when they say there's nothing sexual for themselves or the patient? Why only females for mammograms if there is nothing sexual about healthcare procedures?

I'll answer the question. It's because they know it is seen through a sexual lens for the staff and/or the patient but choose to go on making believe it's not.

 
At Saturday, May 18, 2019 7:59:00 PM, Anonymous Anonymous said...

I’m devoting this comment to wackos who like reading this blog for fun

You are a wack job if you

1) Have a fetish about intimate procedures being performed on you
2) Like reading this blog for fetish purposes only
3) nurses who wear their scrubs to coffee shops, grocery stores or bars
4)nurses who have bumper stickers describing themselves as nurses
5)people who watch medical tv shows all day long
6) people who watch medical tv shows all evening long
7) nurses who after work watch medical tv shows ( you are a real WACK job)
8)extra wack job credits to female nurses who request female providers
only although you work in urology or an intensive care unit.

PT

 
At Saturday, May 18, 2019 9:11:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, I didn't intend to get you all "wacked up" about my comment about the spam attempts that I have to delete and not publish. The content of what is written by these spammers is to sell a drug or an overseas doctor or something but not any contribution to the underlying theme of this blog thread or the matters under current discussion. "I love this blog" (with no further explanation for the "love") comes before the advertisement description and has no specificity with regard to the current topic or topics which have been written by others. And there is no evidence in what they are attempting to post is of emotional ventilation that you and the other contributors are posting. Their intent is obviously, to me, $elling, $elling, $elling.

I have repeatedly encouraged overseas visitors (like our F68.10) in my postings to contribute to the discussions here.. and, yes, "sell" us a view or actions in their countries that can contribute to our discussions with the insight from experience of those outside of the USA.

I hope I have clarified what I wrote.

..Maurice.

 
At Saturday, May 18, 2019 10:18:00 PM, Blogger 58flyer said...

Maurice,
Thanks for allowing my plug for the procedure shorts. I have no personal business interests in the company and just answered the question about how to get the shorts. I can say from personal experience that wearing the shorts during a procedure adds greatly to the comfort level. You don't have the feeling of being bottomless. I am thinking that I will wear them for the cysto this week. Anyone reading this blog is now aware of procedure shorts and how much it adds to the comfort level. In my situation, I was able to educate my urologic provider about something they didn't know about. Hopefully they will place an order and use them in future patient encounters. I hope I have made a difference.

Biker,
Yes, I agree that she was most likely an MA. Never would a male MA chaperone a male doctor during an intimate exam of a female patient. In my opinion, MA's have no business having access to patients of the opposite sex. If I were king of the world I would make things different. But I am not. I am thinking about approaching my congressman or senator, or both, to push for changes in the laws regarding just who has intimate access to opposite sex patients and making changes in the area of who and what a chaperone is.

PT,
Funny you mentioned the nurse bumper stickers. In my 41 year Law Enforcement career I have always strived to be the most professional and caring officer as I could possibly be. But I have to admit to being human. In stopping cars with nurse related bumper stickers, while I have never made a false charge, there were the times when I adopted, in the moment, a "zero tolerance" policy. "Sign on this line Ma'am, and be sure to press hard with the pen as there are 5 copies."

58flyer

 
At Sunday, May 19, 2019 6:29:00 AM, Anonymous F68.10 said...

Yes I'll try to keep contributing.

 
At Sunday, May 19, 2019 6:39:00 AM, Anonymous F68.10 said...

"Bc Leslie didn't to leave against medical advice was reason enough to have her committed is unbelievable."

The problem is that we do not know. Wanting to leave against medical advice is the right moment when a doctor should judge whether or not to coerce. So the coercion is not necessarily "because" she wanted to leave against medical advive, but rather occured "at the time" she wanted to leave, which does indeed give the illusion of direct causality.

So nuance would be required.

However, the lack of good quality data is appalling, which means that no one else than those in the know can make a judgement call about whether any or all of this is legit. That's, to me, rather a matter of making a case for the independence of Science and Medicine.

 
At Sunday, May 19, 2019 7:16:00 AM, Anonymous Anonymous said...

JR said:

PT,

Liked your wacko list. On Friday, I must have seen at least 20 scrub wearing medical people at Walmart. It got me to thinking about the germs those scrubs have on them. For that matter, the medical staff themselves. Many hospitals like the hospital from hell are jumping on limiting visitors bc of the few measles/mumps cases. What if those scrub wearing people have a sick kid w/ a temp.? They go into work w/ those scrubs and maybe a germ jumps onto their skin and maybe that skin is uncovered. Many of the medical workers are germ carriers rather than the patient themselves. What about the medical person who doesn't wash or wash properly their scrubs? Patients are stripped and scrubbed. So why are medical staff stripped and showered? If it is so important why is this not happening? Patients are less likely to get an infection from a hair on their body than if a hair from the medical person falls in them. I noticed my husband's cath heifer-hags had hair hanging all over the outside of their headgear. Of course, the reason they ask all the questions is they need that information because they sell it for money. It falls under the guise of information needed to run the healthcare administration. This is the way they avoid HIPAA constraints and other regulations limiting the use of PHI & PII. The more information they have, they more money they get. They also use the info to in studies they participate in on a voluntary basis. Your name, ssn, address, phone #, info about family, work, etc. go everywhere. You have no right to any type of privacy once you become a patient bc you cease to exist as an individual. You are merely an object for them to manipulate at will. If you happen to find respite from your illness per their treatment, that will look good for them overall but even if you don't they can falsify your med. records so they don't look bad. Falsifying med records is absolutely acceptable per the government.

Those med. assts. think they are as important as med. staff who go through years of education. They may be even worse in their attitudes bc they are trying to assert their control & power to make up for their lack of standing in the hierarchy of the med community. The only ones they can bully are the patients. When my mother has an EKG done, she is told depending on how many leads to "remove" or "change" for EKG access. When my husband has even just a 3 lead EKG, he is told to "strip" from the waist up. It is indeed very different how they even have patients comply w/ the same procedure instructions. The one tech started to unbutton his shirt but he stepped back and told her not to that he could unbutton his own shirt. What would happen if a male tech started to unbutton a female's shirt? There was no offer of a gown and he was expected to do this in front of them. Is this the same for female patients. Are they forced to undress from the waist up in front of a male tech? If no, then why not? That is bc they know there is a sexual component to all of this. Do male techs just stand and stare at the genitals of a female patient like the female techs do when a male patient is exposed? No, generally that does not happen. Although my husband had a male dr. and he had a male PA for his prostate procedure, the rest were females. The OP report lists the dr., the PA, and a scrub nurse as positioning him in an extreme lithotomy position. It lists the Dr. as inserting the foley and rectal caths. However, there were 5 others listed as being present and all of those were females. This was a urology practice that specializes in cancer in a hospital where this dr. had his own OR setup so you would think he would have made his practice more friendly to the male only clients he served? What you don't know when unconscious won't matter it the slogan. Back 13 years, the reports gave much more detail than w/ the electronic pick the phrase type reports of today. JR

 
At Monday, May 20, 2019 1:27:00 PM, Blogger NTT said...

Good Afternoon Ladies & Gentlemen:

After writing 100 letters and speaking with many local healthcare executives, I've come to the conclusion that compassion & empathy are no longer part of the healthcare equation.

I agree with 58Flyer & Biker. If we want to see a change in the system in our lifetime & spare our boys & their boys the embarrassment & humiliation we are being FORCED to endure if we want medical care,we are going to have to get it legislated.

Most guys would be to afraid of the embarrassment of a court case so I don't see that happening. Plus lawyers see taking on healthcare a no win situation.

I've been writing people in congress but have had no takers to date.

We need to find someone who's willing to take up our cause. Someone who wants the glory of breaking new territory & putting the healthcare system on its ass.

If we can't get help from our elected officials, I for one will send them a clear message the next time they are up for election. You don't help people, so why do we need you in congress?

We need to come up with rules for what I would call the Male Patient Protocol (MPP) for short. To be implemented in every medical facility in this country whenever a male patient presents at their facility with a male specific intimate care issue.

Instead of hearing excuse after excuse, it's time the medical community got off it's lazy ass & put male patient protections in place.

It's time for male radiologists to cross-train & do male ultrasounds. Male hospitalists must step up & take over when a male nurse is not available.

These are just common sense answers to the issue of a shortage of male sonographers & nurses.

Men should NOT have to suffer when there are answers to be had.

It's time we shoved their canned answers up where the sun doesn't shine.

Since the system has no compassion and empathy for men it's time we played hardball too & find a way to force their compliance with new laws.

I feel, it's the only way left that will allow us to make a difference in a BIG way & spare our male offspring from our nightmare.

I end this by saying the American healthcare system should be ashamed of themselves for the way they treat male patients.

Best regards,
NTT

 
At Monday, May 20, 2019 6:57:00 PM, Blogger Biker said...

A politely phrased and executed offense can shift some of the power dynamic back to male patients. It could result in some degree of acceptable accommodation or at a minimum will have the female staff on their best behavior in hopes you don't drag them personally into a subsequent complaint.

When faced with "we don't have any male staff" respond with "that's not your fault, you don't do the hiring (or scheduling), but its not my fault either and I shouldn't be expected to pay the price for those hiring (or scheduling) decisions.".

In response to a "you don't have anything I haven't seen" type statement, you can pull some of the power back to yourself with a "I don't know whether that was intended to mock me or bully me but it was offensive and inappropriate". I expect they'd do some quick backtracking followed by an attempt to appease you.

Lastly in response to a "we're all professionals here", the response can be "Of course you're comfortable, you're fully dressed. It was my comfort that I was talking about.".

 
At Monday, May 20, 2019 8:26:00 PM, Anonymous Anonymous said...

Biker

Why should we play that power game? Why should it be a game? Being ill isn’t about games. Being nice dosen’t
work either, it just gives them more opportunity to be a bully. I’ll agree to your second comment regarding “ you
don’t have anything I haven’t seen “. As far as the first comment “ we don’t have any male staff “ would prompt
me to say “ that’s discriminatory, I’d like to talk to your charge nurse.” I’m sure the charge nurse will find a male
nurse etc. Now for the last comment “ we’re all professionals here “ My comment would be “ No one suggested
that you are not professionals here, I just want the same privilege you get as when you go for your mammogram.

The power dynamic, a concept I despise should really not be. I’m the customer, I’m paying for the service and that
should be the end of it but their arrogance allows them to be clouded by ignorance, pervasive in our healthcare
system. What stems and promotes bullying, arrogance. Therefore you will never ever win by being nice. Throwing
in their face the concept of guilt as when their comment “ we don’t have any male staff” No, it is their fault and that
is an excuse you should never accept. Telling them that is discriminatory further illustrates they too are culpable
because secretly that is what they promote. You don’t know that but that’s what they do.

PT

 
At Monday, May 20, 2019 11:34:00 PM, Blogger 58flyer said...

As to the comment, "we are all professionals here" or "you don't have anything I haven't seen" my response would be "it's not about you."

I think the first step towards a fix would be for a talented writer to write a book on the real reason men avoid healthcare. Biker, you would get my vote to be that author. The book would be a culmination of all we have discussed here and other sites for the past 10 years or so. Not only abuse, but the many other issues we have discussed. We know what they are. Once in print, the book could be sent to lawmakers at both the state a federal levels. It could also be brought to the attention of the television news shows such as 60 Minutes, Dateline, and others. That would force people to face the issue head on.

In my experience, opening up and talking to other men about the overwhelming presence of women in men's health, gets other men to open up about their own experience. Just last week I was telling a friend of mine about my desire for same sex personnel when it comes to my recent urology issues. He quickly agreed that he has experienced the same problem but didn't know how to express it or even who to address it to. My main point is that once you get men to talk candidly about their experiences with healthcare, it is amazing as to the amount of bad experiences with and the inappropriate behavior of female medical personnel that have occurred in their lives. The level of dissatisfaction is astonishing.

Men being men, it's difficult to talk about something emotionally distressing. As a result, we don't find it easy when we are asked why we avoid healthcare. I've been there. When asked by a urologist why I lived with a painful lump on my testicle for over a year before coming to him, I couldn't muster the courage to tell him the real reason. A really good friend of mine, fellow police officer, and one of the finest human beings as ever walked this Earth, did not act on the visible blood in his urine until it was stage 4 cancer. He and I discussed this before he died. Like me he had had a bad experience with a nurse earlier in his life.

We are long past due for men to address the antiquated idea that men have no modesty. We live in a clothed society and our Christian beliefs instruct both men and women to dress modestly. We are not supposed to be seen by those of the opposite sex other than our spouses. That's why it seems so awkward to be asked to show those intimate parts to the opposite sex. The moral compass inside says that this is not right.

I know I am preaching to the choir at this point but we have to get the message out there. A book would be the logical first step and then the approach to lawmakers to bring about the needed legislation. Preferably at the federal level. HIPAA could be expanded to protect not only patient information, but physical modesty issues as well. A chaperone could be defined as a medically trained person of the same sex as the PATIENT. An across the board requirement that any medical person having access to intimate parts of the body of a patient not of the same sex would be required to be assisted by a chaperone of the same sex as the patient. The only exception would be a life or death emergency outside of a medical facility or the patient's spouse would suffice as the chaperone. Outside that, no exceptions. I think that one requirement alone would fix the majority of the issues discussed here.

What do you think folks?

58flyer

 
At Tuesday, May 21, 2019 6:08:00 AM, Anonymous Anonymous said...

JR said:

NTT,

I agree. The politicians I have spoken with have been no help. They mostly say the medical lobby is so strong and influential that getting change through is almost impossible. They also cite the number of politicians that come from a medical background as not be cooperative too. Like I have said before, if we want to bring about change then we need to become organized. Working separately, we are not going to make any difference but if we can organize and grow, then we can bring about a change. I know there has to be more than just us who are unhappy with how treatment is delivered.

PT,

I agree. Going to the doctor should not be viewed as a game. You should not have to defend your right to be treated with respect and dignity. It should be an automatic right. They are arrogant, bullies, and it is a power game for them for which we will ultimately lose. Care and how it is given is discriminatory. Another poster once said they didn't care when they went to ER and were very ill if their modesty was intact or not for treatment. But that is just it. All you do to preserve your modesty during an office visit is pointless if you don't care what happens when you are in ER, a procedure, or a hospital patient. You can almost guarantee they will take advantage of you then. When you are very ill, you should not have the additional burden of being sexually assaulted and discriminated against. That is when it really matters they respect you as you are too ill to defend yourself or too drugged. Modesty, dignity, and respect needs to matter all the time to all--the patient and the staff.

Misty,

If you are reading this, can you help? We need to get some strength. Patient Modesty already has a lot of followers and I would like to use some of my energy and frustration in becoming a force of change. Women have fought hard for the advances we have made. It is way past time for men to be allowed to have some of the same rights of dignity and respect. JR

 
At Tuesday, May 21, 2019 11:21:00 AM, Blogger Biker said...

Dr. Bernstein, can you check to see if a post I made early this morning got caught in spam or something? It didn't come through with the latest batch you posted. Thanks. Biker

 
At Tuesday, May 21, 2019 3:28:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, this last post was the only one that I had received. Please post again.
If any other contributors here have not seen their writings posted today also
please post again. ..Maurice.

 
At Tuesday, May 21, 2019 9:32:00 PM, Anonymous F68.10 said...

"Like I have said before, if we want to bring about change then we need to become organized. Working separately, we are not going to make any difference but if we can organize and grow, then we can bring about a change."

OK. How do we organise?

 
At Wednesday, May 22, 2019 5:28:00 AM, Anonymous Anonymous said...

JR said:

We would need people willing to help. We need to get our message out there but first we need to decide what are message(s) is, what we want, & how we can get it done. We need an overall person-in-charge & since we are all from different areas, people working those areas. We need to be able to let people know about what we are doing so this issue no longer remains undiscussed or in the dark. We need facts & stats so we can talk about our cause. Healthcare is a mess. There are issues not just w/ the lack of respect for dignity (modesty) but an attitude of patronizing, condescending attitudes toward patients in general. There is an extreme secretive society that makes up the medical community. There are power &control issues. Not to mention billing that is hard to decipher & upfront costs are hidden. There are issues with where does all your personal information really go--who gets it, why, and how much of it is used. Also, how much money is involved--what are the kickbacks from pharm companies and from information brokerages? Exactly what rights do doctors have over patients & when can they override your rights? I think 58flyer was right that a book should be written. I have thought that for a while. There are many stories that need to be told. I imagine just about everyone could relate to the stories in some way or know someone who could. We need to get the public thinking & talking. That is why I thought about Misty as Patient Modesty is already up & working. The core group from here could really add to the male patient part. Both sexes have same & different issues but it all comes down to the same point--how healthcare is delivered. For example, if a male doctor/nurse told a female patient to strip from the waist down and get on the table & spread her legs while he was in the room, there would be shock waves felt. However, when a female doctor/nurse (w/ her female asst) tells a male patient to strip from the waist down & bend over the table, it is thought of as being okay. No one should be told to strip. That word needs to be removed from their vocab. Being told to strip is a command prison guards give to prisoners or in the days of old what PE instructors told us so they could stare at us while we marched in front of them to the forced showering ritual. Never should a female nurse be present when a male is cleaning up after an exam. For us females, they leave the room so we can clean up. These may be thought of as small picky items but they do go a long way in the showing of respect. Should patients be thought of as being prisoners? Healthcare needs to revisit how they interact with patients. Healthcare should be working for the patient & not think they are in charge of the patient.

Each of us could start writing down some of the things we would like to change. We need a place to send those things so we could comply them and work on the them--maybe a website. We also could do hospital ratings on dignity issues so people could check out before using that hospital or doctor? There are endless possibilities. JR (My first name is Jeane & I have been a victim and have witnessed dignity & respect abuses. I remember when I was 11 years old, I had bronchitis & my dad took me to a male doctor that I did not know. He told me to strip from the waist up while my dad & he were in the room. There was no gown. I was a girl who had developed. My dad looked away but I was mortified. I did not know at the time this was sexual abuse but I knew it was wrong. I did not need to be completely exposed for him to listen to my lungs. This doctor had the same last name as I do (no my husband & I do not have the same last name). Whenever people ask me if we are related, I shock them w/ the venom of my tone & saying that I hope that man is rotting in hell but after I explain they too have their story. Sad thing is though, as adults we still suffer from the same abuses.) JR

 
At Wednesday, May 22, 2019 8:29:00 AM, Anonymous Anonymous said...

"I think the first step towards a fix would be for a talented writer to write a book on the real reason men avoid healthcare. Biker, you would get my vote to be that author. The book would be a culmination of all we have discussed here and other sites for the past 10 years or so. Not only abuse, but the many other issues we have discussed. We know what they are. Once in print, the book could be sent to lawmakers at both the state a federal levels. It could also be brought to the attention of the television news shows such as 60 Minutes, Dateline, and others. That would force people to face the issue head on."

I agree with 58flyer--sometjing akin to Silent Spring which paved the way for the environmental movement. Biker gets my vote too though a number here could serve as reviewers to help the effort along.

REL

 
At Wednesday, May 22, 2019 12:14:00 PM, Blogger A. Banterings said...

Rel,

Since I started posting in 2016, I have been attempting to write a book about protecting ALL patients in a medical setting. The ADHD has prevented me from making any noticeable progress.

My goal is to have a book that warns providers of the pitfalls of not protecting dignity that a lawyer can also pick up and use as a template to file a lawsuit.


F.68.10,

I have seen change in the last 3 years. Language that is exclusive to this blog and/or posters here has started appearing in policies for providers (such as the word "dignity").



-- Banterings



 
At Wednesday, May 22, 2019 12:27:00 PM, Blogger Maurice Bernstein, M.D. said...

I thought my thread followers would be interested in my first time description of my experience this morning. I, for the first time, went to a urologist's office to evaluate a bladder emptying issue. I experienced a urethral catheterization for collection for urine volume measurement. It was all performed in a little exam room by a youngish female LVN. She was totally unknown to me. Nobody else besides she and me were present for the procedure which took about a half hour. Of course, my external urethral opening of the penis was uncovered and she engaged in clinically pertinent discussion during the procedure. Nothing more-- and I felt quite comfortable during the procedure except during insertion and removal of the catheter.

I present this because I want you to know that sensitive male genital experiences can occur without fanfare or sexual behavior and the entire event becomes a straightforward clinical experience. It can happen..even with the presence and actions of a female LVN. There are..especially as Biker, as one, has previously noted..straightforward clinical experiences, male genital in nature, that can go forward without issue.

Now some critics of what I wrote may argue "well, she knew you are a physician (true) and were receiving VIP treatment." Should I argue back that conclusion? I don't know.. but my feeling is that I was simply her patient and I felt everything was performed professionally and not guided by my title.

Anyway, I thought you might be interested. ..Maurice.

 
At Wednesday, May 22, 2019 1:44:00 PM, Blogger Biker said...

Dr. Bernstein, concerning your urodynamics testing, the issue isn't that the staff won't generally act in a professional manner, but rather that for many men it is still embarrassing to have female staff doing it. All they can hope to accomplish by keeping it purely clinical and straightforward is to not make the embarrassment worse. There is nothing they can do short of swapping out with male staff to keep it from being embarrassing. Urology practices have to be aware of this but most choose to not hire any male staff anyway. Even one would make a difference.

 
At Wednesday, May 22, 2019 3:34:00 PM, Anonymous F68.10 said...

It's good you see the need to protect ALL patients, and not deal only with male modesty issues. However, do you think just a book will cut it?

 
At Wednesday, May 22, 2019 4:19:00 PM, Anonymous Anonymous said...

Maurice


Clap, Clap, Clap. Oh wow, no one took a cell phone pic of you and hopefully it won’t happen if you eventually end up
in a nursing home. But, look at it from another perspective. Do you think “she” would allow a young male to cath her
in a small exam room? I doubt not. That makes her a hypocrite in a healthcare setting where “ everyone is supposed
to be professional”. Surprise, they are not!

PT

 
At Wednesday, May 22, 2019 4:46:00 PM, Anonymous Anonymous said...

Biker said

“ the issue isn’t that staff won’t act generally act in a professional manner”

Where have you been?

Let’s see, Dr Sparks and all the staff in the operating room at a hospital in New Mexico, the Denver 5,
the female nurse in New York, the female nurse in Penn. nursing home, the incident at a hospital in
Penn. and the hundreds of incidents on www.Problica.org.

These are the ones that we know.

PT

 
At Wednesday, May 22, 2019 5:33:00 PM, Anonymous Anonymous said...

Let’s see

When female patients accuse their physician of sexual assault, they sue. Physicians hire only female staff
for the sole benefit of their female patients, yet we still see female patients successfully sueing their male
physicians for assault. Can male patients successfully sue their male and female physicians when we are
groped or assaulted or other inappropriate behavior such as cell phone pics or comments sexual in nature
made by their female staff? Why is 4 Trillion dollars not enough that physicians can’t assure professional
behavior is maintained or that hospitals and nursing homes can’t do the same. Is there soo much greed in
healthcare that the money grab is to important when quality and patient comfort fall by the wayside.

PT

 
At Wednesday, May 22, 2019 5:40:00 PM, Anonymous JF said...

Dr B
I was OK with med students observing my surgery because I was under. That doesn't mean that anything goes though. At one point after my surgery I started to worry that maybe I went to the bathroom on myself while there were med students present. It started to eat at me for awhile but then I got over it and started thinking about other things.
I'm a person who can and has been checked out by male/female staff for those naked exams. It's the same to me. It's the being on display for an extra person that I find so wrong.
Akso just because I'm OK with med students present during my surgery, not everybody is.
Also wanting privacy doesn't automatically mean we think other people are being sexually thrilled. Although that exists to.
JF

 
At Wednesday, May 22, 2019 6:25:00 PM, Blogger Biker said...

PT, there are millions of nurses, doctors, techs etc. in this country. Do you really think the examples you gave are representative of the norm? I don't. I haven't worked in healthcare like you but I've been a patient intimately exposed far more than most will ever experience. That's where I've been. Most of my experiences have been in line with what Dr. Bernstein described for himself, except that unlike him I was not comfortable with it but rather quietly embarrassed simply because it was a female doing the prep or other function. Yes I've experienced inappropriate behavior too but it's been the exception rather than the norm. This is why I am more concerned with the lack of male staff than I am the quality of the female staff. Lack of male staff is the predominant situation men face, not inappropriate behavior.

PT, my question for you is as an insider who seems to be saying that every day every female staff member sexually abuses every male patient that they can gain access to, what have you done about it? How frequently have you reported them to administration and to the medical and nursing boards? It would seem proof of the abuse wouldn't be that hard to come by given the astoundingly high frequency with which you say it happens. Or are you guilty of tacitly approving it by your silence just like those OR staff that worked with Dr. Sparks?

 
At Wednesday, May 22, 2019 8:23:00 PM, Anonymous Anonymous said...

Biker

I suppose you could say I’m just as guilty for allowing it without voicing it up through the chain of administration. But you know that’s what happens when you are a victim, dosen’t mean I’m the one at fault. I assure you it will never happen again. You continually bring up the
embarrassment factor, why? There is more to this than simply embarrassment, modesty etc. as you’ve said yourself you have never
worked in healthcare but have on a number of times have experience as a patient. You said yourself some of the instances were
inappropriate. It may be in those instances that you were poorly draped, remember we don’t set or make the rules as to what is
considered sexual impropriety, state nursing boards do. For what you consider embarrassment from your perspective for not being
properly draped amounts to sexual impropriety as defined by state nursing boards.

Unbeknownst to the readers of this blog I have written to State nursing boards, nursing ethics committees etc, State representatives
and a governor. Let me be right to the point. Embarrassment would never be a factor for me, NEVER. I’ve no fetish to pursue and
I’d get no sick enjoyment. As a patient who is medically knowledgeable regarding every test, procedure I know what to expect and
therefore I WILL be treated to my expectations, not anyone else’s. As I’ve said and illustrated many times before we will never hear
about all the unprofessional behavior in healthcare, you won’t and you may not see or experience it. One could navigate as a patient
through the myriad corridors for some time and not be a victim whereas it could be a revolving door.

My final question back to you is this if as you say you’ve experience inappropriate behavior but it’s been the exception rather than the norm than it’s been insignificant enough to the point that you don’t find it relevant and if so why are you on this blog or why do you
post on this blog?

PT

 
At Wednesday, May 22, 2019 8:35:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker wrote: "Most of my experiences have been in line with what Dr. Bernstein described for himself, except that unlike him I was not comfortable with it but rather quietly embarrassed simply because it was a female doing the prep or other function."

I should explain my comfort with the female LVN who "worked with me" this morning. As I am a medical professional, I know in advance what "is to be done" and how how it "is to be done". As long as I find that she is following the criteria I have learned in the past, I have no basis for feeling uncomfortable with her though the procedure is a bit uncomfortable.

Perhaps some of the "professional misbehavior" described on these Volumes personally affecting the writer are based on lack of knowledge or misunderstanding of the procedures or actions described. That is understandable,but of course personally disturbing.

Now, it is my understanding that PT has had direct experiences in the "medical professional mix" and hopefully has knowledge of proper medical professional behavior and techniques and standards and that should provide PT with some attention with regard to PT's conclusions.

So far and including this morning, I have not witnessed nor experienced PT's descriptions of professional misbehavior.
They certainly, however, do exist as exemplified by the two medical school deans and male gynecologist at the university I have been participating and, of course, the bunch of published gross examples presented by the news media and presented here on this thread.

However, certainly it does take a knowledge of medicine and its practice to identify with confidence the "good" vs "bad" behavior in the profession. ..Maurice.

 
At Wednesday, May 22, 2019 8:38:00 PM, Anonymous Anonymous said...

Maurice

The concept of a VIP patient dosen’t sit well with many. You can always predict the outcome. The concept of a VIP dosen’t sit well with me either. I’ve seen physicians bring their wives in thus bumping patients already on the schedule and no it was not an emergency. So is it
ethical. Does any of our readers expect VIP patient to enter flawlessly without a hitch.

Of course Maurice was a VIP and treated as a VIP I’ve seen a Saudi Prince come to our hospital and changed the decor,carpet walls,
brought his own selected medical staff and his own kitchen. All patients are VIP and should be treated as such.

pT

 
At Wednesday, May 22, 2019 8:48:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, I think I have noted this previously. but is common professional knowledge that being considered a "VIP" such as being a physician as a patient, actually leads to impaired physician-patient care both inpatient and outpatient. ..Maurice.

 
At Wednesday, May 22, 2019 8:55:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, one other point with regard to Biker or others. Setting the writer's experience, knowledge or feelings here is personal to each individual and may be, in fact..as I have written numerous times, may be therapeutic. ..Maurice.

 
At Wednesday, May 22, 2019 10:01:00 PM, Anonymous Anonymous said...

Today a female sheriffs deputy is under arrest in Sacramento Calif for having sex with a tennage boy, nothing new really, if it’s not a
female cop it’s a female teacher having sex with her male student. If it’s not that it’s a female nurse taking nude cell phone pics of her patients and sending them to everyone. Don’t worry, this kind of behavior marches on while some here apparently don’t get it.

PT

 
At Thursday, May 23, 2019 5:21:00 AM, Anonymous Anonymous said...

JR said:

PT,

I do get what you are saying. I believe that many patients are needlessly exposed. Sexual abuse does not have to be a typical sexual act but it can be unnecessary exposure. It can also be comments about the patient. Some may view this a just unprofessional behavior but when the comment has to do with the opposite sex making a remark as such, it is sexual harassment even when the patient is drugged, unconscious, or dead. You are an insider and you have seen many things. Knowing these things can be helpful but when you are drugged, even you won't be able to protect yourself. Being an insider, you know that is when they will more likely abuse you. I think most of us are more likely able to control the situation during exams when they are not giving drugs to make us submissive or compliant. Your insight into how things are done is invaluable.

My husband has had prostate related procedures done in the past. Although he didn't like having them done, nothing inappropriate happened. All had female staff involved because male dignity does not matter in the healthcare setting. Female patients have more consideration given to them as a whole. However, dignity issues can still happen. What happened to my husband went beyond a dignity issue. For one thing, he was completely at their mercy of which that had none. Second of all, there was no medical reason for the exposure. Thirdly, he was drugged and does not remember everything that happened but what he does remember is bad as he remembers being their entertainment.

Dr. B.,

Although he did not know beforehand about the procedure or even that he was having it done as it was being done, it would not have mattered. Access to the femoral arteries does not require genital exposure. Most cath lab descriptions say the genital area will be covered so personal dignity will be maintained. He was left completely exposed before and again after the procedure. This completely contradicts procedure descriptions. Once he was taken to the CCU, it is not necessary for the nurse to push the patient's gown to around their breast line and pull the blanket to his knees for hours. This was done while the room was full of IT techs and the woman who drew blood. It continued while she and another nurse was alone with him for hours. It continued by her alone until her shift ended. Is this typical care for a nurse to have to have the genital area exposed for 5 hours? Is it typical for 2 nurses to be in a drugged patient's room laughing hysterically at the patient? Is it typical for nurses to make false entries into medical records? While your procedure went well, since you are a medical school teacher, I would assume you would not have problems as you as present when others are patients being examined by the opposite sex. Are you and a male student ever alone w/ a female patient? Why is it acceptable for a male patient to be alone w/ 2 female medical staff members? Are females exempt from being sexual predators? Or does the medical community turn a blind eye to this? I am not questioning that professional care can be given but rather how do you know when it is not going to be given? How can you prevent what happened to my husband? Because of what happened, he no longer trusts or will accept female care if he is alone or will be drugged. Of course, they could again drug him w/o his knowledge and all of his preventive measures will mean nothing bc in the end, they will win by doing what they want to him. JR

 
At Thursday, May 23, 2019 5:54:00 AM, Blogger Biker said...

PT, my embarrassment factor stems from the manner in which I was raised to be modest around females and simply being somewhat shy. I have been with my wife since I was 19 and do not casually accept being exposed to other women no matter the licenses they may hold. If embarrassment is a factor 100% of the time and inappropriate behavior is a factor 10% of the time, then the 1st aspect of healthcare that I'd like to fix is the gender mix. Let men like me who would prefer male staff for intimate exposure matters have that choice. In fact, fixing the gender choice issue would also eliminate the incidences of inappropriate behavior because the opportunity just wouldn't arise.

I am not modest around men given a lifetime of locker rooms starting in 6th grade. I don't care if they are gay or not because never have I observed or experienced anything inappropriate in locker rooms or with male staff in healthcare settings.

My wariness with women in healthcare began when hospitalized at age 11 when a female staff member forcibly bathed me. The way she went about it was traumatizing. That and a couple other experiences continue to make me wary until they prove to me otherwise.

Years ago I assumed that the most I could hope for with females in healthcare settings was that they'd keep it purely clinical. It didn't occur to me that staff gender choice could even be an option. I maintained my "manning up this doesn't bother me" gameface because to betray my discomfort would make it more embarrassing. Now I'm comfortable speaking up asking for male staff or in the case of extra eyes in the room saying I don't want them there, and I am ready to speak up if anything inappropriate occurs. Years ago I just silently suffered it.

Women began hitting on me at about age 15 and while it rarely happen now that I'm older, I knew that if I was viewed through a sexual lens in non-healthcare settings, the same is occurring in healthcare settings, except they get the full view. While for some it would be flattering, my shy nature always found it embarrassing. At this point in life I know that to the younger staff I am just another old man but I remain modest and shy nonetheless.

Staff gender choice thus remains my primary issue.

 
At Thursday, May 23, 2019 6:48:00 AM, Anonymous Anonymous said...

Maurice


You presented your VIP club membership while at the Urology clinic, does this entiltlement guarantee ensure a waranty, that all club members will be treated professionally. I just don’t see how that can be in this lopsided care modicum that’s been presented, hood over everyone’s face fashion. The phrase “ we are all professionals here” is a falsehood, that long-lasting laminate is just what it is, fake.

Accepting the phrase “ we are all professional” has consequences and for the assumptions that it carries, would that LVN assume the same position of patient if the circumstances were reversed. We are all professionals only when the circumstances suit them, that it says you can trust me but I can’t trust you only because that scenario suits me only because of our genders.

PT

 
At Thursday, May 23, 2019 7:30:00 AM, Anonymous Anonymous said...

Maurice


When many female nurses present to medical facilities unknown to them they too present their VIP card, which entitles members to an exclusive array of professional services, more so than those of course who are not card carrying members, the card that identifies them as a nurse. Often there is no card to be presented, it’s a verbal membership. The platinum plan which is of course the most exclusive membership one can have, is recognized at all mammography suites across the nation. This plan is unique and recognizes all female patients with an absolute guarantee “ we are all professionals” phrases and other good for business falsehoods are not used. We also
accept this plan at all L&D suites as well.

Do leave home without it!


PT

 
At Thursday, May 23, 2019 9:49:00 AM, Blogger NTT said...

Good Afternoon:

Dr. Bernstein, in regards to the urodynamics testing. You’re a doctor. As such, you are part of the medical community’s brother/sisterhood. Being a part of that brother/sisterhood means you are treated totally different than someone who walked in off the street for attention.

Everything is done “professionally” by the book for all brothers and sisters in the hood. No levity, no staring, snide remarks, checking & rechecking that connections are in place correctly. No, everything is prim and proper as the brits say.

Totally different than the way they’d handle ordinary jane’s and especially john’s here.

Say Jane Doe comes in off the street and has a female related cancer issue she’s been forced to deal with. She’s going to go to a medical facility for all the intimate testing and treatment.

Now this woman, is NOT going to want anything to do with any male healthcare workers being around her space during the testing and/or treatment. She doesn’t want to have to bear her innermost feelings to a complete male stranger(s).

Our medical community knows this since they’ve catered to women since the rise of the modern-day feminist movement back in the mid 1960’s.

So, they will do their very best to surround Jane Doe with an all-female support system so as to give her the best possible outcome from her ordeal.

Now let’s look at John Doe.

John Doe presents at a medical facility with prostate or urinary issue. Which one is to be determined.

Now, not knowing up front the modus operandi of our terrific healthcare system because his doctor nor anyone else explained how things work because they know if they did, Mr. Doe would say NO, so he has NO CLUE how bad things are going to get for him.

Ah, but our medical community sure knows though. How you ask? Because they abandoned men with the rise of the modern-day feminist movement back in the mid 1960’s. So, they know he’s stuck dealing with female healthcare worker(s) whether he likes it or not if he wants answers and treatment.

Since the mid 1960’s the American healthcare system has had absolutely NO MALE support system in place for men like John Doe to support him through the shame, embarrassment, and humiliation of the ordeal before him. Nor have they worked on getting a system in place to this day.

He, unlike Jane Doe, is being FORCED by a brutal compassion-less system to bear his body and innermost feelings to complete female stranger(s) whether he wants to or not.

And as we know from years of experience, a majority of men don’t talk about their feeling especially in mixed company no matter what. It’s part of the “Macho Code”.

Many men don't come back from the psychological trauma they've experienced.

And that ladies and gentlemen is a HUGE reason why so many men walk away from needed medical care and die sooner than they should which makes it even more imperative, the we MUST get society talking about this issue so in turn the medical community has NO CHOICE but to come up with a support system for men even if that means cross-training employees just like many other companies in this country does all the time until enough men enter the field.

Healthcare has lived in and ran their business model in the dark ages long enough.

Its time society knows and sees for themselves just how brutal and compassion-less the American healthcare system really is, towards males in this country.

Regards to all,
NTT

 
At Thursday, May 23, 2019 9:50:00 AM, Blogger Maurice Bernstein, M.D. said...

PT, I have no literal VIP document (card) and if there was such a card, I definitely would not present it. Yes, the LVN knew I was a physician from the outset through the referral information showing MD in my name.

But I reject the VIP concept since it is not to anyone's best attention and best of care goals. VIP only degrades best therapeutic actions by medical staff and by the alleged VIP patient him/herself. The VIP concept is clinically harmful to the patient.

I have told this blog thread in the past that my first patient as I started internship was a city politician who tempted me to take and keep one of three wrist watch on his wrist. (An obvious cue for me to realize that this man was a VIP patient). I rejected the offer and informed him my duty at that time was to take his medical history and not his watches. ..Maurice.

 
At Thursday, May 23, 2019 12:12:00 PM, Anonymous Anonymous said...

Maurice

Wether you realize it or not, you invoked your VIP card. The LVN needs no such card, that’s my point. She would never need such a pass, it’s already been approved for her. At all participating Mammo suites, L&D suites, etc, furthermore, should she ever choose a female urologist and require urodynamics testing, we all know who would be there. How does that “ we are all professionals” grab ya?

PT

 
At Thursday, May 23, 2019 4:18:00 PM, Anonymous Anonymous said...

You don't have to deliberately DO anything to receive VIP status. Just like a black person doesn't have to do or say anything to a person who hates blacks and desires to torture and hurt them.
Dr Bernstein. Do you remember RG? He wrote Ambushed by a Chaperone. He went to a female nurse practitioner for swelling on his testicle and could have tolerated exposure to her on a stand alone basis.
But she chose to bring in a female chaperone. Didn't bother to inform/ ask anything and then the ambush happened.
Later when he asked her why she treated him that way she said a chaperone protects her AND him.
The chaperone didn't protect him. She harmed him. It's like the medical world, to prove they're not abusing patients, abuse patients.
It may have protected her amongst her job but were she to harm certain males doing what she did she may have endangered herself and her family in a longer term kind of way. Especially if his loved ones learn of it as the reason he refuses care in the future.
JF

 
At Thursday, May 23, 2019 5:32:00 PM, Anonymous Anonymous said...

JR said:

Most male patients would have had an extra female person in the room. Since they knew you were a dr., they did not. No, you may not have played the VIP card but your title of dr. may have done it for you. If you were to go to someplace that didn't know who you were and you were not to use the title of dr., I imagine your treatment would be different. Most men know that for prostate procedures, there will be women present as they do not have choices like women. My husband knew it, didn't really like it but accepted it as part of the obstacle course he had to go through for treatment. The difference is he choose, knew it and still did it. They did not sexually molest him. Whether they were professional once the drugs took hold is debatable as hospital people on a whole are petty and like to gossip. See the Reader's Digest article on MSN about 100 Things Nurses Know. He knew his genital area would be exposed bc it was a prostate procedure. With the cath. lab, he didn't choose it and certainly didn't know his genital area would be exposed especially w/ him in such a state as to be a silent, helpless spectator while they mistreated him. Most people do not know about the exposure and the hospitals sugar coat the reality.


By the way, received a letter from the hospital from hell saying they had his information to the voluntary data registries they originally said couldn't be recalled, has been recalled. It was pointed out to them that he did not sign the consent or even give consent for the procedure they forced on him to sexually abuse him and punish him for life by having the 2 stents that will forever cause issues. Since there was no consent there was no implied permission for them to use his data or even have his ssn which he never gave to them but they just pulled out of their as_es from previous contact from another location. They are really slick w/ the EHR bc they have your info forever at their fingertips. It is the best interest of a patient to lie about much of their information as once they give it, they have no control over how it is used. They really only need all the information so they can sell it and make money. I know this experience has taught us to no longer give them valid information bc they do not have our best interests at heart (pun intended). Since it is acceptable for them to falsify medical records then patients can also falsify information. Have read more and more articles about they do know that stents are harmful but continue to use them anyway. They care nothing about the patients but only for the control, power, and money. This took from last winter for them to finally do something. JR

 
At Thursday, May 23, 2019 6:04:00 PM, Anonymous Anonymous said...

Speaking of VIP treatment, two cases come to mind. First case a nursing home in Ohio. The patient was private pay. Our workload was heavy but whatever else we were doing , if this guys call light were to come on , we were required to immediately stop what we were doing and attend to him NOW.
This particular patient was demanding and time consuming.
The second case was at a different nursing home. Another private pay person. Same deal. What WAS different about this guy was that he wasn't hard to take care of. He didn't require anymore care than the average patient.
Just we had to delay meals if his call light came on or interrupt care to another patient when his light came on.
JF

 
At Friday, May 24, 2019 1:13:00 AM, Anonymous Anonymous said...

PJF here.

Dr. B.: I read with interest your recent experience at urology (sorry to hear about your medical issue). While you talk about the procedure, I am curious about the your interaction with the urologist or MD who ordered the procedure. Although it appears that you were comfortable with the female LVN, did you take the opportunity to “speak up” and inform the MD that you manage a blog about Patient Dignity of almost 100 volumes where dozens upon dozens of men say they would prefer a male staff for such an intimate procedure? Did this urology practice have male staff available to perform your procedure? If so, how did you end up with a female? Did you likewise inform the female LVN about this blog?

As others have stated here, it appears that this issue is only going to get resolved “one brick at a time” as each of us makes the case to our health care providers that more male staff are needed, especially in urology. This seems like it was a good opportunity for you to be an advocate.

PJF

 
At Friday, May 24, 2019 5:41:00 AM, Blogger Biker said...

The only relevance to what we discuss here and VIP treatment is that those who work in healthcare may not experience the full extent of what the general public experiences. That it occurs is just human nature. People are tribal by nature in that we identify with those who have some degree of commonality with us. That commonality might be occupational such as we're discussing here, geographic, racial, religious, ethnic, interests, age, gender, sexuality, disability, and so forth.

VIP treatment can be purposeful and open such as what JF described with the private pay patients or it can be unconscious with the one giving VIP treatment not even realizing that they are doing it. I'm not convinced that a low level employee such as an LVN is seeing an MD as part of her tribe so much as she's seeing Dr. Bernstein as a high status individual who could make her life difficult if she doesn't adhere to all of the protocols.

What I find most interesting about Dr. Bernstein's experience is that it was only that LVN in the room with him. I've never had a urodynamics study but I always heard that it was typically two female staff members present. The other thing that surprised me a bit was that it was an LVN doing it. I thought urodynamic studies were done by higher level specialized staff.

 
At Friday, May 24, 2019 6:42:00 AM, Anonymous Anonymous said...

JR

The fact is and this is between you and I, VIP patients are usually someone from administration or some addition of their family. I personally don’t think the concept of a VIP patient should exist in healthcare for that implies not all patients are treated the same. But, we have known this all along, this facet of healthcare and it’s disparities.

Half of our population are treated like VIP’s while the other half are treated like discarded meat rotting in the alley. Visit most any mammo suite and you will be treated to a nice pink robe while you lounge in a fashionable private patient area awaiting your mammogram. The staff are all female of course and should you need a breast biopsy, no worries, they even have a female radiologist board certified to address those patients.

Now when it’s time to deliver your child you are in for a real treat. L&D suites have beautiful private rooms, birthing centers and an all female staff, catering to your every need. Tell me this isn’t VIP service. Do you think male patients get any kind of VIP service? My last visit to the urologist was met with an hour and a half wait to see this clown, a female MA who did not know how to take a blood pressure and without the courtesy and professional demeanor to knock on the door to my room before entering.

All women’s centers are another VIP service that half of our population enjoys by focusing specifically on the health needs of women, look them up on the web., pay specific attention to the broad ( no pun intended) services offered and specifically to the staff. Now a few years ago I had an injury to my ankle. The injury was potentially vascular so with that in mind I went to the ER, saw a PA and he requested an ultrasound of my leg.

I was met by the ultrasound tech, female, young and was as tall as she was wide. Asked me to remove all my clothes nude, just for an ultrasound of my leg. I took one stern look at her at which time she gave me a gown. No, it wasn’t a nice pink robe, no I didn’t get to change in a private room. No, I wasn’t not provided VIP service, Hell I wasn’t even offered privacy to change but then you see, I’m the other half of the population that is not afforded that. Half of the population pays the bulk of $4 Trillions dollars annually to be treated like rotting meat in an alley while the other half, well you know how they are treated.

PT

 
At Friday, May 24, 2019 7:14:00 AM, Anonymous Anonymous said...

JR

Please forgive me as I have left one small detail out about VIP patients. These are the potential females who work in healthcare who talk about how they want their care delivered “BEFORE” they become patients. I overheard a young female nurse who said “ if I’m ever to be cathed it has to be done by another female and she needs to be an Rn. Now mind you this nurse works in the Er.

Another comment I heard a female nurse say after her young male patient was wheeled out to his family’s car was “ I could say something nasty”.

Current healthcare workers, specifically female nurses can be considered VIP as well since they can commit crimes against patients and other people and still retain their nursing license. Murdering your patient by administering the wrong medication, committing murder by poison, burning their house down and then having sex with your male inmate prisioner while maintaining your nursing license most certainly puts you in a VIP status not only in the healthcare industry but the criminal enterprise industry as well.

That is called dual VIP status.

PT

 
At Friday, May 24, 2019 10:08:00 AM, Blogger Biker said...

PT, I apologize for my ignorance but on what basis would protocol ever warrant completely undressing for an ultrasound of your leg? Assuming there was a valid reason to do so, it is inexcusable that you weren't offered a gown and that she didn't step out of the room for you to undress.

 
At Friday, May 24, 2019 10:31:00 AM, Blogger Maurice Bernstein, M.D. said...

Clinically, there should NEVER be as a isolated "special patient" case: a certain patient" who is treated as a "very important person" who needs to be given personal services not offered to all other patients or services removed at the specific request of the patient and without further doctor-patient discussion of that request. Also procedures not considered by the physician because of the physician's own personal distaste if applied to him-herself.

All patients, regardless of personal "stature" should be considered "special" and given the power and opportunity to express themselves and receive professional feedback as necessary. Clinical decisions should be provided the patient to consider based on the specific patient's clinical condition and not on the personal whims of the physician, nurses or other professionals. Every patient should be considered and treated by the professionals as "very important". ..Maurice.

 
At Friday, May 24, 2019 10:43:00 AM, Blogger Maurice Bernstein, M.D. said...

On entry to the urology clinic, of course the clinic was aware that their patient was a physician and I was not aware whether I was to be "manipulated" by a male or female but I was aware it would be a "nurse". For me, what I experienced was clinically and professional appropriate"manipulation" which provided the appropriate outcome. I have no knowledge of previous concerns of nurse behavior with other patients at that clinic. ..Maurice.

 
At Friday, May 24, 2019 11:09:00 AM, Blogger A. Banterings said...

Maurice,

I have to agree, you did invoke your VIP card. I suspect that the prestigious institution that you work/teach for has its own insurance plan that utilizes its own network of providers of all specialties, many of which have been acquired because the partners can no longer afford the mad mal. I have personal experience with a GP practice being acquired by the University of Pennsylvania for similar reasons.

The physicians that were the partners are told you will now be a professor at the University of Penn (along with being an employee). This is to allow them to save fave with the community; we "traded up" to being a prestigious professor.

I am sure that your urologist is a member of the "Keck Medicine of USC" healthcare system (which has almost 50 locations). I am sure that they are aware that you are a professor at the med school. That carries considerable weight, after all the reason that the Keck Medicine of USC healthcare system exists is due to the Keck School of medicine. I am sure that you must sit on some committees or boards that create policy that has bearing on the healthcare system.

At the very least, you work near he ivory tower where the executive suites are.

I would also ask, that prior to the procedure did the LVN introduce herself, state her purpose, and explain the procedure?


The real question for you Maurice, that if one of your (previous) FEMALE students, now beyond her 2nd year, but still in a position of learning, whether introduced properly or not, was brought in to further her PROFESSIONAL education, would you allow that?


We know that due to your affiliation with the med school, this would never happen?

I also ask, that as a proponent of a PROFESSIONAL education, why not ask the practice if there are any students currently there and allow them to further their education?

I am being dead serious about these questions. After all, at the urologist's office, are you not just another patient? If you believe it is acceptable to have other patients subjected to students, then why not have students involved in your care too?

I am sure that you can appreciate the utility of having students participate in the care (especially the intimate care) of those patients who have been professionally trained to treat the breasts, genitals, rectum, etc. just as any other body part.

The inference of your posts has been that due to your medical training, you readily accepted non-gender concurrent care.





-- Banterings





 
At Friday, May 24, 2019 11:42:00 AM, Anonymous Anonymous said...

Maurice, I am rather shocked that, in light of all that has been discussed/revealed on this blog, that you didn't educate the physician and LVN and demand a male LVN. I'm betting your urologist has no males on staff, right? That was the time to walk out and educate him about discrimination and male dignity.
I must agree with PT that male customers who end up in the cruel grasp of the makemsick industry are just so much rotting meat for the hags and assorted greedicos.
As many have said on this blog, it's the arrogance of these hags and greedicos that is one of the most dangerous mind sets to have, for arrogance corrupts all, not only male dignity but correct medical care as well. In light of my last horrible ER experience I see that it is the money flow that directs triage - not the customers! Yes, they'll take obvious customers such as the one having a heart attack or stroke, but the rest of the time triage is to make the most money possible. Why not stitch up some minor wounds to keep the money train flowing while letting the senior pork belly with internal bleeding collapse in the waiting room - they know they'll get their outrageous compensation in the end anyway. Who cares if some senior pork belly is suffering?
Yes, of course we need Medicare for all. I recall the nutcase Palin from Alaska screaming about "death panels" from a system such as Canada's. Well, here in the good ole' fascist states of america we already have death panels - and it is performed in two ways: either denying people medical care and/or bankrupting them, or, giving them shitty or dangerous treatment/treatment they did not consent to as in JR's husband's appalling "care."

EO

 
At Friday, May 24, 2019 11:47:00 AM, Blogger Biker said...

Dr. Bernstein, though technically correct, their telling you it would be a nurse was the kind of purposely misleading language used in the medical system all the time. To most patients "nurse" infers an RN. An LVN (or LPN, the equivalent in most States) should always be introduced as an LVN, not as simply a nurse.

An egregious violation of patient trust comes when individuals are referred to as "student", inferring to the patient a medical student or RN student depending upon the circumstances when in fact the student might be an undergrad, a high school kid, or an MA or CNA in training. In some States the MA or CNA student might only be 16 and the high school kid might be as young as 14.

I've read there is a growing issue of NP's who have gotten a doctorate introducing themselves to patients as Dr. The patient takes that to mean they are an MD with the NP taking no responsibility for the misinterpretation because their badge says NP. Of course the badge may be turned around so as to not be readable anyway.

 
At Friday, May 24, 2019 12:24:00 PM, Blogger A. Banterings said...

Maurice,

You stated:

So far and including this morning, I have not witnessed nor experienced PT's descriptions of professional misbehavior.
They certainly, however, do exist as exemplified by the two medical school deans and male gynecologist at the university I have been participating and, of course, the bunch of published gross examples presented by the news media and presented here on this thread.


I would like to let those readers not familiar with those cases know what you are talking about:


USC gave nearly $1 million to medical school dean linked to drugs


USC settles class action lawsuit against gynecologist accused of sexual misconduct

Another USC medical school dean resigns


Message from USC Provost Michael Quick


Here are a couple more headlines from USC's School of Medicine:



USC-sponsored plastic surgeon used patient’s insurer as ‘personal ATM,’ k

A former patient is suing her Beverly Hills plastic surgeon, saying he created fake diagnoses to charge her for a dozen unnecessary surgeries across a 4-year period. She also claims sexual assault during one of the procedures. According to the lawsuit, he used the patient's health insurance "as his own personal ATM machine," fraudulently double-billing her for roughly $16,000 and the insurance company for around $330,000. (Los Angeles Times)

LGBTQ alumni at USC allege men’s doctor sexually abused them

USC cardiovascular fellowship to be stripped of national accreditation, in major setback

USC was told gynecologist could be preying on Asian women, secret records show




-- Banterings





 
At Friday, May 24, 2019 12:25:00 PM, Blogger A. Banterings said...

Now how chaperones and the system do NOT protect patients:

In 2016, former New York-Presbyterian ob/gyn Robert Hadden, MD, surrendered his license after pleading guilty to felony and misdemeanor sex crimes. But according to a recent lawsuit, the first complaint against Hadden came to light in the early 1990s, when a nurse walked into an exam room at a Columbia University clinic to find him "sexually abusing" a patient.

The nurse reported the incident to her supervisor but was told to keep quiet, stay with her doctor, and not "let him get himself in trouble." The December 2018 lawsuit, which initially included 17 women but has since grown, alleges that Columbia University and its affiliated hospitals knew of and "actively concealed" Hadden's actions.



At the University of Southern California (USC), administrators denied they knew about sexually inappropriate behavior of longtime campus gynecologist George Tyndall, MD, until 2017, but colleagues say they reported his "creepy" habit of inappropriately touching during pelvic exams and excessively photographing patients genitals back in the 1990s. At least three patients submitted letters reporting inappropriate touching and remarks from Tyndall in the early 2000s.

In 2013, chaperones reported their concerns over Tyndall's behavior to their supervisor, but an investigation found that no school policy violation had occurred and the only apparent repercussion was that he was barred from locking his office door when seeing patients.
Source:



Passed as a constitutional amendment in 2004, Florida's "three-strike rule" was designed to automatically revoke the license of doctors with multiple malpractice judgments against them, but an ABC Action News investigation found that the rule has been invoked just twice in the last decade. This despite hundreds of doctors with multiple medical malpractice payouts, involving almost 1,400 patient deaths and totalling over $460 million in paid claims, since being signed into law 15 years ago. The investigation uncovered one St. Petersburg doctor with 16 paid claims -- six involving patient deaths -- who nevertheless maintains an active license after being disciplined by the state's medical board just once. Notably, out-of-court settlements don't count as a "strike."


ABC Action News investigation



After a 9-month investigation and 30-page report, a Florida gastroenterologist accused of groping, fondling, and sexually assaulting more than 21 of his female patients will not face charges. The investigator in the case ruled that although his actions "may have been unethical," they did not "rise to the level of criminal."

will not face charges



-- Banterings



 
At Friday, May 24, 2019 1:16:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, the clinic is in no way associated with the medical school I have been teaching all these years but is part of the medical facility from where I retired from internal medicine practice there 18 years ago and have always remained a patient there.
To All:
I haven't seen the assigned urologist as yet but it is a "he". Yes, I was seen by a LVN which was a surprise since having had no contact in recent years with that clinic, all I knew was that I was going to be attended by a "nurse" and no gender of the nurse was given to me until she welcomed me into the treatment room and saw her badge which had the characters "LVN" in very large text after her name. I never asked for a male nor did I ask if there were male "nurses" in the clinic. Yes, she did see me behave as a medical teacher after she was beginning to repeat a blood pressure determination after the first reading. She restarted the BP machine immediately without having the patient (me) elevated my retested arm for a minute to allow the venous flow in the tissues of the arm to decongest which is the proper maneuver for retesting BP in the same arm.
So yes, she recognized by this education beyond my title that I was a "instructor".

The remainder of the procedure continued to be straightforward for a urethral catheter insertion and function and removal with no behavior suspicious of some "other" interest on her part.

So, all in all, though this description of my recent experience may disappoint many of my blog thread contributors, I found the experience (which is the first urinary tract catheterization) since many years ago undergoing heart surgery) a straightforward action with no behavior by me or she which could be interpreted by our group here as undignifying or unprofessional. And to be honest about my entire life, I have never seen any unprofessional medical behavior EXCEPT (as I may have noted previously) when I was a hospital intern and standing at the operating table, the orthopedic surgeon was angry with the instrument nurse across the table and threw a scalpel at her. Fortunately, it missed her and ended up on the floor.

Anyway, this is your Moderator's personal experiences and views. ..Maurice.



 
At Friday, May 24, 2019 3:37:00 PM, Anonymous Anonymous said...

To All


I do not blame nor do I hold Maurice accountable for not asking for a male tech, nurse etc to perform his urodynamics. Remember, he is a physician and has tended to female patients. He would be considered a hypocrite in the eyes of many if he refused a female to perform the study. I’ve said this many times, that female nurses, techs etc perform intimate exams on male patients yet they say openly they would refuse a male nurse, tech etc. I know most wont even see a male physician and in my opinion they are a hypocrite.

Don’t anyone come back and give some long winded crap about bla bla bla, past sexual abuse. Males have experienced sexual abuse in healthcare as well. For a quick educational point on urodynamics there are NO specific educational requirements to perform those studies, medical assistants often perform the study which can involve not only urinary catherization but a tube placed in the rectum as well.

Additionally, a new product out is called uro cuff. It is a small blood pressure cuff placed around the penis along with sensor problems placed on the lower abdomen as well as some placed around the rectal area. Personally, I’ve said this before and that is that urodynamics is a useless test which in my opinion the same information can be obtained by a bladder ultrasound after drinking 16-32 ounces of water, voiding and then performing the ultrasound to evaluate residual urine.

I assure you, no urologist is going to make a diagnosis on urodynamics alone. Furthermore, I will say that MD showing up on his name most likely invoked a degree of VIP ness which most likely only assured that female staff acted appropriately and professionally and that is it. As far as surgeons throwing scalpels across the room, hitting the scrub tech on the hand with a mallet, I’ve seen that scenario perhaps a hundred times.

Yes, Maurice is a very experienced physician but, he has not waded through the battlefield, waded through the MUCK and seen first hand many many times the disgusting inappropriateness that goes on. We cannot blame him nor can we expect him to understand the lack of trust that we so openly display, the absolute hatred that we have towards those in healthcare.

PT

 
At Friday, May 24, 2019 3:42:00 PM, Anonymous Anonymous said...

Biker

Yes, she wanted me to completely undress nude for an ultrasound on my leg but again, I’m the victim and yes I’ll take the blame, yes I should have complained. Many situations has happened like this to me but I’ve learned and as I’ve said. I will never allow this or anything like this to happen to me again. Rest assured every licensing agency in the world would hear about it. At some point we learn to get a voice.

PT

 
At Friday, May 24, 2019 4:27:00 PM, Blogger Biker said...

Thanks PT, I understand completely. I just started speaking up about 3 years ago. Before that I quietly accepted whoever was assigned to me and tolerated the occasional inappropriate behavior on the part of female staff. I kick myself now for not finding my voice sooner. Finding this forum played a big role in empowering me and liberating me from the shackles of the "manning up" socialization most of us grew up with.

Note that my empowerment also includes refusing sedation. In addition to no longer suffering the after effects of being sick for the rest of the day, I get the benefit of not being subject to needless lifting of the sheets (colonoscopies) or even having to take my pants & underwear off (upper endoscopy & transesophageal echocardiogram).

I agree with your comment that it would have been disingenuous of Dr. Bernstein to insist on male staff when he himself treated female patients. That many female healthcare staff who treat males insist on only female providers for themselves affirms that they see healthcare as being sexual.

 
At Friday, May 24, 2019 5:15:00 PM, Anonymous Anonymous said...

Time to pull that gun out of your purse Ladies and administer some staff discipline that comes from the customers and not administration.
JF

 
At Friday, May 24, 2019 9:55:00 PM, Blogger 58flyer said...

Maurice, I posted early Friday morning an account of my experience with my cystoscope and the results of my biopsy. It was somewhat lengthy but I don't think it went over the limit. I don't see it posted here. Could you check and see if it was missed somehow? Thanks, flyer.

 
At Friday, May 24, 2019 10:18:00 PM, Blogger Maurice Bernstein, M.D. said...

58flyer, I can't find that your posting was received by the blog.. so re-write.
Everyone: Be sure that the "text space" where your typed words appear is empty after you have, hopefully, sent your message to the blog. If the text space is empty, that then is a good sign.

Also.. if you find after some hours that your message is missing from publication, please write me about it VIA E-MAIL rather than post your concern directly to the thread.
Just write me
doktormo@aol.com directly.

I will respond to your concerns via e-mail. I also promise to keep your return e-mail address secret and will not engage in other e-mail conversation with you unless you want me to do that. Thanks.. Maurice.

 
At Saturday, May 25, 2019 1:51:00 AM, Anonymous Anonymous said...

Before a book be written, I think a TV show that comes on once a week might get more attention.
The show could have lawyers on it for the problem laws enabling patients to be overcharged. Giving patients tips about how to vote those laws out. Maybe even require the persons who were overpaid to return some of the extortion money.
Also patient injury, and tips for getting and staying healthy. Accident prevention. Learning the step by step ways medicines and equipment are manufacturered. If any extortion is being practiced there tell veiwers how to vote problem laws about that. As in create a position for somebody to manufacturer medicine and equipment willing to do it and get a fair wage. Not being overpaid.
One Assisted Living Home Director said that our patients paid $60 dollars to be assisted/given ONE SHOWER! As the tech giving/assisting with that shower,I received approximately $5 dollars of that $60. My take home pay for an entire shift would be roughly $60 dollars. We earned less than McDonald's employees. One roommates baby grandson couldn't hardly eat so she bought the nutritional supplements from the boss in the kitchen at a nursing home we worked at. The lady sold it to her at the same price as was paid for. The patients however, paid the total price TIMES TWENTY FIVE!
If and after the show gets a decent following, then adverise the book you were talking about. Talk about letters not getting to where they need to go and some of the hidden reasons patients avoid needed care and especially male patients.
JF.

 
At Saturday, May 25, 2019 5:11:00 AM, Anonymous Anonymous said...

Biker and PT's little argument yesterday made me think about the nurses working with/under that Twana Sparks person. PT claims he HAS spoken up. Maybe a number of the nurses working with Ms Sparks spoke up to. When Sparks former lady love reported her, the boss jokingly said " O Twana"s doing genital exama again, is she?" Meaning of course it wasn't the firsg time he'd heard of it.
JF

 
At Saturday, May 25, 2019 10:51:00 AM, Anonymous F68.10 said...

@Banterings: you know what? I think we should start to document everything that goes wrong in healthcare in the most scientific manner, and set up a website in order to document things publicly and enable researchers to get access to controversial data in a easy format amenable to datamining.

What do you think?

 
At Saturday, May 25, 2019 4:33:00 PM, Blogger A. Banterings said...

F68.10,

I agree. I have attempted to do that on my blog. I have since taken to Twitter because I can put a brief description, hashtag it, and a URL link. This thread in particular, along with this entire Bioethics Discussion Blog is a goldmine of data.

It is essential a longitudinal study that tracks the evolution of dignity in healthcare. I find it hard to believe that this has not caught the attention of any researchers, department chairs, or committees at USC.

What format would you recommend?

What data?




-- Banterings




 
At Saturday, May 25, 2019 5:00:00 PM, Anonymous Anonymous said...

Dr. Bernstein,

I wish you well with your health. I do however feel that you missed an opportunity to bring light to the problems of men in our country. I wish you would have at least questioned the Urologist about the hiring of men for those men who do not want to be ambushed by female support staff. A LVN (LPN here) is not a nurse, a nurse is not a doctor. Men deserve to be treated better. What you found to be acceptable , many men feel is humiliating and a hit to their modesty and dignity. You have the knowledge as a physician to know what to expect. You also most likely feel more comfortable being exposed to opposite gender since you are a doctor and your wife is a nurse. I hope when you see the Urologist again that you might seize the opportunity to broach this subject with him or her.


PT,
I am shocked that you of all people were able to be taken off guard by this female low life. I would have expected you to have raised heck and even walk out or refuse to have the ultrasound until you were able to be provided shorts many facilities have for your modesty. Why were you told to get NAKED? After all the humiliating things female support staff (this includes nurses, scrubs, cnas, rad techs etc) have put my husband through he refuses to go for anything by himself.Take your support person with you. You should not be treated this way.

We both have had our problems with opposite gender support staff. I have learned to walk out and refuse the procedure or test. My poor husband has had much worse than I have. I have told a few of them on here.

I visit this site daily. It gives me courage to stand up for both of us. I do notncontribute often as PT! JR and Biker say it much more eloquently than I can. My husband will not even go to our doctor who we both love because of his cna.(PT, you are right they can not take BP readings accurately) He wants me to go to every appt with him. He has recently been diagnosed with Parkinson's so now I definitely will go with him even for xray. He like PT has been told to strip recently for a hip xray. He had on no metal gym shorts. They said He Could wear those but the young girls took him back and told him he had to strip ..He had her and a female student. I was furious. Last week he went for a test. The CNA asked me if I had to go back for the eeg, I think it was ,with him as they normally did not want a spouse as they got patient ready. Now I had recently had the same test and knew he did not have to remove all his clothes.I told her yes I had to and I was going back with him. Upon entering the room she picked the gown she had previously put on the table , put it back in the drawer and told him he would only have to roll up his sleeves. Awfully funny. If I had not insisted she would have had him strip down and put gown on him. He is now set up for a MRI and I think CT, both with injections . They told me when we return for the tests after a 3 hr wait THEY would put scrubs on him. I told her that if anyone puts scrubs on him I would be doing it not them. She was upset. I am married to this wonderful guy , and I not strange self important females will be helping him with the jeed that may occure. I also informed her that he would be wearing the appropriate clothing so he will not have to change at all. He is willing to get the necessary tests for this but will not allow a female to embarrass or force him to be exposed or touched by them again. We both have medical power of attorney for each other along with living wills. With this diagnosis, we are going to get full power of attornies for each other. We are both scared about this. He refuses to ever have prostate procedures or heart cath again because of the actions of female staff, unless he has Covr or modicine undergarments or all male staff. It is time for men to make their own movement and stand up against female medical support staff.

Sorry this is so long but, I just wanted to try to contribute a little something. Thank you Doctor Bernstein for having this board for us. MS KS

 
At Saturday, May 25, 2019 6:25:00 PM, Blogger Maurice Bernstein, M.D. said...

The individual who wrote with a pseudonym MS KS, please clarify whether you are actually have previously used the pseudonym JR. The narrative you wrote sounds like JR. However, it is important for reader continuity to keep the same pseudonym or if you need to change it then please instruct the readers that you are making a change.

There is a problem with changing one's pseudonym in terms of continuity if a reader misses the posting regarding the change.

Please clarify any changes and, again, let us all know perhaps with multiple postings.
This issue is important in terms of continuity.. it is better to keep a pseudonym for years as PT and others have done over a number of years.

Finally, again.. it would be much, much better to sign in to the Blogger program as Biker has done and you are immediately identified at the top of the posting by the system. Maybe Biker can go over how this he entered his pseudonym as part of the Blogger system. ..Maurice.

 
At Saturday, May 25, 2019 7:15:00 PM, Anonymous Anonymous said...

MS KS

The incidents I experienced were many, too many before I found a voice, it took me years to do that. People in healthcare are not what they appear to be. The last incident I experienced was the last straw and that is when I started reading and posting on this blog as well as Dr. Sherman’s blog. You have to know how to handle the negative experience, have to know when it is a negative experience and if you don’t stop it how and who to complain to.

I’ve recieved my fair share of criticism over the years on this blog from people who question me about how things are. I’ve done my share of educating and being educated. I have stated unequivocally that unprofessional behavior happens substantially every day in healthcare, I know because I’ve seen it while working in healthcare and it’s happened to me as a patient many times.

Yes, I do bash nurses because they are the main contributors but it’s also physicians, techs etc. Think about this for a moment, negative unprofessional behavior happens in Ultrasound, X-ray, Cat-Scan, MRI, Nuclear Medicine and Respiratory. It happens in wound care, ambulatory pre-op, surgery, recovery, nursing floors, Pet Scan, physicians offices, intensive care units and there are about 12 different kinds of intensive care units, neuro icu, cardiac care, pediatrics, MICU just to name a few.

You get my drift, I have left out the emergency room as well as other places. Think for a moment how many patients cycle through these facilities across the country at 10’s of thousands of facilities every day, billions of interactions each year. When you break hospitals down departmentally you see how many areas where patients can experience a positive or a negative. Many healthcare staff are just down right rude and lazy which can create a negative perception, giving the patient the idea that the medical staff deliberately chose not to allow the patient to change in a dressing room as an example or exposing the patient out of laziness by not closing the curtain.

Then there are medical staff that are so jaded that this kind of unprofessional behavior is deliberate, that they get a thrill out of it, yet you the patient cannot differentiate between the two, therefore the appropriate action on you the patient is to report it and complain. There are reasons State nursing boards have rules which state that leaving the patient unnecessarily exposed or improperly draped is considered sexual impropriety. First, the nursing boards really don’t care wether the caregiver did the exposing because they were lazy or just unprofessionally jaded. At least on their websites it’s just inappropriate.

PT

 
At Saturday, May 25, 2019 7:35:00 PM, Anonymous Anonymous said...

JR said:

That was not me. JR

 
At Saturday, May 25, 2019 8:12:00 PM, Anonymous Anonymous said...

No Dr. Bernstein I am not JR. Not from Indiana. Where we live we just have female staff that have very little respect for male intimate care. We have been told that to hire male support staff for those men who do not want to be exposed to or by female staff is discrimination to females. He has been humiliated and refuses to have heart Cath, TURP or any other treatment where he is exposed again. When we found out they only had male techs for my echo he supported and encouraged me to find a location where there was a woman for the test. We support each other and prefer not to be exposed to opposite gender unless we choose a physician of opposite gender. It is time that men receive the respect women get. Knowing many nurses, scrubs and other medical staff and hearing their stories also puts a bad taste in your mouth for medical female support staff. I do feel JR and her husband have a lot in common with us. She is much better at writing than I. My work was in engineering as senior support staff. In the type of employment I was in if you did not have a bachelor's degree you were support not professional. That is why I call anyone in medicine that does not have a 4 year degree support not professional. Hope this helps. The 3 or 4 times I have posted it is as MS KS

 
At Saturday, May 25, 2019 8:31:00 PM, Blogger Maurice Bernstein, M.D. said...

I apologize to "JR" and to "MS KS". I appreciate both of you for your contributions and I am sure the others here would say likewise. There seems, though, a bit of commonality of experiences as I try to pair both of your stories.

It is my problem having had no experiences on my two hospitalizations and also, as I may have previously mentioned, I only entered the hospitals to workup and followup on my patients there but these were relatively short time periods of hospital exposure and very limited number of my patients and even less time in the hospital with my patients as hospitalists seemingly took over. I was never part of or witnessing pathologic physician, nurses or other staff misbehavior. Can you believe it? But what I state is true and if it is true what has been repeatedly described on this thread it has truly "shocked" me. And I agree..something has to be done to bring this unethical and professionally undignified behavior to some sort of an end! ..Maurice.

 
At Sunday, May 26, 2019 12:00:00 AM, Blogger 58flyer said...

Reposting, since my last was lost.

I arrived at my urologist's practice at 330 PM Wednesday for the cystoscope. I was nervous for many reasons. For one, I knew my biopsy report would be in, and, of course, for the scoping itself. I expected the same nurse I had had in the past to call me in but it turned out to be someone else. She was a young LPN (LVN) complete with tattoos, about 23 years of age. She was nice, she introduced herself to me. She first asked me to give a urine sample in a cup and then finish in a special urinal that measures flow rate and volume. In a small exam room she took my blood pressure and found it to be 200/110. My pulse was at 115. She noted my nervousness and performed a bladder scan. She then walked me to the cystoscope room and the male RNP took over.

He proceeded with a discussion about what I was about to experience. He said that this would be nothing compared to the Urodynamics I had experienced earlier. I had a previous cystoscope about 10 to 12 years ago and it was traumatic. He said the scope would be about the size of the straight Cath I had experienced for the Urodynamics and that made me feel good as my earlier cystoscope was about the size of my pinkie finger. I undressed from the waist down, put on the procedure shorts with the opening to the front and covered up with a large paper drape he supplied. The RNP came in and administered an antibiotic injection. He then had me sit on the table, lay back and put my feet in the stirrups. Then the table was raised to a comfortable working height and he injected the lidocaine gel into my penis. Of course he told me what he was doing before he did it. He said that some of the gel would ooze out but that was fine and it would still work. There was no clamp applied this time. He covered me back up with the drape as we waited for the doctor's arrival. Soon, the doctor arrived and the TV screen was positioned so I could see what was going on. The scope was very small. I was glad the technology had advanced since my last cystoscope. The discomfort was minimal. The doctor pointed out large left and right lobes associated with BPH and then a very large ventral lobe that he referred to as Mt. Everest that was the source of my present problems. The bladder appeared clear of any other concerns. I was covered the whole time. With the scope removal, some saline fluid came out and made quite a mess. When the doctor left, the RNP remained to help me clean up and get dressed. This time it was way more comfortable than my last scoping.

Then I was escorted to a room where the doctor told me about my biopsy results. The bad news, I have prostate cancer. The good news, it was non aggressive, with a Gleeson score of 6, and confined to a very small area. He recommended active surveillance for now with a PSA test every 3 months, with a DRE every 6 months. We will address the Rezume procedure when I come back in 3 months.

I needed to go to the bathroom before I left but I had no burning sensation at all as I had after my last scoping. My only concern is that I still am seeing some blood in my urine at the start and then some really visible blood in my ejaculate after a week and a half since the biopsy. The doctor said this is normal.

I was the last patient of the day and I walked out with the doctor. We stood in the parking lot and discussed many things for the longest time. It's rare for a patient to have a casual discussion with his doctor. He then drove away in his Prius and I drove away in my Silverado.

My journey continues. Biker, you were right that it gets easier, thanks.

 
At Sunday, May 26, 2019 4:56:00 AM, Blogger Biker said...

MS KS, thank you for your comment on support staff vs professional staff. I think it is part of the problem. Physicians, PA's, NP's, and RN's with 4 year degrees and advanced certification are professional level healthcare staff. The rest are not professionals but rather people who have been trained/educated for the roles they hold, including hopefully being trained in maintaining a professional decorum.

Where calling everyone who works in healthcare from physician down to medical assistant a professional becomes part of the problem is that being a professional carries with it a certain amount of autonomy in how one goes about their jobs. Professional level roles have an independence of decision-making and judgement that non-professional roles don't have.

For patients the implications of deeming everyone a professional manifests itself in the lack of standardized protocols as concerns patient intimate exposure. Repeating two examples I've shared in the past to demonstrate this point:

1) My two identical bladder ultrasounds. The first female sonographer had me remove my pants & underwear & don a gown. She then lifted the gown fully exposing me before laying a towel over my genitals. The second female sonographer only had me unbuckle my pants and scootch them down a little. No exposure at all on that one. Each of these sonographers being deemed professional level staff allowed them to decide what the proper protocol was as regards my exposure.
2) My many cystoscopies. Every female nurse prepping me left me exposed after they were done and we waited for the doctor, and they stood right at my hip the whole time. The male nurses placed a towel over my penis while we waited for the doctor and they busied themselves elsewhere rather than maintaining eye contact. Again, being deemed professionals, they all get to decide what constitutes appropriate exposure.

Non-professional level staff should not have independent judgement as to what is appropriate when it comes to patient exposure. They should be trained to industry-wide standards so that they could be held to account for violations. Allowing them independent judgement results in a free for all with some being very lax in this regard and all being able to use the "this is how I do it" defense. These are not complex procedural matters that do not lend themselves to standards.

 
At Sunday, May 26, 2019 5:27:00 AM, Blogger Biker said...

Dr. Bernstein, it's been a long time but if I recall correctly, down below the comment box where it says "Choose an identity", by clicking on "Google Account" a box will pop up asking you to pick a name when you submit the post. I signed out of my Google Account here as an experiment to see if that works. If this post says up top it is from me, then this is correct. If not, then I've got to figure it out myself as I need to get it back. Biker

 
At Sunday, May 26, 2019 7:08:00 AM, Anonymous Anonymous said...

JR said:

MS KS,

I was wondering what had happened to you since I haven't seen your posts lately. Would you be willing to post your stories over on my website Issues4Thought.com? Also, if anyone else would be willing to post their story that would be great. I want to get a lot of stories bc I want to start getting them out there. I am chipping away a little bit at a time. Yes, we do have a lot in common. As I have said, my husband has had prostate surgery. Although there is no consideration for male patients, he did not experience any sexually inappropriate behavior during this procedure. The surgeon he went to is fairly well known but yet he did not have any male nurses/techs. It is amazing that the needs of male patients is so totally ignored. We, too, have the done the extreme power of attorney. We also have supplemented our advanced directives to specify what will be tolerated and what will not be tolerated. I would suggest that everyone does that. My husband states since he was a victim of sexual abuse at the hospital from hell, he no longer accepts female staff care when he does not have his advocate (me) present. He also states female staff no longer may be present when his genital area is exposed for any reason. He also states he refuses versed or any type of benzo., fentanyl or any type of pain medication unless I okay it and am present. He goes on to state that consent must be given by me and if I am not available by one of our children as he no longer wants them to think they have the right to do as they please to make money. He also clearly states he allows no sales reps, medical students, or observers to be present. These are a few of the items that are in the advanced care directory that we have added. The copies are always with us and also spelled out are what paramedics are allowed to do. It is a shame that our trust in the medical community is eroded so far that we feel we have to protect ourselves from further attacks. However, I know that for certain things that will not allow me to be w/ him & those are the things he will not have done. They said if he had issues during his EKG I would have to leave but he said he would have crawled out if he had to so he could get away from them. He is scared of them abusing him again even though this was a different hospital. The female tech tried to unbutton his shirt for him but he told her to stop that he wasn't incompetent. He was since been told to strip from the waist up for 3 lead EKGs. Again, it is the language they use when addressing male patients not to mention being naked from the waist up is unnecessary for the EKG. My husband too has said he will never have another cath done or anything that involves them putting him under. Even w/ the Covr, there is no guarantee they won't remove them. JR

 
At Sunday, May 26, 2019 7:09:00 AM, Anonymous Anonymous said...

JR said:


PT,

I don't find it odd that you were taken by surprise. I know when my husband had his heart attack, I was taken by surprise too. BC the experience was so unexpected & personal, I allowed them to make me a victim and didn't stop or recognize how they were victimizing him. It is difficult to play so many roles when in a crisis (medical treatment) and this is what they count on. In the future, I too plan not to let that happen again. Also, I know that as a single person, you cannot possibly stop all the abuse. Apparently we were not VIPs buth PTAs (people to abuse). As in education, I think there exists in the medical field a great bias. Some people think bc they are so educated, they are superior to others and act on it. JR

 
At Sunday, May 26, 2019 7:20:00 AM, Anonymous Anonymous said...

Dr. B.,

I am not surprised you jumped to a conclusion. Jumping to conclusions seems to be a medical thing as they thought bc my husband had a heart attack, his cholesterol was high and bc he was 20 pounds overweight, he was a diabetic. He was none of those things but they diagnosed him as being that bc of preconceived notions. I also am not surprised that you may not think our stories are "true". I do not have some mental illness that propels me into making up stories of medical sexual abuse. I know what I saw & my husband knows what he experienced. I never dreamed of this type of thing happening & especially to my husband. But if you think back and take an objective look, you may realize that needless & unnecessary exposure may have occurred on your watch. Maybe you are not the type of medical person that exposes people unnecessary but there are those who do. Maybe when you have been present you have not seen sexual abuse happening but at that I am not surprised. Very few criminals will go into a police station with their victim to rob them. The exposure of my husband in the cath. lab was unnecessary & needless as well as sexually inappropriate. They knew he was drugged & therefore took full advantage of him by not using standard protocol. They also were angry to be called in on a Sat. night & took it out on the victim of a heart attack. In the CCU, the exposure was again unnecessary & needless, but she went further than the lab did. She actually committed sexual abuse. Again, he was drugged & she knew she could get away with doing it w/o interference from him & she kept him isolated from us. When we sought medical treatment, being sexually abused was not even a thought in our minds. Sadly, we could have accepted the inappropriate exposure in the cath lab as he does not remember everything they did except they did not get his consent to treatment which is a huge issue which we do not accept as being their right. But the abuse in ccu is not at all acceptable. Although unnecessary exposure of male patients happen very frequently, the hardcore abuse may or may happen as often. I don't know but I do know it happens. Even one isolated incident of abuse needs to be stopped but it is not. It is such a secret society & the protection it offers makes things like what happened to my husband to continue to grow & multiply. Physician abuse is more likely to be discovered bc it is usually a male dr. w/ a female patient. However, for male patient the abuse is likely to be committed by a saintly female nurse/tech so therefore it is dismissed. Society tends to think that males cannot be sexually abused but rather are always the predator. That is why this type of crime is allowed to fly under the radar and will continue to do so. Refusing a female tech at a dr.s office makes no difference in the end bc the abuse during hospitalization & nursing home care will continue as is. Just as Banterings has said, pelvic exams on females in surgery is still happening even though we know it is wrong in "some" states. JR

 
At Sunday, May 26, 2019 3:35:00 PM, Blogger Maurice Bernstein, M.D. said...

OK, here is a thought to consider: Does the very first experienced "unprofessional" behavior of the doctor, nurse or the "medical business" others set the stage for looking at all further professional behavior with a more critical eye toward signs of misbehavior? Does that first experience set, in the mind of the patient, a scale with regard to analyzing (interpreting) further behaviors?

If the first experience "could not ever be a worse behavioral act" sensitize the patient to find in subsequent medical behaviors other behaviors which may not be professionally improper but the patient will interpret it as such?

On the other hand, if the patient has never found themselves a victim of medical misbehavior, wouldn't that make the average patient more tolerable and understanding of various behaviors by their doctors and others within the interaction?

As a personal example, since I never have experienced "unprofessional" behavior towards me, even prior to becoming a physician, would that affect my sensitivity or awareness of the behavior of the profession towards me in the future?

Maybe there are a host (should I say "majority" (oh!oh!) of potential patients out there who don't have a traumatic "unprofessional" experience in their medical past and despite repeatedly published news stories of "bad behaviors in medicine", consider those examples as terrible but rare and does not apply to me, as a patient. If that is the case, these patients with "benign" medical experiences will find the arguments presented by those writing here "difficult to swallow" and may provide a public barrier to execute change.

Any comments to such a conclusion? ..Maurice.

 
At Sunday, May 26, 2019 6:14:00 PM, Blogger Biker said...

Dr. Bernstein, I agree with you in part. Anyone who has had a traumatic experience, especially as a child or teen, is likely to have a permanently increased sensitivity to misbehavior or even unintentional lapses in proper protocol. They grow up to be wary because somehow somewhere the adults in healthcare violated their trust.

However, that we see certain things as professionally improper is because we have a higher expectation for healthcare staff than they have for themselves. For example we expect to be asked before an opposite gender student is brought into the room whereas most doctors and nurses think its acceptable to just bring them in and either say nothing or give a rudimentary "I hope this is OK" putting the patient who wants to say no in an awkward position. They don't think that's improper but we do. That sonographer for my 1st bladder ultrasound didn't think there was anything improper having me remove pants and underwear and then exposing me, if only briefly, but I think it was improper because as my 2nd bladder ultrasound demonstrated bladder ultrasounds don't require the patient to undress let alone be exposed. Different standards, but many patients would side with the 1st sonographer deferring to her as the "professional" who knows what's right.

Where I differ is some people are just more modest than others, and even without ever having had a traumatic experience they are going to be more sensitive to their exposure and how they are treated in healthcare settings.

I agree that what we discuss here is difficult to swallow for the majority. In that regard we are outliers. How else could nurses be voted the most trusted profession year after year if the majority felt as we do here? They wouldn't get many votes from those who post here.

 
At Sunday, May 26, 2019 6:56:00 PM, Anonymous Anonymous said...

Maurice


As perplexing as often this issue is and even without a Richter scale to judge all other events by, I will say that many are put on the defensive after the first event. Yet, when it happens time after time, when the patient is no longer a novice but rather having worked in healthcare many years, aware of patient care guidelines, taking into account knowledge of core values as well as protocols in place, state boards of nursing bylaws and physician oaths, the unprofessional behavior continues to be repeated.

To answer your question, the answer is a big resounding NO. The patient does not set themselves up for failure, rather becomes acutely aware of the unprofessional behavior, is not in the sense conditioned by the behavior but now tends to look for it. Additionally, not all unprofessional behaviors can be classified as and put in one bin. Therefore you, the patient can be continually blindsided and ambushed by it as there are a wide variety of unprofessional behavior. Quite frankly, I’ve had very very few encounters that I would consider on a scale as professional.

PT

 
At Sunday, May 26, 2019 7:12:00 PM, Anonymous Anonymous said...

Most patients think it's OK? Or maybe they/we just don't say anything! How many patients avoid care for years and years because of it?
How many patients suffering for years with fixable symptoms is OK? As far as nurses being voted the most trusted profession, who exactly is voting for them?
The rules about what is acceptable exams and procedures are voted about to , but the vast majority of the patients affected never got to vote about it !
JF

 
At Sunday, May 26, 2019 9:24:00 PM, Blogger Maurice Bernstein, M.D. said...

PT you wrote:" I’ve had very very few encounters that I would consider on a scale as professional."

Can you and the others writing to this thread then present a list of patient or surrogate looked for and acceptable behavior by physicians and others involved in interacting with patients within the medical system? The behavior still has to allow for appropriate diagnosis, treatment and overall care based on valid current research medical-surgical standards. What I am asking for is WHAT BEHAVIOR IS NOT CONSIDERED MISBEHAVIOR?

I will start out with:

OBTAINING FULLY DETAILED INFORMED CONSENT FROM THE PATIENT OR PATIENT'S LEGAL SURROGATE. THIS CONSENT MUST OCCUR AFTER PERTINENT INFORMATION AND DISCUSSION PROVIDED BY THE PHYSICIAN OR MEMBERS OF THE PATIENT'S CARE TEAM WITH THE PATIENT OR SURROGATE. (CONSENT IS ASSUMED IN A LIFE THREATENING EMERGENCY WHEN THE PATIENT IS UNABLE TO COMMUNICATE AND NO SURROGATE IS PRESENT.)
If this is carried out, I would say this described act should NOT be considered MISBEHAVIOR. It should be classified as "professionally proper behavior". What might be some other example of actions you could classify as "professionally proper behavior"? These could be teaching points for first and second year medical students regarding what is proper professional behavior toward patients and their families...Maurice.

 
At Sunday, May 26, 2019 10:30:00 PM, Anonymous Anonymous said...

Biker
I've only heard one person that I personally know tell of being ambushed by med students but it was an absolutely HORRIBLE ambush! She was my best friend and she was having her first baby. She was naked with her feet in the stirrups when the door opened up and the doctor with his group of med students came in.
She had not be consulted about it. The doctor examined her then he said " Next "
She found her voice at that point and said " No".
She was NOT OK with it and always brought somebody with her after that.
I don't think a lot of women would be OK with that. I don't know if I would survive something like that! I would rather die than to go through something like that.
JF

 
At Sunday, May 26, 2019 11:25:00 PM, Blogger 58flyer said...

Biker says,
"Professional level roles have an independence of decision-making and judgement that non-professional roles don't have."

"Each of these sonographers being deemed professional level staff allowed them to decide what the proper protocol was as regards my exposure."

"Again, being deemed professionals, they all get to decide what constitutes appropriate exposure."

Do you think that professional staff should have the latitude to decide for themselves as to the degree of exposure rather than comply with a recognized standard? I would think that being professionals they should be held to a higher standard and more aggressively sanctioned for violations of protocols, if such protocols even exist.

My being a pilot I can give an analogy. Say a pilot holding a Recreational Pilot license commits an airspace violation. Then the same violation is committed by a pilot holding an Airline Transport Pilot license. Who do you think the FAA will come down harder on? The professional pilot, they are held to a higher standard.

58flyer

 
At Monday, May 27, 2019 4:58:00 AM, Blogger Biker said...

Dr. Bernstein, it is all definitional. Before getting into specifics, I will pose a question. You said everything was professionally appropriate as concerns your urodynamics study which was performed by a young woman. If it is professionally appropriate for urology practices to only hire female staff for such things, would it not also be professionally appropriate for radiology to hire male mammographers? Why does healthcare deem one professionally appropriate but not the other? Either medicine is gender neutral or it isn't. By their actions they fairly well shout that they know it is not gender neutral.

Informed consent such as you describe is the way it should be, but again there isn't a working definition behind what informed consent is. When I made my appt. for my 1st ever dermatology exam, I was not told that their standard protocol was for a female LPN and female scribe to observe the exam. I posit that was not informed consent.

Examples of professionally appropriate behavior includes:
- Identify the gender and educational status of student observers (when there will be intimate exposure) before they enter the room, and obtain consent for their presence.
- Knock on the door and wait a few seconds for a response saying it is OK to enter the room rather than be opening the door as you knock.
- Inform patients upfront if chaperones will be present for intimate exams or procedures. Don't disguise chaperones as "assistants" when in fact they are not there to actively assist.
- Similarly, do not allow any staff not necessary to the procedure to be present for intimate exposure without first getting patient consent.
- Close the door, pull the curtain, allow patients to dress/undress in private.
- After cystoscopy prep is complete, cover the penis until the doctor is ready to start.
- Do not expose the patient and then wander around the room gathering supplies or readying yourself. Be fully ready to start before the patient is exposed.
- Inform patients upfront if a scribe will be present, the gender of the scribe, and whether the scribe will be observing intimate exposure (vs being positioned so as to not have visual access). Better yet, automatically position scribes so that they do not have visual intimate access.
- For surgeries, inform the patient if they will be catheterized. All observers (student, vendor, or otherwise) should be introduced to the patient in pre-op and consent obtained.
- For patients wearing only a gown, cover the patient with a sheet before lifting the gown from under it to observe the abdomen or areas above. When done allow the patient to put the gown back in place under the sheet.
- When male staff are available, ask the patient if they have a gender preference for things like bathing/showering, voiding, catheters, or other intimate exposure. This can be handled upon admittance and just made part of the patient record. Then make every attempt to honor the choices made.
- For cardiac cath groin shaves, do one side at a time, keeping the genitals covered. Same for disinfecting the groin area and cleaning up after the procedure.
- Tell patients that "conscious sedation" is an amnesiac rather than making believe the patient is really awake throughout the procedure. If I have no memory of it, then I wasn't awake. Don't tell them it is to help them relax when that isn't it's purpose. If you lie to me about that what else are you lying to me about?
- If you are going to touch the patient or expose the patient tell them what you are going to do before you do it.

I doubt much of the above is even on the radar for what most in healthcare think of when thinking about what is professionally appropriate. Therein lies the problem.

 
At Monday, May 27, 2019 6:18:00 AM, Anonymous Anonymous said...

JR said:

Before this encounter w/ the hospital from hell, we did assert our patient rights. My husband tolerated female care w/o any issue. He did not necessarily like it but there wasn't much choice as far as he and I thought. Yes, he did not always have his personal dignity respected but he thought they were mostly cold, callous, and uncompassionate and didn't care about patients as being people. He never felt sexually violated nor was we aware that sexual violations happened to males although looking back, we should have been better aware. I have had a couple of male drs. that made me uncomfortable (but no obvious sexual violations) and I did not see them again. The one dr's son was actually a friend of my younger half-brother, and later I did find out he had quiet the reputation. He was a married, catholic dr. who didn't mind cheating on his long suffering wife so my gut feeling about him was probably justified. He remained quiet about these attacks on his personal dignity as most males do. Me, however, I would speak up no matter what. I pay those people and demand they treat me w/ respect & I in turn will reciprocate. It is no different than a transaction at a restaurant or store. Customer service is a priority. If I am treated politely and fairly I have no complaints. I have in the past complemented a few nurses/techs to the higher ups for their excellent customer service. I have also brought to the higher ups bad customer service issues.

I am glad we are in agreement about Informed Consent. However, there needs to be more to that. I have prepared a additions to the consent form used by the hospital from hell (their name is marked out). If you would like a copy of what additions or clarifications I have made to make the form more patient-friendly, I would be happy to email it to you. Also, along the consent line, if patients are given any drugs beforehand which have the capability of clouding their judgment, these drugs must be noted. In my husband's case, the massive amount of fentanyl was not noted. Also, the time line for the administering of more fentanyl & versed was skewed as the consent was supposedly given within the same minute of documentation. He clearly was prepped prior for a procedure that consent was not yet given for. The consent should be recorded and/or time stamped to rule out human tampering once it is realized consent was not given or properly given. The patient should have a family member present when consent is given. The only way consent should be signed by medical staff only is when a patient is unconscious and their is not family available. However, documentation should be given that every effort has been made to contact family for consent. These encounters should also be recorded. JR

 
At Monday, May 27, 2019 6:32:00 AM, Anonymous Anonymous said...

JR said:

Medical records should be a true accounting of what happened. They should not be manipulated so lack of, inferior, or mistakes in treatment can be hidden. If a patient tells information such as issues w/ certain drugs, refusal of certain drugs, side effects from certain drugs, etc. things MUST be listed. It is not the right of the medical provider to give drugs to a patient they have refused to take. It is also negligent of a medical provider to ignore what a patient says in order to give them the drugs of the dr.'s choice which may in turn earn them a kickback from a drug company. Many have voice recordings of patient/medical interactions to help control some of the outright falsifications of medical records. Patients should be given a copy of these recordings if requested.

There needs to be and should be standard protocol when dealing w/ patient exposure. NO patient should be exposed unnecessarily. Covr garments or similar garments should be given to patients. For female patients, garments for the upper torso should also be given. ALL patients should be offered gowns. The language in telling a patient to undress should be closely monitored. NO patient should be told to STRIP! Men should not have to disrobe from the waist up for an EKG when female patients do not. Male patients should not be expected to do an exercise EKG shirtless when female patients do not. Male patients should have access to male medical personnel for intimate procedures as do females. There should not be tag team chaperones of the opposite sex for patients. The chaperones are only there to protect the provider against sexual inappropriateness charges not do not actually protect the patient against them happening. Most medical providers will turn a blind eye and if confronted will protect the medical predator. Doctor's should be training their staff on how to properly deal w/ patient exposure. There needs to be guidelines. Patients should also be aware of what those guidelines are so they too can be proactive. If more patients knew what is acceptable exposure, there would be more complaints. I think most people assume what is done is correct and they must suffer through it for the sake of getting medical treatment. JR

 
At Monday, May 27, 2019 7:08:00 AM, Anonymous Anonymous said...

If a woman is giving birth it's ok to depants her. Just provide privacy. If a patient has been incontinent and can't clean themselves up, shut doors. pull curtains and clean them up. If your patient is a healthcare provider who has needlessly exposed and humilated patients, strip them and bring a TV crew into the room!
JF.

 
At Monday, May 27, 2019 7:14:00 AM, Anonymous Anonymous said...

JR said:

Yes, we are more defensive after what has happened. As w/ any victim of sexual assault, you never forget it. A woman who has been raped will pay attention to dark places, make sure her doors are locked, will rarely walk alone after dark, etc. Does it not make sense for a victim of medical sexual abuse to also take precautions. As I have said, we did not go to the hospital that night to become victims. Maybe bc we weren't expecting it is why it happened--I don't know. But I do know that from now going forward, we will be watching. As I have said, both of us have experienced unprofessional behavior in the past. My husband more than me bc he is a male. I speak up when it happens--he didn't. Male patients are left exposed more than female patients bc females are more likely to be reactive. However, the exposure was during what he considered procedures on the area. His genital area was not left exposed while they were doing work on his sinus area. This was different. He was left completely naked for extended periods of time in the cath lab for no apparent reason except they could get away with it. He was left completely exposed in his patient room for no apparent reason w/ a crowd, made to urinate in front of the crowd & be cleaned like a baby. He was done this way for over 5 hours. There was unexplained constant laughter (again, he was drugged) & what was the nurse(s) really doing as the MRs weren’t recorded during this time. The only time the sexually abusive nurse covered him was when I was in there. Immediately after I left, she uncovered him again. When I was in there, he could open his eyes, nod his head, & say yes/no to questions but offered nothing else. He didn't move his hands or arms on his own. He was completely wiped out by the mass amounts of drugs. He was in the dream cycle of sleep as is the signature of versed. Even though he had put up w/ females exposing him during intimate procedures in the past, this encounter changed everything. There was no need for it. He now realizes the procedures of the past should have been more proactive in not exposing him too.

All staff should be professional in their jobs whether they went to a college or a tech school. It is the responsibility of the office (be it the dr. or an office manager) to make certain that all staff follow the same patient-friendly guidelines. Bc a person went to a college does not make them smarter or more able to work independently than a person who didn't. I have met many people during my years as a labor rep and educator who have college degrees and have absolutely no common sense. I have worked w/ teachers who have masters who really are not qualified to be teachers but hold a license. An aide in a school system is expected to follow the same rules as a teacher & there were no exceptions . We weren't allowed to hit, curse, or do anything that would end up on the nightly news. If the medical community would be more serious, they too could do better. While it might be true we are outliers, it is only bc we speak up. I feel more things happen & people just don't speak up bc they feel it’s part of the horrible road they must go down to get medical treatment. Many are also scared they will be put on a secret list so they cannot get medical treatment. Many also will choose not to seek medical treatment. Many are also okay w/ the treatment they receive & some of those are only okay w/ it bc they don't really think about it once they leave the building.

To add to my 1st post, drugging the patient to make them unable to communicate is not okay. It seems that is what they did to my husband as he told them what drugs like fentanyl did to him & they chose not to note that. They also knew that he was not in agreement w/ having a procedure done w/o more info for him & I so they drugged him w/o his permission or knowledge, isolated him from me, made no note on his chart about the drugging him and said he was alert and willing. JR

 
At Monday, May 27, 2019 11:30:00 AM, Blogger Biker said...

58flyer, my apologies for not being more clear but your interpretation is not what I meant.

Non-professionals by my definition are the overwhelming majority of people who work in healthcare. I limit professional status to physicians, PA's, NP's and RN's with 4 year degrees and advanced certifications. What I was trying to say is that the non-professionals should not be empowered to decide what they think is appropriate patient intimate exposure in all its forms (what is exposed, for how long, and to whom). "This is how I do it" should not be an option or a defense. Non-professionals should be operating within established industry norms and expectations. The problem even then is that there is little in the way of industry norms and expectations when it comes to patient exposure. Vague phrases such as "ensure patient privacy" allow all of those non-professionals to then decide what that means. The result is the huge difference in how my two bladder ultrasounds were done.

I agree that professional level staff should be held to a higher standard in most regards, but as a professional they have earned some discretion in determining what and how they do things. Even then they still need to be accountable for adhering to established best practices. For example a physician should have discretion as to who they want to have in the room during a patient exam or procedure, subject to a standard that says they need to obtain patient consent beforehand. Professional level staff violating a patient's intimate privacy should be a graver offense than a medical asst. doing the same thing. This is simply because as a professional they should know better. The MA might instead be deemed in need of more training.

As an aside, sorry about the prostate cancer diagnosis. For the many visits and monitoring exams you'll have going forward it is good you are established with a practice that was willing to meet your needs. I did notice that the male who prepped you covered you up while you waited for the doctor, same as occurs for me. I wonder why the females who prep male patients don't do that.
Believe I know very well from my corporate career the "higher standard" expectation that comes with being a higher status employee.

 
At Monday, May 27, 2019 12:23:00 PM, Anonymous Anonymous said...

JR said:

58flyer,

Some very good points. I think the protocols should be standardized so patients would know what to expect as far as how service is delivered. All persons doing any job should act in a professional manner whether they are a dr., a nurse, an orderly, or janitor.

Biker,

Some very good points, too. Even before pre-op, the patient should be informed if any of those people are going to be in attendance. As soon as they know who, the patient should be informed. If it is at pre-op, then all this must be done before any pre-op drugs are administered. It is strange as the cardiac cath shave is not really necessary if a man is not excessively hairy. Also, the shave is done one side at a time anyhow so why the exposure in the first place? As w/ this procedure and others, the Covr or a similar garment is what should be standard usage. Good points about the conscious sedation. The literature about it just glosses over it & makes you believe you are fully awake when you are usually not. The only reason my husband has so much memory is the drugs worked against one another this time. For him, they gave way too much especially since he wanted none. It is true there is a bias in care but I suspect nurses had a lot to do w/ how L&D, mammograms are done.

No patient should have their clothes removed by staff w/o asking permission and covering them properly before removal. Also, the patient should be given the chance to remove them on their own except when necessitated by gross injury.

Patient advocates should become more standard in usage. The advocate should be someone of the patient's choosing who knows what is expected & agrees to it. There could be special areas in the OR for the advocates just as when a woman has a C-section & the father is present. Recovery rooms should also accommodate the advocates. Transfer to the patient room should be done w/ an advocate present. Purposeful isolation of the patient should not happen unless there is a special circumstance which all is aware of.

If a patient or family member does not someone for whatever reason to be involved in care, that person should be immediately removed.

Medical staff must stop treating their clients as irresponsible step-children. We are adults & ultimately are responsible for our healthcare choices. Medical staff are advisers & then may perform the procedure but they are not in total charge of individuals. Address & talk to the client as you wish to be addressed which is probably in a respectful, polite, informative, and not condescending manner. JR

 
At Monday, May 27, 2019 3:07:00 PM, Anonymous F68.10 said...

Hi. Took some time to come back on this blog. I've been busy elsewhere on the Internet.

I'd recommend a searchable website. Not a blog. Linking back and forth to twitter is fine. I'd also recommend structuring the data in a format that can be data-mined, for example with the R programming language. Set a web page like this one too, to enforce good scientific practices:

http://www.scilogs.fr/ramus-meninges/you-are-welcome-to-use-my-data-after-preregistration/

Then engage researchers and academics publicly to name and shame them into using this data in their work.

 
At Monday, May 27, 2019 3:44:00 PM, Anonymous Anonymous said...

Maurice

My advice would be for your female med students to fly to Europe when they need a mammogram. I’m told there are a few male mammographers there. If not tell them to look up this word in Merrian-Webster “ hypocrite”.

PT

 
At Monday, May 27, 2019 3:45:00 PM, Anonymous Medical Patient Modesty said...

JR


Here's response to your paragraph below:

Each of us could start writing down some of the things we would like to change. We need a place to send those things so we could comply them and work on the them--maybe a website. We also could do hospital ratings on dignity issues so people could check out before using that hospital or doctor? There are endless possibilities. JR (My first name is Jeane & I have been a victim and have witnessed dignity & respect abuses. I remember when I was 11 years old, I had bronchitis & my dad took me to a male doctor that I did not know. He told me to strip from the waist up while my dad & he were in the room. There was no gown. I was a girl who had developed. My dad looked away but I was mortified. I did not know at the time this was sexual abuse but I knew it was wrong. I did not need to be completely exposed for him to listen to my lungs. This doctor had the same last name as I do (no my husband & I do not have the same last name). Whenever people ask me if we are related, I shock them w/ the venom of my tone & saying that I hope that man is rotting in hell but after I explain they too have their story. Sad thing is though, as adults we still suffer from the same abuses.) JR


Jeane,

I wanted to let you know I have been in touch with CNN and they are interested in helping me to raise awareness about patient modesty issues. In fact, two men who submitted their modesty violations on this web page are willing to talk about their experiences publicly.

You should contact me via email to talk about this further.

I actually have a patient friendly doctors database. It’s small at this time. There is one problem with doing ratings for a hospital is that one department may be very sensitive to patient modesty while another department is terrible. I know this is true of some hospitals especially bigger hospitals.

I am sorry to hear about your experience with that male doctor.

Misty

 
At Monday, May 27, 2019 6:52:00 PM, Blogger A. Banterings said...

Maurice,

Let us look at sexual assault statistics:

One in five women and one in 71 men will be raped at some point in their lives
In the U.S., one in three women and one in six men experienced some form of contact sexual violence in their lifetime
51.1% of female victims of rape reported being raped by an intimate partner and 40.8% by an acquaintance
52.4% of male victims report being raped by an acquaintance and 15.1% by a stranger

81% of women and 35% of men report significant short- or long-term impacts such as Post-Traumatic Stress Disorder (PTSD)

Source: The National Sexual Violence Resource Center

The litmus test for what is assault is to take the same situation out of the healthcare environment and put it in a motel room.

In healthcare, either you are part of the solution or you are part of the problem.

That being said, every provider is judged on every experience that the patient has had before you. Again, either you are part of the solution or you are part of the problem.


Finally, you have patients that have been hospitalized, have you ever asked your patients about their hospitalization experience?

In teaching your students about medical ethics and patient dignity, have you ever asked about their experiences in healthcare?

I can NOT believe that all of your patients and all of your students have never had a bad experience in healthcare.






-- Banterings

 
At Monday, May 27, 2019 6:57:00 PM, Blogger Maurice Bernstein, M.D. said...

From Patient Modesty Volume 22. It is a story written by a second year medical student Asrei Beyewitz in Pulse, a medical humanities publication of the Albert Einstein School of Medicine in New York. ..Maurice

Looking for Respect

Ashrei Bayewitz


This may sound strange, but I secretly looked forward to my colonoscopy.

I was excited to see the people in the colonoscopy suite--the receptionists, the nurses and my doctor. I knew that they would like me, because I would be brave and respectful. That's what's always happened since I was diagnosed with Crohn's Disease ten years ago. During my multiple colonoscopies and countless doctor visits and other outpatient procedures, I invariably build up a rapport with someone, be it a doctor, nurse or staff member. I've always been a good patient, and now that I'm a second-year medical student as well, I can understand their work a little better. I expect them to sense my goodwill and to treat me in turn with respect and caring.

This appointment got off to a good start: The woman who registered me seemed nice and appreciated my interest in the pictures decorating her cubicle wall. And I wasn't just being polite--I really did like those black-and-white photos of old TV and film stars. She even had The Honeymooners up there! I also got along well with the first nurse--we shared a laugh about the trouble I'd had finding a quarter to pay for my locker.

But a few minutes later, my interview with the intake nurse took me aback. Staring at her computer screen, she recited a series of questions. Seated facing away from her in a gigantic reclining chair that seemed cemented in place, I couldn't turn around far enough to catch her eye. The nurse's lifeless, monotonous tones conveyed zero interest in who I was or what I had to say. I'd never felt so unimportant.

CONTINUED ON NEXT POST.

 
At Monday, May 27, 2019 7:04:00 PM, Blogger Maurice Bernstein, M.D. said...


To make matters worse, people kept interrupting us. The first time it happened, I thought that something serious must be happening--maybe a patient was having difficulties, or the computer system had crashed.

No. It was lunch time. They needed to coordinate their take-out orders, and my nurse, it became clear, was the lunch organizer.

Sometimes coworkers called her out of the room (but not out of earshot); other times they conversed right in front of me. Eventually I got so used to it that I began letting her know when someone was waiting for her.

Still, I felt stung at receiving so little respect. Was I invisible? Couldn't their lunch plans wait a few minutes? Nevertheless, I swallowed my pride, reminding myself that healthcare professionals are people too, with needs of their own. Maybe my nurse had found that distancing herself from patients helped her to do a better job. When she expertly inserted my IV line, I felt I'd taken the right attitude. Our relationship wasn't very satisfying, but at least she had technical skills.

Soon I was called to the procedure room and introduced to my next nurse, who would actually assist with the colonoscopy. She seemed down-to-earth and likable, but that's when things really started to go wrong.

For one thing, she'd forgotten to put a bed in the procedure room. Then, when she did bring it in, she had me lie on it facing the wrong way. After we'd fixed these details, I heard someone down the hall talking excitedly about a "scholar." There must be some talented pre-med students shadowing the doctors that day, I surmised. Feeling a sense of kinship with them, and renewed self-confidence, I hoped that they would stop by my room.

When my nurse brought in the student, I waited eagerly for her to introduce us. Instead, she started helping the young woman to put on scrubs. And while that was happening, I learned that this "pre-med" student was actually a ninth-grader.

My pulse quickened, and my mind raced. Was I some animal in a zoo for children to gawk at? I was having a colonoscopy--the procedure where they stick a tube up your rear end. Couldn't they ask my permission before inviting a spectator?

Struggling to sound calm, I asked, "Does my doctor know that a student will be watching my procedure?"

My nurse didn't seem too pleased: I'd breached the unofficial patient's code of conduct. She blinked and said, "This is a teaching hospital," adding that patients should expect to be observed.

CONTINUED ON NEXT POSTING

 
At Monday, May 27, 2019 7:06:00 PM, Blogger A. Banterings said...

This is NOT a pitch for a commercial product. It is a relevant story reported on the Everyday Health website.

No Need to Go Naked: New Medical Garment Provides COVR for Patients




-- Banterings




 
At Monday, May 27, 2019 7:09:00 PM, Blogger Maurice Bernstein, M.D. said...


I knew that this was utter nonsense. As a patient and a medical student, I care deeply about the principle that a patient's dignity should be respected at all times. I felt ready to fight for this.

"It's probably okay," I said, "but it would have been nice if you'd asked me first."

"Patients can always refuse being observed if they wish," she retorted, contradicting her earlier statement.

All I wanted was an apology and an acknowledgment that they weren't allowed to coerce or take advantage of me. After some more back-and-forth, my nurse conceded her mistake. But the whole exchange left a bad taste in my mouth.

When my doctor came in and learned what had happened, he told me that I was under no obligation to be observed. Before I'd even finished nodding, the student was taking off her scrubs; a few moments later, she was gone.

Ironically, I still liked the nurse. I felt sorry for her that she'd been making mistakes, and I appreciated that she'd apologized for them. And when she started telling me about herself, I liked her even more.

She'd had a lot of experience in surgery, she confided, but was still fairly new to the colonoscopy suite. She'd felt that she had to let the student observe because her boss had requested it. Although it didn't excuse what she'd done, I appreciated her candor. It was as if we were meeting for the first time.

An hour or two later, I was waking up in the recovery area. Looking across the hallway, which looked blurry to me without my glasses, I saw someone walk by with a friendly wave and a smile. I can't say for sure, but I think I know who it was.


Sound familiar? ..Maurice.

 
At Monday, May 27, 2019 7:19:00 PM, Blogger Maurice Bernstein, M.D. said...

Hopefully this link to the

Volume 22 will work. ..Maurice.

 
At Monday, May 27, 2019 8:58:00 PM, Anonymous Anonymous said...

Misty

You know, it’s kind of a joke really. I mean to list gender friendly doctors in the United States and on your website you have one urologist in the entire United States for men. Let’s think about this, at first he agreed but someone in his office reniged but after some banter then he agreed. Do you know how insurance works? There is something called in-network services and the bottom line is that anyone traveling to him will be paying the full amount in cash. How Fu$king pathetic.

We have a system that racks in $4 Trillion dollars a year and this is what we get. The bimbo I experienced at the urologist office didn’t know how to take a proper blood pressure and didn’t have the decency to knock on the door to the exam room. Why do men have to put up with this Bullshit? Wether you know it or not listing this one urologist just actually shows how ridiculous this whole system is. I hope someone can show this crap to CNN and if they present it or not who knows.

Every news organization could be instrumental in helping correct a lot of wrongs in the healthcare industry but I also believe that Medicare should be the agency to step in and say to every male urologist to hire male medical assistants or we are withholding payment.


PT

 
At Monday, May 27, 2019 9:55:00 PM, Anonymous Anonymous said...

JR
13 years ago my wife and I did a little experiment . We called about a dozen urology , GI , and imaging department at different hospitals and asked if they employed male techs/nurses and if you could ask to have one assigned . Only two said yes with both employing 2 or more males in each department . 10 had none . Why did we do this . We figured it would give us a inside look into the culture of that institution . What did these 2 institutions do to find males for their departments that the others couldn't . We all know the answer to that question . We also looked into their Patient Bill of Rights . One had in their bill of rights " that the patient has the right to refuse care from any person and for any reason ." Little did we know that a year later we would find out if they lived up to their bill of rights while my wife was undergoing treatment for cancer . AL

 
At Monday, May 27, 2019 10:41:00 PM, Blogger 58flyer said...

Misty,
Great job on getting CNN interested. I think it is a great start. While female issues are important, the male issues are equally important.
Biker,
Thanks for the clarification. The need for standardization is an absolute must.

All,
One of the conversations I had with my doctor last Wednesday is that most healthcare facilities are owned by a corporate conglomerate. That is the case with my primary care practice as well as with my urologist practice. My urologist informed me that only about 10 % of healthcare dollars go to the physician, by comparison NFL players get like 50% of ticket sales and merchandize sales. My family practice group is owned by business investors, one of whom is a lawyer. So basically doctors are told by businessmen and lawyers how to practice medicine. That is a huge part of the problem that we have to address. Again, it is going to take legislation to make healthcare right to all.

58flyer

 
At Tuesday, May 28, 2019 4:19:00 AM, Blogger Biker said...

I had noted it previously but in light of that med student colonoscopy story Dr. Bernstein posted, I will note again that his encountering a 9th grade girl shadowing the doctor was not an isolated event.

I had shared this story before but my wife told me about a young woman she met who recounted her experience in 9th grade observing a hip replacement surgery at the local hospital. She said the doctor's name. I looked him up and yes he was an orthopedic surgeon. When I contacted Patient Relations at the hospital to inquire about their policies I learned that there weren't any beyond students must wear badges that say they are students and that patients can refuse their presence. I could not otherwise get a straight answer to questions that included "Is it made clear to the patient what the educational status is, in this case that she was in 9th grade rather than allowing the patient to just assume she was in med school?" and "For OR observations, is the student introduced to the patient and consent requested for their presence or is the sign off on the general consent form in which the word student is buried on page 2 taken as the patient consenting to a 9th grader observing". That I couldn't get straight answers affirmed for me that patients there are unawares that they having kids as young as 14 observing their surgeries if the doctor doesn't think it is important enough to get real informed consent.

That was one of the reasons I moved all of my healthcare to a very large (by Northern New England standards, 400 beds) teaching hospital in NH.

I wonder how many male patients having colonoscopies that day had this young girl observing them. I wonder if any of the nurses "adjusted" the patient's gown before or after the procedure exposing him to the girl.

Just how common it is for high school kids to be observers in medical settings I don't know, but as patients we should not be afraid to ask just how young they are because that kid that looks like she is 14 might in fact be 14. My understanding is that the high school kids who get to be observers are typically kids who have connections; the children, relatives, family friends, or neighbors of doctors.

 
At Tuesday, May 28, 2019 5:45:00 AM, Anonymous Anonymous said...

JR said:

Misty,

I will contact you later this afternoon. Great Job!!!!

58flyer,

The hospital from hell is in 3 states. They now have mini hospitals all over the place and are taking over more smaller rural hospitals. Most of their practices like cardiology is owned by them but is listed as being separate but in reality are not. The lesser drs. get to go to the more rural communities & are the ones on call for emergencies like for my husband. That dr. did not have the experience they cite a interventionist needs but they are able to fly solo on unsuspecting patients & thus gain experience while maybe committing more harm than good. As I said, the urologist my husband went to is fairly famous for his procedure. He sees mostly prostate cancer men but he had no males on his staff. We flew to see him & insurance covered his operation. Make sure you do your research before agreeing to any type of treatment. There are a lot of prostate boards out there that I visited for info for my husband. He had surgery but no other treatment. It has been 13 years. What they say is often not what is reality.

AL,

It is a shame that the medical tech field & nursing is so discriminatory. There needs to be a government mandate to hire more males. That is the only way to break down the doors of this type of bias. I have read articles on male nurses who talk about the ordeals that have to go through in nursing school to become a nurse. As I have said before, industries such as nursing & education which are primarily women, is a cut throat atmosphere.

Banterings,

My husband, at 67 years old, became one of those sexual assault victims. Who would have thought as he laid having a heart attack that he would be victimized? However, it is viewed as okay as long as they stick an IV or 4 in his arms & are able to "cure" him to send him home. Anything goes when in the hospital. JR

 
At Tuesday, May 28, 2019 9:05:00 AM, Blogger Maurice Bernstein, M.D. said...

Speaking of being a VIP in the matter of medical care:
https://www.kevinmd.com/blog/2019/05/physician-patients-shouldnt-be-special.html ..Maurice.

 
At Tuesday, May 28, 2019 1:14:00 PM, Anonymous Anonymous said...

JR,
I will try to respond to your request on your site. We are both going through some issues right now so may be a week or two. We will always use the MS KS as our identifier. Thank you for taking up the cause. I do think it will take more wives or significant others to help men in this fight. Females in the support roles always have a come back to make men feel they are in the wrong for wanting not to be exposed to them. I will do all I can to stand up for my best half. Medicical support staff need to realize and acknowledge that family need and want to be advocates for our loved ones. MS KS

 
At Tuesday, May 28, 2019 4:54:00 PM, Anonymous Anonymous said...

What does that exactly mean , that doctors only get 10%? The nurses and CNA's and cooks, housekeepers, maintenance workers, x ray technology.....employees are paid also. Is that what was meant by that?
Or is it like our patients at Assisted Living paying $60 dollars for one shower? Is it like our patients paying the price of a nutritional supplement times 25?
Who is getting the extra profits and why?
I know hospital and clinics have to pay gas water and electricity. If an air conditioner breaks down it has to be repaired.
Bills should be explained. Accountability for WHO gets paid what and WHY!
Also let it be investigated whether or not patient death or injury has occurred because of extortion.
If it turns out to be the case let the extortioners face prison.
JF

 
At Tuesday, May 28, 2019 5:02:00 PM, Blogger NTT said...

Good Evening:

Healthcare in America has gotten so big, they truly believe themselves to be untouchable. They’re their own entity who feels they should police themselves without any outside interference from any & all state or federal entities.

They make their own rules (which by the way, are structured so they can do things whichever way is easiest for them not the patient), & if a state or government entity tries to legislate anything that will directly affect their way of doing things they send out their lobbying wing which so far in the end has convinced all entities that their way is best. How do they do that you ask, with money. They call it campaign contributions. In their terminology, it’s like they are shooting antibiotics at a disease & the disease being federal & state oversight.

Next, they rely on their extensive public relations arm to continually snowball the general public into thinking they are the next best thing after mom & apple pie.

For decades they have snowballed the public into thinking they & only they know what’s best for each & every one of us. They are the “professionals”.

The only time this scenario doesn’t play out is when one of their own commits a crime & they cannot buy the silence of the victim & the story goes public via the major news services.

At that point the PR arm goes to work snowballing the general public that things are as bad as the news services are making it out to be.

If the perp isn’t a doctor & the victim didn’t die, the perp is quietly given a vacation until things quiet down they brought back & transferred to another area in the facility & life goes on. If it’s a doctor & the accusation is true, he’s left to out to dry so as to limit the damage done to the facility’s good name. Most medical boards let these perps keep their license. That has to stop. All boards should have a civilian majority. If the medical people on the board are so sure the perp should keep their license, let them convince the civilian majority to vote their way. If medical boards are allowed to keep a medical majority then 99 times out of 100, the perp will keep their license even though they shouldn’t.

There also needs to be created a national medical DO NOT HIRE list.

ANY healthcare worker convicted of a crime against a patient, would be required to add their name on this list so as to stop said worker from going to another state & starting all over again possibly ruining more lives than they already have. All healthcare facilities will be required to check this list before hiring any healthcare worker. We MUST do better at protecting the public from these pervs.

Healthcare today suffers from a loss of ethics, morals, empathy, & compassion. The underlying case to those losses is pure & simple GREED.

Those that say that it hasn’t, have lost touch with the pulse of the beast because they are no longer in the trenches practicing medicine. That would be people like med school teachers, AMA executives, Secretary of HHS, CMS administrator.

Things will not change until the ship is righted & it cannot be righted without first dropping the veil of secrecy that’s been hanging over the industry for decades & embrace total & complete open transparency going forward.

New rules & protocols have to be made with the public’s input & then set in stone with harsh no choice consequences for violating them. It’s the only way to clean up the system.

You have doctors violating female patients, female nurses & techs are violating male patients, & nurses are stealing drugs that are meant for patients all this is going on daily in today’s medical facilities.

These are people that the system DOES NOT NEED. Stop holding their hands & giving them chance after chance. GET RID of THEM!

Congressional mandates are needed to fix the system. I urge everyone to put pressure on your federal legislators to ignore the medical lobby & do the WILL of THE PEOPLE or don't bother running for ofc again.

Regards,
NTT

 
At Tuesday, May 28, 2019 8:40:00 PM, Blogger Maurice Bernstein, M.D. said...

NTT, I agree. The legislators should attend to fix the defects in the medical system and pay less concern to the legislators' own re-elections, the latter seems to be their main concern. ..Maurice.

 
At Tuesday, May 28, 2019 10:25:00 PM, Blogger 58flyer said...

Biker Says,
Dr. Bernstein, it is all definitional. Before getting into specifics, I will pose a question. You said everything was professionally appropriate as concerns your urodynamics study which was performed by a young woman. If it is professionally appropriate for urology practices to only hire female staff for such things, would it not also be professionally appropriate for radiology to hire male mammographers? Why does healthcare deem one professionally appropriate but not the other? Either medicine is gender neutral or it isn't. By their actions they fairly well shout that they know it is not gender neutral.

Women are much more vocal about their feelings, in this example, they would vote with their feet, just walk out. Men, on the other hand, just accept the situation and then come away with the attitude of "never again" and then live with problems until it is stage 4.

As to walking out, the mammography clinic will see a declining number of patients seeking their services. That results in less $ for the clinic and a change is made to accommodate the patient's preferences. They hire female staff and fire the males. Problem fixed.

The problem for men is the lack of male medical personnel and/or perhaps the refusal of management to recognize there is a problem. Another problem is the general shortage of doctors in our society. Doctor's offices and clinics can fill their waiting rooms with patients even though many more men would come forward for treatment if accommodations were made for the gender imbalance. As long as the schedule is full, why make a change? It really comes down to there being no incentive for change as long as the waiting room is full.

But, if men voted with their feet and there appeared large gaps in the schedule where there were no paying patients, and therefore no income, that would get the attention of the medical community. Problem is, men just accept the gender imbalance and go along with it, despite finding the situation disgusting. They see no other way. Just go in, get it done, and move on.

But what of those men who find the situation intolerable, who go in for that first scoping, and come away with the attitude of, "never again." Simply enough, they die at an early age. Of course you hear all the typical talk about why men don't go to the doctor, which is really a farce, no one wants to confront the REAL reason men avoid the doctor. That, as we all have discussed here, the gender imbalance.

I discussed this once with a urologist. The fact is that as long as there is no FINANCIAL reason for change, there will be no change. In the present, enough men fill the waiting rooms so there is no incentive to change. Going forward, there will always be enough men to fill the schedule so nothing will change.

That's why I propose that only legislation will fix the problem. Make it so urology practices cannot stay in business unless they comply. Nothing will change until it affects the bottom line. Sorry it has come to that.

58flyer

 
At Wednesday, May 29, 2019 4:48:00 AM, Anonymous Anonymous said...

JR said:

NTT,

A really good piece. This piece needs to be sent out everywhere. When I have talked w/ legislators, they say the medical lobby is very strong and they seem to be unwilling to tackle it. They seem to be scared of the medical lobby, the legislators in bed w/ the lobby or are medical in their background, or maybe they are scared of getting medical treatment in the future if they spearhead medical reform. It goes back to control, power, and money for all concerned. There exists in the medical community such outright bias and/or discrimination against males both as employees (nursing/techs) and as patients and it seems to be accepted as common practice. I don't think any advances have been made in male healthcare for years. With all this talk of men trying to control women's bodies over the growing abortion debate, I see male patients getting more abused during healthcare encounters where women are in control of the men.

With our issue of being overcharged for a room, it was a nightmare. You have 60 days to appeal it. In reality, we did not get the bill within the 60 days. When we first received it, it was not an itemized bill. That took more than a month to get an itemized bill and then it was not complete which took more time. We had never questioned a bill before so we did not know the guidelines. The insurance company for Medicare didn't seem to care they were overcharged. CMS did not care & of course, the hospital simply hedged and stalled. Finally, when we made it apparent the hospital corrected the bill to reflect just 2 room charges but it had to go back to insurance/Medicare for their approval. The whole process is totally ridiculous. Insurance/Medicare certainly is not on the side of the patient. Again, it seems acceptable that when criminal acts are committed everyone should be fine with it. It is set up to be against patient rights.

I think having the right to have an advocate present w/ the patient at all times is very important. It can be done even during procedures w/o compromising the sterile field. It is the veil of secrecy they are maintaining that is the real stumbling block. If I had been permitted to be present during my husband's ordeal, the exposure & abuse would not have happened. I would not have been tortured by the lack of info., the isolation, the invasion of our privacy & religious choice, & seeing him sexually abused. In addition, we would not be at this point where he had a procedure done against his will/knowledge, my knowledge, & both our consent.

Medical records also need to be addressed to be a real representation of the patient's medical journey & not just a source of protection for the medical provider.

The abuse alone is enough to permanently scar an individual for life. Add onto that having to live w/ the knowledge you had treatment you did not consent or would have chosen, is unbearable. It doesn't matter that it may be their gold standard bc individuals are supposed to free in this country but that freedoms apparently ends once you enter the door of any medical facility. JR



 
At Wednesday, May 29, 2019 6:30:00 AM, Anonymous Anonymous said...

NTT

There are male physicians who violate, sexually assault male patients too. An example is the Ohio State University male physician who abused 177 students. Thus male patients are abused more so by male and female physicians, staff than are female patients. This is even more evident with young incarcerated males as evidenced by the justice department statistics.

There is virtually no evidence anywhere of female physicians and female staff abusing their female patients. Male patients get the abuse from everyone.


JF


The annual cost, room and board of a nursing home patient is $200,000, Medicare pays this and the patient forfeits their social security income. Additional costs such as x-rays, respiratory, physician visits are all paid by Medicare. As you can see the Nursing home industry can be a lucrative business. That is until abuse is documented and the facilities are shut down.



PT

 
At Wednesday, May 29, 2019 6:37:00 AM, Anonymous Anonymous said...

JR said:

Check out my latest post on Issues4Thought about my view on the opiate crisis. It is beyond interesting that big pharma has been thrown under the bus when it is really the medical community of doctors/hospitals who have allowed the opiate crisis to grow. If it were not for the doctor/drug dealers, the average person would not have been exposed to the magical powers of fentanyl. It is also sickening the medical community is going to make staggering amounts of money from this crisis in form of addiction treatment. It is beyond ridiculous that the drug dealer is also offering drug treatment but I guess any source that brings in revenue is good. It certainly shows a lack of conscience. Big pharma should not be the only ones the bus in running over. So now a patient has to go to his drug dealer and say I need help to get off the drugs you so very freely prescribed for me. What irony? Guess what you get more drugs of a different type to get off opiates. I know of many who say they are getting off opiates so they can get the drugs to get off opiates because they give similar effects. What a vicious circle the medical community has created. There simply is no respect/dignity for the life of the common patient in any sense. JR

 
At Wednesday, May 29, 2019 3:03:00 PM, Blogger NTT said...

Good Evening:

IMHO, GREED and the Sackler Family's manipulation of the healthcare system are mainly responsible for the opioid crisis.

https://www.statnews.com/2019/01/15/massachusetts-purdue-lawsuit-new-details/

https://www.iflscience.com/health-and-medicine/oxycontin-how-purdue-pharma-helped-spark-opioid-epidemic/

Regards,
NTT

 
At Wednesday, May 29, 2019 3:51:00 PM, Blogger Maurice Bernstein, M.D. said...

For those who are planning to go on Twitter or present documents to other sources arguing the viewpoint of you and others here, you may find that the information regarding Hoaxy in the current USC Annenberg Center for Health Journalism should be of interest regarding sources of possible "truths" and "untruths" Here is the link to the article:

https://www.centerforhealthjournalism.org/2019/05/07/use-hoaxy-track-down-source-false-health-claims


..Maurice.

 
At Thursday, May 30, 2019 6:52:00 AM, Anonymous Anonymous said...

JR said:

The fact that Hoaxy was created by IU makes me disbelieve in its use.

NTT,

That may be but opioids are prescribed by doctors. If a doctor did not know that an opiate class drug is addictive than you have a really bigger issue of having a doctor who is not well educated. If you look at any drug, they all have horrible side effects as do the procedures themselves. Take for instance, stenting which I now have been educated about more than I ever wanted to be. The stents themselves cause the arteries to reclog because the artery forever thinks it needs to heal from damage of having a piece of metal in it. So it will send plague there to heal it. What does plague do? It can build up & cause the artery to become clogged thus another heart attack/ procedure. This is a simple explanation. We are, w/o a doctor's involvement, getting a specialized test to tell us how much of a certain protein my husband has to better forecast the chances of this happening. He is currently on a regimen of natural supplements to prevent this from happening. Also, the drugs (DAPT) they mandate you take cause devastating consequences. Brilinta is the big one now. A small cut can cause you to bleed like a stuffed pig. Being in a car wreck could actually cause you to bleed to death. It also makes you look like one big walking bruise which a hospital will then ask if you are a victim of abuse. It can cause internal bleeding. The ironic part of Brilinta is that it causes shortness of breath & irregular heartbeats which are heart disease symptoms. Some of the other drugs may cause kidney failure, loss of muscle tone which helps cause kidney failure, bleeding again, just a feeling of not ever feeling good again, death. But why worry because these drugs will save your life if they don't kill you first. There are other medical treatments you can have done to counter the side effects. It is a vicious, never ending circle. All drug companies and doctors are aware that most drugs have serious consequences. Look at all the issues Plavix has had but it is still on the market and is the alternative to the new super drug of the moment, Brilinta. So if you can't take Brilinta, you can take the very dangerous Plavix.

It goes back to the opiates being too freely dispensed by doctors. Morphine is an opiate & has been used for years. It does have its place for pain control but it is also addictive. The problem is that having a hangnail can get you a RX for a painkiller. The kids in high school who I talked w/ who had drug problems mostly got hooked from having access bc of their own medical issue or through the issue of a family member. They then would turn to street drugs to feed their addiction.

The fact is none of the ones involved seem to care about the long term side effects. These come after years of people taking unsafe drugs. At the moment, they only care about the revenue & the revenue they will earn from the side effects. There are new medical jobs being introduced to "cure" the opiate crisis the medical industry (including big pharma & doctors) have created. The "cure" will certainly introduce the use of drugs to bring about the "cure". My niece, who is an opiate addict who got her start from a dr.'s too easily prescribing and from dental issues, loves the drugs issued for a cure. She gets "cured" quite often. She knows how to play the cure game as do many others. It is very ironic the very people who were instrumental in causing the opiate crisis are going to be the ones making more money off the cure. The fines on the drug companies are only for show. There should be consequences for the ones who actually wrote the RX. Again, my husband was given a massive amount of fentanyl without need, knowledge, or consent. They had no knowledge if he was a recovering addict—he’s not. At no time was he asked this by the 1st hospital or the helicopter service. Many enjoy their ambulance rides bc they are given drugs so freely. JR

 
At Thursday, May 30, 2019 9:19:00 PM, Anonymous Anonymous said...

To all

This subject matter as well as this blog is so damn pathetically stupid. That people, human beings as patients have to be stripped of dignity by hateful reckless people in healthcare in many situations that we have mentioned countless times. Even more insulting is the fact that it’s done by an industry that brings in so much money annually that the amount, $4 Trillion dollars is stupid in its own right. One dollar out of every 5 dollars spent in our economy goes to healthcare.

That value is increasing each year, thus for 2020 it’s projected to hit $5 Trillion and so on and so forth. As we approach the 100th installment on this blog what exactly have we learned. We have become acutely aware of the gender discrimination that exists and we have discussed prominent news issues that been reported, Denver 5, etc. it’s bad enough that we as victims post here and it’s even worse that people who read this blog for fun and entertainment.

To me that’s just about as sick as the ones who enjoy dehumanizing people. Each day they hide behind their fake facade of being professional caregivers all the while looking for opportunities to abuse and enjoy the abuse they cause. Few on this blog truly understand the mindset of of many in healthcare who love tyranny and mayhem, backstabbing and sexualizing patient care scenarios. This is why they chose this industry. Aside from pornography where else can they engage in BDSM and get paid for it.

PT

 
At Thursday, May 30, 2019 9:48:00 PM, Blogger Maurice Bernstein, M.D. said...

PT et al: The goal of this blog thread is to allow ventilation since ventilation may prevent hypoxia and you know what hypoxia may lead to. It is unrealistic to consider this thread with a relatively limited audience to itself create change in the medical system and behavior. But those who do come here to read, may with others, move on to create change utilizing other media and methods. PT, yes at current 160 Comments for this Volume 99, we are on the verge of moving on to Volume 100 and yet since I started this thread in 2005, a little math will give an idea of the number of postings. Yet, that number does not reflect an activity to actually create change in the medical system. Something more is necessary.

PT, maybe political governmental and legal changes are necessary and not just ventilation on blog threads hoping for the best. Or maybe we are dealing with a pathology..a behavioral cancer in some to ??all the people who make up the medical system and that cancer at this time is untreatable and and incurable. Anyone have a solution to this system dilemma? ..Maurice.

 
At Thursday, May 30, 2019 11:40:00 PM, Blogger 58flyer said...

Maurice says "PT, yes at current 160 Comments for this Volume 99, we are on the verge of moving on to Volume 100 and yet since I started this thread in 2005, a little math will give an idea of the number of postings. Yet, that number does not reflect an activity to actually create change in the medical system. Something more is necessary.

PT, maybe political governmental and legal changes are necessary and not just ventilation on blog threads hoping for the best. Or maybe we are dealing with a pathology..a behavioral cancer in some to ??all the people who make up the medical system and that cancer at this time is untreatable and and incurable. Anyone have a solution to this system dilemma? ..Maurice."

I have 3 solutions...Legislation, Legislation, Legislation. I don't see change happening any other way.

To do the math, 14 years of this blog's existence, assuming an average of 170 comments per page and now at volume 99, that's is 16830 comments total, so far. How many people feel as we do and don't even know of this blogs existence? Comments could number into the millions if people aggrieved by the current system knew about it. Would that number reflect an activity to actually create change in the medical system?

58flyer

 
At Friday, May 31, 2019 4:38:00 AM, Blogger Biker said...

Dr. Bernstein, political/legal changes are needed, but the reality is that society as a whole is not yet accepting that there is a problem to be solved. To that can be added the powerful healthcare lobby and the power feminists hold currently. Healthcare finds it cheaper/easier to cater to only female patients with men being forced to accept 2nd class status. Feminists and their allies are not going to tolerate gender equality at the nursing & tech/support ranks in healthcare. Their focus is solely on equality at the physician level.

What it would take to shift the societal mindset I don't know but change does come slowly one confrontation with one caregiver or practice or hospital at a time. Some here have effected policy or protocol changes. This is something each of us can do. There is a cumulative effect that has slowly made for improvements. Not enough by any measure but improvements nonetheless.

Boys are no longer forced into nude swimming classes in schools, which occasionally were subject to female observers. Boys are no longer receiving the kinds of school group physicals with female staff and/or observers many of us endured growing up. Years ago when I had a vasectomy I did not have any draping at all. Literally I was there wearing a polo shirt and socks w/o a gown or towel or sheet on me. I doubt protocols anywhere do it that way anymore. I also doubt any modesty/dignity based changes for men have come out of the goodness of the female staff's hearts but rather from people speaking up and saying this isn't right, eventually reaching a critical mass where improved protocols and practices become the norm.

Getting laws passed or major court cases decided is far beyond what I'm capable of but I can confront one staff member or practice or hospital at a time. And yes there is a pathology called the human condition. People are sexual creatures and in healthcare yes they are going to find themselves somewhere in the continuum of enjoying, being neutral to, or being repulsed by the view each patient provides them. To say otherwise is disingenuous. I can't control what they think nor should I care but I should be able to control that I am not on view any more than I have to, for any longer than necessary, or to more people than I have to. It isn't asking too much.

 
At Friday, May 31, 2019 5:59:00 AM, Anonymous Anonymous said...

JR said:

PT,

I hear you and agree. I, too, am frustrated. I asked others on this blog if they were willing to do something but no takers only talkers. I will continue to do what I can while still seeking to do more. I understand from what happened to my husband how twisted the system is. There were many others who saw what was being done to him in the cath. lab & in his patient room but no one corrected the situation. They knew he had family there but no one talked w/ us. They knew he had not agreed to any treatment & also that he was drugged & therefore incapable of making a decision or refusing what they were doing. It may only take 1 to actually perpetrate the abuse but the others are culpable as they stand by do nothing & enjoy the misery, humiliation, & assault. You have worked in a hospital so you know what goes on. You have seen the abuse happen day in, day out. You know w/o any doubt what awaits for us all when we go to the hospital and it is scary. Hospitals all in total are probably the largest business in the US and then add to it the other medical related fields which is totally overwhelming. I am just guessing on that. It is a total lockdown and lockout. Again it comes back to power, control, & money. Greed, power, & control attracts a certain type of person. Look throughout history for examples. Hospital personnel are taught to be in control--to tell you MUST do as they say or else. The hospitals knew my husband was a non-conformer. It is mentioned in his medical history by the dr. who admitted him into the hospital from hell. Maybe this is one of their signals along w/ them mislabeling him as gay in a Catholic hospital. They double punished him is my thought. I have concluded there are some patients they pick for more punishment. Those who work w/ the ccu nurse who sexually abused my husband knows about what she does as they were witnesses. My hope is that all involved will have a family member suffer the same experience or worse. That will hit them where it hurts. I know from what both he & I suffer from such abuse doesn't go away or lessen as the thought of being rehospitalized is always a lingering thought in back of the mind. While dr.'s offices visits can be better controlled, hospitalization cannot. You recognize that and I applaud your passion. Don't give up. If it matters, you are not alone. As for people who read this blog for fun, don't forget they are also potential victims of medical abuse. Fate can be a _itch in a white coat or scrubs! Dr. B.--please don't take offense at that remark bc it was not aimed at you. I really appreciate your hosting of this blog for us and for your research on how to improve delivery of treatment. JR

 
At Friday, May 31, 2019 7:49:00 AM, Blogger NTT said...

Good Morning:

I look at our group as the tip of the spear.

We're showing other men that yes, its okay to speak up say NO when your in a medical situation you are not comfortable with.

The more the word gets out the more men will join the fight.

MS KS is a legend over on you tube. She's spreading the word there that whay's being done is wrong.

Banterings is spreading the same word over on twitter.

Its not fast enough I know but, we are making inroads. We've just got to keep talking and spreading the word until healthcare has no choice but to listen.

Keep it up!

Regards,
NTT

 
At Friday, May 31, 2019 8:59:00 AM, Anonymous Anonymous said...

I don't think this blog is just venting. Different people have found their ability to speak up from this blog and even though things aren't happening fast enough, that doesn't mean we'll never have the victory over our issue.
JF

 
At Friday, May 31, 2019 9:42:00 AM, Blogger A. Banterings said...

PT,

You stated:

That people, human beings as patients have to be stripped of dignity by hateful reckless people in healthcare in many situations that we have mentioned countless times...

...Few on this blog truly understand the mindset of of many in healthcare who love tyranny and mayhem, backstabbing and sexualizing patient care scenarios. This is why they chose this industry. Aside from pornography where else can they engage in BDSM and get paid for it.



As to being stripped of dignity and tyranny, as I have stated ad nauseum, power corrupts and absolute power corrupts absolutely.

This is seen in the conclusions of the Stanford Prison Experiment:

...At this point it became clear that we had to end the study. We had created an overwhelmingly powerful situation – a situation in which prisoners were withdrawing and behaving in pathological ways, and in which some of the guards were behaving sadistically. Even the "good" guards felt helpless to intervene, and none of the guards quit while the study was in progress. Indeed, it should be noted that no guard ever came late for his shift, called in sick, left early, or demanded extra pay for overtime work.

I ended the study prematurely for two reasons. First, we had learned through videotapes that the guards were escalating their abuse of prisoners in the middle of the night when they thought no researchers were watching and the experiment was "off." Their boredom had driven them to ever more pornographic and degrading abuse of the prisoners...

...After observing our simulated prison for only six days, we could understand how prisons dehumanize people, turning them into objects and instilling in them feelings of hopelessness. And as for guards, we realized how ordinary people could be readily transformed from the good Dr. Jekyll to the evil Mr. Hyde.



Your reference to the pornography industry is very spot on. A friend from college had worked as a producer in that industry and I have some very interesting conversations with him. Just as in healthcare, there are those who this is just a job and act very professional, there are others that give in to their gluttonous desires, and there are those that use it as a means of dominance that is borderline abusive.

It is commonly accepted in that industry "the kid in the candy store may sample any of the yummies that are there." The newbies tend to overindulge. When trying to get a part in a project, it is a given that the actor will undress for the producer and others, be groped, probed, examined, and engage in sexual acts.

All this can be justified (just as in healthcare), we need to make sure the actor will appeal to the audience, make sure that the actor will not panic and walk off the set, and (the most common) make sure that we are not wasting the investors' money. The ones that are brutally honest will say "because I can."

Even my friend admitted that he has because he could.

While the majority of these events are consensual, certain ones, like the screen tests are understood that if you want the part, you will audition. There are also instances where an actor rejects the advances and the person in power exercises that power. Some people are just A-holes and treat everyone in an abusive manner.

-- Banterings

 
At Friday, May 31, 2019 9:42:00 AM, Blogger A. Banterings said...

Maurice,

This blog and other places that your contributors post ARE making a difference. One of the earliest references to the "patient-physician relationship" is 1999 in JAMA. Still the term "doctor-patient relationship" has been the most common term used until recently. That term was coined by the profession, ensuring the naked patient in the flimsy gown knows who is in power.

In light of patient centered care, the realization that the patient is the most important person in the relationship (after all, they have to live with the consequences of treatment), the patient is listed first. See this February 2019 article in NEJM that sees patients as consumers/customers.

I have also seen terms used exclusively by posters her making their way into healthcare policy.

Do you think that institutions are not data mining or researching social media? Even law enforcement mines social media.

Posting here does create change!!!





-- Banterings

 
At Friday, May 31, 2019 11:59:00 AM, Blogger Maurice Bernstein, M.D. said...

AS OF TODAY MAY 31 2019, NO FURTHER COMMENTS WILL BE PUBLISHED ON VOLUME 99. HOWEVER, COMMENTS CAN CONTINUE BY WRITING THEM ON
VOLUME 100
. ..Maurice.

 
At Thursday, July 11, 2019 12:43:00 AM, Blogger Sherin said...

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