Bioethics Discussion Blog: Patient Dignity (Formerly:Patient Modesty):Volume 100

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Friday, May 31, 2019

Patient Dignity (Formerly:Patient Modesty):Volume 100








Should we all look at this blog thread as an elevator where a small group of patients or potential patients are gathered together, floor by floor, to talk about the issues that disturb us within the current medical system? As we stop at a floor, others may look in and even join us in conversation to move along to another floor.  But, beyond our conversations, the only way to make change is to step out of this elevator and walk into the governmental, legal and medical business world and carry out the declarations and approaches which has been repeatedly discussed during the elevator ride.
How is that for an analogy to Patient Dignity (Formerly Patient Modesty) as we have moved up to the 100th floor in our little elevator?  ..Maurice.

                                                                                                      Graphic: From Google Images.
AS OF JUNE 23 2019 THERE WILL BE NO FURTHER COMMENTS POSTED ON THIS VOLUME. COMMENTS CAN NOW CONTINUE ON VOLUME 101.

175 Comments:

At Friday, May 31, 2019 12:56:00 PM, Blogger A. Banterings said...

NTT,

Where is MS KS on Youtube?

Can you provide a link?




-- Banterings



 
At Friday, May 31, 2019 1:31:00 PM, Blogger A. Banterings said...

Maurice,

Have you ever been approached by your institution or others as part of research or a longitudinal study?

As a researcher and a scientist, this blog is part of your research at your institution. I am sure that you have made arrangements with your institution on the continuation of this valuable research when you retire from teaching, at the very least you have made arrangements on how this will be dealt with as part of your legacy and research.

Your elevator analogy is appropriate. This is a timeline, a longitudinal study with various contributors over the years that provides the dismal state of patient dignity in healthcare.


- Banterings



 
At Friday, May 31, 2019 1:55:00 PM, Blogger NTT said...

Good Evening:

MS KS goes on the medical you tubes pertaining to men. If she see's he's being disrespected in the video she leaves a comment. A friend of mine & her have hit numerous you tube sites over the months & years sticking up for men's right to privacy.

She's made a few guys think twice & change their view on the subject.

Regards,
NTT

 
At Friday, May 31, 2019 2:33:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, I have had no discussion regarding formal research with the medical school where I have been teaching all these years. This has never been a formal research project. My discussion of this blog and views expressed here has entered in my sessions with my group of first or second year students and I have mentioned this as part of my input to discussions at the "doctoring" course faculty meeting and the directors of the "doctoring" course know about this blog thread and its orientation.

What has been written here over the years has almost never been reviewed here by admitted physicians except by one or two which includes one with whom most of you are familiar, "Dr. Joel Sherman. With no major contradictory viewpoints, this blog thread is hardly a research tool.

That is why it is necessary for some in the "elevator" to move out the door and "take a walk" and together to work to have changes made in the medical system. Look at the "elevator" as a resource but not a "cure" for this "personal-social" problem.

I think I have sufficiently explained this "elevator" analogy unless others have more to say about it. ..Maurice.

 
At Friday, May 31, 2019 4:41:00 PM, Blogger Biker said...

I will amend my prior comment that each of us can effect some degree of change by confronting one caregiver, practice or hospital at a time to also include seizing opportunities to respond to even peripherally related internet discussions and posting questions or articles yourself. I have done that many times, often without much of any response, but it adds to the general awareness nonetheless each time someone reads it.

 
At Friday, May 31, 2019 5:32:00 PM, Blogger A. Banterings said...

Maurice,

As a former researcher, this blog is definitely valuable research and part of your legacy. I would hope that you consider making such provisions even though this is not considered formal research.

I find it hard to believe you have not considered this.

This also does not mean that the data here has not been mined by another institution either.



-- Banterings


 
At Friday, May 31, 2019 7:04:00 PM, Anonymous Anonymous said...

Hello,

Outpatient Surgery Mag. has an article re video and audio recording of all OR activities via a black box. Apparently they have not heard of Grossmont in San Diego. Please see http://www.outpatientsurgery.net/surgical-facility-administration/healthcare-information-technology/real-time-or-monitoring-leads-to-better-safer-surgery--hot-technology-19

Reginald

 
At Friday, May 31, 2019 7:11:00 PM, Anonymous Anonymous said...

Biker

As you’ve mentioned to caregivers often without much of any response. Oh, believe me they know and they are aware and besides what would be their response. They are speechless and maybe a little even shell shocked perhaps but, do you think they would admit to the discrimination despite working under this umbrella that they think has everyone’s approval.

I’ll tell you what the thought process is “ we are all professionals here” yet when they are presented or read of unprofessional behavior within their ranks their backup punch line is “ well, here we treat everyone professionally, I don’t know about other places.” . Is everyone on the same page on this bullshit or what.

The second insult on the dignity of patients is to lie to them. Medical institutions pretending to be transparent, another lie. It dosen’t add to the general awareness, they are very very aware. They just don’t think that patients are aware and thus when the subject is brought up they are at a loss for words.

PT

 
At Friday, May 31, 2019 11:44:00 PM, Blogger 58flyer said...

So today, actually yesterday, this being Saturday AM June 1st, I went for an appointment at my Dermatology place to get a couple of suspicious spots looked at and perhaps a skin assessment. About a year ago I went to this same practice and had a cyst taken off my back with the doctor performing what looked at the end, like the chainsaw massacre. I wrote to management my list of concerns and took them to my primary physician in the practice, which is known as Ocala Family Medical. The dermatologist is part of that group. My concerns then were that nobody wore any kind of identifying data, dirty exam rooms, meeting the doctor for the first time while undressed, and teaching without asking permission. My doctor assured me that he personally took my letter to management.

So, yesterday I went in and first noticed that everybody present had name tags on. The MA who took me back and started the workup was cordial, introduced herself, and wore her name tag with the words "Medical Assistant" displayed. Then we go to another exam room and I am told to wait a few minutes for someone to come in. So far, so good. I see improvements. My first mistake was letting my guard down by playing solitaire on my cell phone while I waited, instead of just leaving the phone in my truck and focussing on what what was to come. Soon, a very pretty young woman comes in and says hello and she hands me a black sheet while at the same time telling me to undress completely, get on the exam table, and cover up. I had previously observed that there was a curtain situated so that it could be drawn so that it was between the exam table and a desk placed against the wall. In other words, the patient would be on the exam table with the curtain preventing visual access to the patient directly. I thought that was fine. Getting undressed it occurred to me that I had failed to ask to meet this new physician while dressed. It was not the same physician as last year. Even before I was ready there was a knock at the door and I had to say wait!, I'm not ready yet. Realizing my mistake in not knowing who the assistant was and in failing to meet the doctor first, I kept my underwear on.

Once ready, I announced such and the doctor and the unnamed assistant came in. The doctor introduced himself and offered a handshake and I returned it, feeling pretty awkward at meeting the doctor for the first time lying basically naked under a sheet. The doctor asked what brings me here today and I told him about a couple of suspicious spots and the need for a total skin assessment. The personalities of both of them was very engaging and light hearted, with the doctor making numerous funny remarks. Soon ,the unnamed female asked as too my occupation to which I answered "retired." She then asked what I did for a career. I told her 41 years in law enforcement. She said "I knew it, my Dad is a cop and you just have the look." Good for her.
Continued.

 
At Friday, May 31, 2019 11:55:00 PM, Blogger 58flyer said...


The doctor began with a scalp exam and then with sequential draping examined my arms, chest, then both legs, and then rolling over, the backside. He only uncovered what he had to examine me and then covered me back up, better than in times past. The unknown female sat at the desk writing down what the doctor said and continually added to the conversation. She faced me the whole time except to write down what the doctor said. The curtain was never drawn. The doctor assured me what was suspicious was in fact not of any concern and all was well. They both left and I got dressed.

Coming out of the exam room, I walked over to the place where the unknown female was sitting at a computer. She asked what would be a good time to schedule my exam for next year. We picked a date and she wrote out the data on a business card and handed it to me. I said to her "I have just one question" she said sure and I asked "Why are you the only person in this place not wearing a name tag?" She said she had left it at home that day. She then told me her name and said she was a medical assistant, and she was sorry that she had failed to introduce herself. I then went to the front desk, paid my copay, and left.

Coming out of this experience I noticed several things. I don't know if my letter to management the previous year had any effect as I heard nothing back from management. But what I did see was an entirely different group of people, not a single one that I saw on this visit was there last year, including the physician. At least everyone was wearing a name tag with the exception of the medical assistant and the doctor.

What I noticed most was my failure to advocate for myself. Having recently come out of the urology experience where I was able to effect a comfortable outcome for myself, there I was all haughty and feeling like I had this all under control. How wrong I was! Coming from a career in law enforcement, I have always, ALWAYS, been able to protect myself from all manner of attacks, even those subjecting me to extreme violence. Yet I couldn't even muster up the nerve to ask the unknown female who she was and to ask to meet the doctor while dressed to establish the professional relationship. I can blame having the cell phone as a distraction but really, I failed myself. I have a lot to learn from this experience.

58flyer

 
At Saturday, June 01, 2019 4:02:00 AM, Blogger Biker said...

Pt, yes they know and though they may not respond to any given post made to an internet discussion or article, there is value in it nonetheless because it reminds them that some of us are aware of how men are treated and that we don't like it. Hopefully it punctures little holes in their mindset that men don't care. There is also value in these posts in that it tells other men that they are not alone and that they can speak up. Reading what others had to say about their speaking out or recounting their experiences is how I came to find my voice.

 
At Saturday, June 01, 2019 4:28:00 AM, Blogger Biker said...

Following up on PT's comments about healthcare staff being fully aware of what is going on, what is really hard to comprehend is that the women who are needlessly or carelessly or purposefully exposing their male patients must surely know that when the patient is their son, husband, boyfriend, brother, father, grandfather, uncle, cousin, friend that their counterparts will most likely do the same to them. Are the female posters here the outliers who care how the men in their lives are treated vs most women just not caring?

On that last comment I am reminded of a 30 something female friend whose husband had lymphoma in his 20's. She recounted to me one visit that she accompanied him to where they needed access to his hip for something. A young female tech with 5 young female students or trainees in tow had him drop his drawers and stand there fully exposed to all 6 women who were roughly his age. At the time it didn't occur to my friend that maybe it could have been done without him being fully exposed or that maybe he should have been asked him if it was OK to have all those observers. She didn't see the problem and only came to realize it afterwards when he told her how embarrassing it was. That would fall into the realm of just not thinking about it vs being aware but not caring.

 
At Saturday, June 01, 2019 7:16:00 AM, Anonymous Anonymous said...

JR said:

Of course they don't think the patients are aware of what happens bc they drug them to make them unaware & not remember. Also, they think the patients gratitude for "saving their lives" should outweigh the method in which it is done. They actually don't save lives as they are trained and paid for what they do. A McDonald's cook doesn't save people from starving as they too are only doing what they are trained & paid to do. It seems to be acceptable even to government investigators that hospitals can lie & falsify records. Look at how long many of the investigations take. They go to a hospital & follow them around. Of course none are going to sexually assault a patient in their presence as they do know how to properly care for a patient. Of course, none will admit to assaulting or witnessing the assault. They check the medical records which of course will not state "I molested this patient by leaving him exposed." As I have said before, the investigative methods only empower and emboldened them to do it again and more often. Patients are also guilty of not doing something about what happens as many of them choose to forget it until it happens again, chalk it up as a necessity of getting medical care, avoiding medical care, etc. Some patients may not have any recollection due to the drugs. It is a subject that many lay people do not want to talk about bc they are scared of the absolute power & control medical people have over them. It is like you see a cop speeding or doing something you know is illegal but you do nothing bc of fear. There are some professions that give the impression of being bullies & the medical profession is one bc they tell people they WILL, MUST, ALLOW/DISALLOW, PERMIT, etc or in other words, issue commands of which patients must follow or else. I think bc men are viewed as being stronger & more non-compliant is why they are targeted especially by female medical staff. It goes back to power & control = bringing in revenue (money). If $1 in $5 is spent on medical care it must be in their wheelhouse of thoughts that it isn't enough. More should be spent. I also think at a certain age as the hospital from hell said, they think you should get use to having your modesty violated as you are getting older & older people have more care needs & medical encounters. I think they feel they have to condition you for it. That seemed to be their message in the letter I was sent about my husband's ordeal. At a nursing home I recently visited, there were males taking care of women for bathroom duties including toilet & showering. Of course, there are always the young 18 yr. old female staff caring for the men bc men do not have the right to any bodily privacy for medical care. JR

 
At Saturday, June 01, 2019 1:27:00 PM, Blogger Maurice Bernstein, M.D. said...

I read an advertisement via "Careers by Kevin MD" for a internal medicine trained physician
to join an "established and highly regarded primary care practice" taking over the practice of a retiring physician.

"The practice itself offers a strong administrative support team that fosters physician autonomy when it comes to clinical decision making and day to day practice operations. Qualified candidates will join providers that are committed to practicing collaborative, evidence-based care within a patient centric model."

The Company of the practice "offers a competitive salary package that is based on productivity. Our benefits package includes time away for vacations and meetings/conferences, health insurance, disability coverage and retirement savings options."

What I want to know is how visitors here interpret some of the words used in this advertisement since there is no followup description of the words meaning or intent for definition. For example, "physician autonomy" and "within a patient centric model" and finally "competitive salary package that is based on productivity".

Words count and words in an advertisement set something about character and behavior within this advertised occupation. Any thoughts? ..Maurice.

 
At Saturday, June 01, 2019 2:36:00 PM, Anonymous Anonymous said...

Maurice


What? To build relationships and trust with patients and their families. Isn’t it a little late for that? How many new gimmicks, phrases will they come up with next. Who comes up with these phrases? These CLOWNS have had decades to build trust, too late, the circus has left town and good riddance. Take the trapeze midgets and don’t come back.

A competitive salary package based on productivity. Awwww, poor babies! This is a fancy phrase to be effective in time management and don’t let the patients ask too many questions. Do you think they can build trust in this patient-centric model with a female scribe in the room who stares a hole in every patient’s head.

Collaborative based care is another fancy name for when your physician is absent guess what? You get to see the nurse Quacktitioner. Good luck getting ahold of the physicians nurse lpn, or ma when you are trying to figure out why your script hasn’t been called in. Smart potential applicants should run like hell. So much for collaboration from that health care team.

Marcus Welty would be doing flips in his grave if he could see this crap. You can also thank your health insurance company pencil pushers as well for helping to create this nonsense. I miss the days when life was simple.


58Flyer

How ODD! They didn’t make you pay your co-pay up front. Your response to the un-badged medical assistant when asked what your occupation is and was should have been. “ I believe I wrote it on my forms during initial patient sign-up and what is the medical relevance of such questions.

PT

 
At Saturday, June 01, 2019 3:12:00 PM, Anonymous Anonymous said...

Maurice

Ok, so I’ve just read an online application on indeed.com for a medical assistant at a Urology practice.

* Minimum 2 years medical assistant experience
* Strong verbal and communication skills
* Prior Urology experience preferred but not required
* Assists with in-office procedures
* Performs diagnostic tests
* Contacts patient’s regarding test results

Our integrated approach to urologic care provides patients with access to experienced specialists, a comprehensive support team of healthcare professionals, innovative diagnostic tools and highly advanced treatment and therapies.

What I want to know from our readers is: Do you think they are going to hire a male medical assistant? The ad never said they are an equal opportunity employer. Someone posted on Allnurses a question as to what would a medical assistant job responsibilities entail at a Urology office.

The response from someone on Allnurses to this potential job applicant was “ you will be cathing, cathing and cathing.

Not “ you will be performing a variety of patient care duties, anserwing the phones, assisting the physician. “

But cathing,cathing and cathing.

Maybe this is how Urology job posting should just say for medical assistant and lpn’s.

Female medical assistants and lpn’s to work for a Urology clinic. You will be cathing, cathing and cathing.


PT

 
At Saturday, June 01, 2019 3:16:00 PM, Blogger Biker said...

"physician autonomy" and "within a patient centric model" and finally "competitive salary package that is based on productivity".

I'd say "physician autonomy" in combination with "competitive salary package that is based on productivity" means "do what you want so long as you make us money". "within a patient centric model" means "keep the patient coming back for more services".

"Collaborative" is just a new buzz phrase thrown in to sound all modern like. It runs counter to autonomy.

 
At Saturday, June 01, 2019 3:38:00 PM, Anonymous Anonymous said...

Biker

Your female friend’s husband. Why such a small group of 5 female trainees? C’mon now. He should have complained that there should have been a minimum of 10-12 who watched him lower his trousers. Let’s reverse the roles, how many men should have been in the group if the patient were female.

Speaking of applicants, take a closer look at the logistics of these medical assistant jobs, nursing jobs, tech jobs. Schools are churning them out by the hundreds every few weeks. Why? It’s not because of the high job market demand. It’s to flood the market, thereby lowering wages!

Salaries for medical assistants applying at above mentioned Urology practice are offered $12-17 an hour. Let’s see, starting salaries minimum wage jobs at McDonald’s is $15 an hour. Now at Urology clinics even after 2 years of experience you are not making much more but then you are not flipping burgers, you are flipping something else, all day long.

The deliberate intent with these colleges, community colleges, technical schools and medical assistant reject centers are to flood the market while telling students the Sky is the limit when in fact it’s to lower wages and benefit hospitals, physicians office and improve their bottom line.

Now that line is $4 Trillions dollars and growing, you as a patient at one time another will be the recipient of care from one of these underpaid burger flippers, complete with the fake facade of a “ we are all professionals “ attitude, I don’t know how to perform a proper blood pressure and a why should I have to knock on my male patients exam room when I enter.

PT

 
At Saturday, June 01, 2019 5:49:00 PM, Blogger Biker said...

58Flyer, about 2 years ago I sent a message to a practice about an MA not wearing a name badge and not introducing herself pr even saying what she was doing.

In my case I had an appt with a PA to remove stitches from a finger. I had met him before so I knew who he was. I'm in the room waiting for him and a young woman walks in, no introduction as to who or what she was and no name badge. Without even saying what she was going to do she grabs my hand and starts to take out the stitches. I stop her and say who and what are you and what are you doing, I have an appt. with PA so and so. She turned out to be an MA and was quite startled that I stopped her. I then got a proper introduction and let her proceed but when I got home I sent the practice a message suggesting badges and a little training was in order.

My guess is she must have caught holy heck because the next time I was there I passed her in the hallway and I could tell she remembered me. Not fondly but she remembered me and she had her badge on.

 
At Saturday, June 01, 2019 5:55:00 PM, Anonymous Anonymous said...

Salary based on production. Sounds good to me. I always thought Drs. should be evaluated and their wages reflect that.
It's too late to go back in time and save people who have died or suffer needlessly over our issue but it isn't too.late to come through for patients who will need care in the future.
Speaking up may work for some providers but not all because their behavior doesn't always come from ignorance. If and when a healthcare worker does it because they enjoy humiliating other people or get pleasure from the veiw , what good would speaking up do ?
JF

 
At Saturday, June 01, 2019 6:52:00 PM, Blogger Biker said...

PT said: The ad never said they are an equal opportunity employer.

Interesting observation. I wonder if that is code within healthcare to tell men not to bother applying?

 
At Saturday, June 01, 2019 8:33:00 PM, Anonymous Anonymous said...

Biker

Physician’s offices are about 30 years behind the curve ball at least in regards to many hospitals policies and procedures are concerned. As far back as I remember and that is to the early, mid 70’s hospitals have always required for all their employees to wear a name badge. Now I recall in the late 80’s picture ID was then required. In the last 10 years or so if you came to work at a hospital and forgot your ID badge, you would be required to report to HR for a temporary.

Currently, hospitals give you two ID badges. One to wear and the second behind it that way your name and credentials are always visible. In addition, the badge has a barcode that allows you access into all nursing icu units which are always locked or should be locked. I’ve been a patient to a number of physicians offices and not one staff member I’ve seen wears a picture ID let alone a name badge. Why?

I’ll tell you why! The physician knows the names of his staff but, they don’t care if you do because to them it dosen’t matter. You see they don’t care about the gender, as long as the staff are female. They need females to adore them everyday, like a harem. Do you think female physicians in private practice are going to hire males in their practice? Of course not, they don’t need males to adore them at work, they want their female patients feeling safe and comfortable.

Now, if anyone out there wants to doubt me about what I’ve just written please bring on the criticism, I’ll show you web examples of the imbalance. Do I think physicians offices can be forced to hire an equal balance of male staff. I do. The key is through Medicare.

PT

 
At Saturday, June 01, 2019 9:44:00 PM, Blogger Maurice Bernstein, M.D. said...

So..I was interested to read some examples of what the clinic, I described, was attempting to express their approach to patient care by the phrase "within a patient centric model".
I found a relatively recent and excellent article by the New England Journal of Medicine Catalyst titled "What is Patient Centered Care?"

From the discussions written to our Volumes, it seems that "PCC" is some imaginary hope for patients but nothing more. Is my interpretation of the writings here correct? ..Maurice.

 
At Saturday, June 01, 2019 10:13:00 PM, Blogger 58flyer said...

PT,
I see an up front demand for a co-pay to be a red flag. My personal experience with paying before receiving service is that the quality of service is substandard. The patient will walk out early without paying because he/she finds the service not up to expectation. And why should the patient pay? Because no service is rendered, payment is not justifiable.

It's like walking into a restaurant and taking a seat. You find that the place is filthy, the table hasn't been wiped, the menu is greasy, the seat is grimy, and you are just generally grossed out with the place. Even if they bring you a glass of water, you feel no obligation to pay since you have received no service. What if the business says, "you took up our time"? Sorry, no service no pay.

So, it's the same way in a doctor's office. They might want you to pay for appointment time, but if it's of no benefit to you, you are not obligated to pay for services not rendered. Then the substandard facility adopts the rule of up front co-pay. It's harder to walk out if you have already paid. My last colonoscopy clinic demanded an up front pay. I said I will pay upon completion of the service. The girl at the front desk just said, OK. That was it. Sitting there waiting a managerial person comes to me and says, "when you are done, you will want to just go home and not have to be bothered with payment. We do this for you." I gave in and made the payment up front. I regretted it. I would have walked out but since I had already made payment I stayed and then wished I hadn't.

My current doctor sees patients late in the day, often after the front office crew had departed, which can be as late as 7 PM. In that case, I do make an exception, as I often made late day appointments due to my employment. I am however well established at the clinic, and I have come to expect high quality service.

58flyer

 
At Saturday, June 01, 2019 10:23:00 PM, Blogger 58flyer said...

Biker,
I am with you in that I want to know who is treating me. In my latest experience, she might well have been just a scribe. If I knew that in advance, there is no way I will allow a female scribe to see me in any state of undress. I regard scribes as just a secretary, and a non clinical, non professional person. Kinda like the building janitor.

I plan to write yet another letter to management. I see my primary in 2 weeks. I will give that letter to him then, but this time I will ask to speak to a member of management. My 2 prior letters to management went unanswered. I did see a slight improvement in the Dermatology practice, but there are still issues.

58flyer

 
At Saturday, June 01, 2019 10:27:00 PM, Blogger 58flyer said...

PT,
I hope Medicare can help. My only question is where have they been all along. Why start now?

58flyer

 
At Saturday, June 01, 2019 11:01:00 PM, Anonymous Anonymous said...

I would like to see a staff meeting that was requested by patients and patient advocates regarding patient dignity. Women/family members getting up front and telling of early deaths of husbands, fathers ..... and modesty violations named as the reason these men avoided care until it was too late.
Elderly women sobbing out how tried and tried in vain to get their husbands to get the medical attention they needed so badly.
Then somebody gets up front and repeats PT speech about the physicians surrounding himself with female staff and giving the same reasons PT talked about.
JF

 
At Sunday, June 02, 2019 3:55:00 AM, Blogger Biker said...

Dr. Bernstein, I think for the most part "patient centered care" is just the current trendy buzz phrase. Give it a couple years and there will be a new phrase everyone latches onto. Everyone is expected to say it whereas only some practice it. Yes visiting hours in the hospital are much more family-friendly than they used to be and is somewhat universally applied, but that is only one small piece of what was said in the article. 30+ years ago when my then 4 year old son had major surgery to correct a pectus chest, my wife was able to sleep in his room with him at the Boston Children's Hospital so that part of patient centered care is not new.

Interesting that the article included these two phrases though:

- Care focuses on physical comfort as well as emotional well-being.
- Patient and family preferences, values, cultural traditions, and socioeconomic conditions are respected.

Those statements would only be true if they added at the end "so long as male patients are OK with all-female intimate care and staff being casual with his exposure".

 
At Sunday, June 02, 2019 4:21:00 AM, Blogger Biker said...

58Flyer, modern medicine treats scribes as professionals in that they expect patients to accept being intimately exposed to scribes same as any other employee. Personally whether it is an MA or a scribe in the room I do not accept them as being professionals.

A few years ago my primary care sent me to the ER for what my 1st visit to a PA a year later figured out was simply vertigo. As an aside my primary care didn't figure out what the problem was nor the ER doctor nor my cardiologist, but a PA did. When the ER doctor came into my room with a scribe in tow he didn't introduce her or ask if it was OK that she be there. I didn't say anything because I had only removed my shirt for EKG's, but a couple days later I got a call from someone at the hospital asking how things went. I seized the opportunity to tell her I'd of been rather upset if I was intimately exposed and the doctor just walked into the room with her in tow, but that regardless he should have introduced her nonetheless. I also pointed out the admissions/billing clerk just walking into the room without 1st asking if it was OK to enter and without introducing herself, again saying I'd of been very upset if I was exposed. I could tell she was taken aback by my comments and said she'd bring them up when they had their weekly meeting.

One last aside about that ER visit. They sent me for a head scan to see if I had had a mini stroke. I don't know what her title was but the woman who brought me from the ER to where I had the scan was about my age and she flirted with me shamelessly the whole way and back. I did nothing to encourage her. Even though I was covered with a sheet I was glad I had only removed my shirt, not knowing whether she'd find some pretense to pull the sheet off. This was the same local hospital where I heard the RN, again close to me age, tell her sister RN I was so cute she wished I had been sedated for my TEE.

I gladly drive the 75 miles through the mountains to go where I moved all of my care, except for an ER scenario of course.

 
At Sunday, June 02, 2019 7:18:00 AM, Blogger NTT said...

Good Morning:

Dr. Bernstein, in regards to the article in the New England Journal of Medicine Catalyst titled "What is Patient Centered Care?"

The very 1st paragraph tell you were healthcare is as far as PCC goes. One doesn't have to read any further.

"In patient-centered care, an individual’s specific health needs and desired health outcomes are the driving force behind all health care decisions and quality measurements."

The "need" of many men is to have their medical community respect their dignity, and protect their privacy by means of having same gender caregivers available for their intimate private issues just like the system has done for women now for over half a century.

"Patients are partners with their health care providers, and providers treat patients not only from a clinical perspective, but also from an emotional, mental, spiritual, social, and financial perspective".

If providers were treating men's emotional & mental needs, there would be male caregivers in place of female voyeurs who just like to embarrass & humiliate male patients.

Sir, PCC is just a pipe dream to the healthcare community. They know, it unattainable but they want to snowball the general public into believing it exists.

That's it for now.

Regards to all.
NTT

 
At Sunday, June 02, 2019 8:21:00 AM, Anonymous Anonymous said...

JR said:

The hospital from hell talked about PCC but look at how that turned out. It is merely lip service to make patients think they are important and have rights when in reality they have none. They also had a Patient Bill of Rights which also said things that certainly weren't true like respecting personal privacy but again--not true. They know what they should do & say it but it doesn't get further than that. Apparently, the administration makes up these polices but the rank & file do no carry them out. Why is that? Does the rank & file know it is only lip service to trap patients into feeling the care they receive won't be a total nightmare? Why does the administration when face w/ a patient complaint not take action? What PCC means to mean is the patient is going to be the center of both medical & sexual abuse if the medical staff wants them to be. It is like the spin of wheel--you never know who is going to be picked as their next victim. Men, though, can count on at least the sexually abusive part happening each time.

It is just like your information of the forms you fill out for HIPAA protection. The way they get around being able to sell your info. & have it used is labeling it as a necessity to run the medical business. Whether you sign to allow it or not is mute as they have the right to use everything about you including your ssn even though Medicare now uses its own unique number. I now endorse giving incorrect information as they are able to falsify your medical records for their purposes so why now skew the info they collect on you? It seems to me that medical providers are evasive & skew the truth as standard procedure so patients in turn should do the same. Men, next time some female assistant tells you to strip in front of her ask her how she would view having a male telling her to do the same? Watch her expression more than the words coming out of her mouth. Her expression will tell you more than her words. Record the encounter or have a person w/ you writing down everything just like they have. Remind them they also have loved ones will most likely at some point receive the same treatment especially as they age. Give them food for thought & let them know they are not immune to being disrespected. This is not being combative as it should be done in a polite but firm manner. Much like how they deal w/ you--adult to unruly toddler. JR

 
At Sunday, June 02, 2019 8:36:00 AM, Anonymous Anonymous said...

JR said:

Here is an example of the hospital from hell hiring criteria:

It is a policy of The hospital from hell to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.


The hospital from hell reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

The hospital from hell is committed to equal employment opportunity.

You can see they contradict themselves. They follow laws except when they want an exception. They have a Right of Conscience objection but they didn't allow me to have one or to have free exercise of my religious beliefs. They are involved in several lawsuits against LGBT rights. My husband went there being mislabeled as a gay, married man. They believe you can be gay but cannot act on your gayness i.e. being married or having sex. They also asked him if he was sexually active as he laid there naked & "gay." So much for religious charity. So it makes you wonder what else would they object to. Hospitals w/ this attitude should not be public hospitals but rather labeled private & serving only those of the same belief so atrocities that happened to us cannot be repeated. What they state as their delivery of treatment should actually be how they deliver it. They did have male nurses in CCU & seemed to be more respectful but that cannot & did not make up for all the other abuse. He had 2 male nurses during his 2 day stay. Most of the female nurses were like female Hitlers or the guy from North Korea--Kim Jong Un(?).JR

 
At Sunday, June 02, 2019 5:48:00 PM, Anonymous Anonymous said...

The beauty giants product Sephora will close its doors for the morning of June 5 to host inclusion workshops for its employees.

The temporary store closures come at a time when consumers are becoming increasingly aware and averse to the discrimination
that happens while shopping, eating out or grabbing a coffee at brick-and-mortar giants.

Now as you all know Starbucks did the same thing in 2018. I’ve never shopped at Sephora,I’m a male and I don’t buy beauty products. So who shops there? Women! Yet, they think they need workshops to prevent discrimination. Really!!!

When are hospitals going to do this is my question. There are 400 Sephora stores in the nation, but there over 100,000 medical facilities in the United States too. Healthcare takes in a whopping $4 Trillion dollars annually, Sephora took in somewhere around $100 billion annually. Sephora needs workshops to prevent discrimination in stores that employ only women and only women shop there. What am I missing here?

PT

 
At Sunday, June 02, 2019 9:30:00 PM, Blogger Maurice Bernstein, M.D. said...

I wonder if "AB in NW" is still reading this thread. If so, I would be interested in your take, as one participant in medical institution management, regarding the concept of "patient centered care" in hospital practice. ..Maurice.

 
At Sunday, June 02, 2019 10:36:00 PM, Blogger 58flyer said...

Biker, I am in total agreement with you with what pertains to scribes and medical assistants. I consider a scribe as a non professional, non clinical employee. Basically a secretary. I think the next time around I will just tell whoever takes me to the exam room and tells me to undress and cover up with a sheet to not come in with the doctor. Just me and the doctor, no one else.

I am mentally formulating my complaint to management to bring with me when I see my primary in about 2 weeks. I might even ask him to introduce me to the management team and bring my issues up to whoever they are at that time. My most significant issues being no name tag and no introduction, therefore I have no idea who is involved with my care. In keeping my underwear on I was deprived of a truly full skin assessment that I paid for, because of my inability to ascertain just who this woman was.

Thanks for telling of your experience with the nurse who found you attractive. Looking at me now with gray hair, age spots, wrinkles, and beer gut, it's hard to imagine me being attractive these days. But in my early 20's, pressing weights, running 5 miles at a time, I was a rather attractive man, if I may be so vain to say so. In those days, I was receiving my annual flight physicals with a former US Navy flight surgeon for my commercial pilot's license. He wanted his applicants to be shirtless for the exam. I noticed every time the nurse, or perhaps a medical assistant, would make an excuse to come back into the room after I was told to take off the shirt and wait for the doctor. Then, a second female would come into the room and make a show of rummaging through the drawers as if looking for supplies. I noticed that she would always allow herself a look at me either directly or in the mirror. Sometimes a third female would do the same thing. After observing this behavior for about 5 years, I finally suggested to the doctor that he should have a central supply closet to keep supplies so his staff would not have to go looking for items in the other exam rooms. He looked startled for a moment and then said "we do have a central supply location." I then informed him of the females coming into the room looking through the drawers for stuff and asked why they just didn't go to the supply closet. To my astonishment he said "Hey, your are a nice looking guy, the girls just want to check you out. Don't you see that?" I suppose I should have seen that as a compliment, but I really didn't, still stinging from my abuse memory. Upon leaving from that very visit, one of the girls, an actual nurse, slipped me her phone number in with my paperwork. I recognized her as a high school classmate. I didn't call her, nor did I go back to that doctor.

Imagine that behavior from a male nurse towards e female patient.

 
At Monday, June 03, 2019 5:01:00 AM, Blogger Biker said...

PT, I know you know this but not everything is male vs female. Sephora is most likely just virtue signalling for the free advertising it'll generate, but those sessions will have nothing to do with male vs female discrimination but rather racial, religious, sexual identity etc.

It would be wonderful if hospitals and medical practices would hold similar sessions focused on gender discrimination, but they won't because to acknowledge a problem would require taking some action to address it. Instead the "gender neutral" and "men have no modesty" memes will continue unabated, except where men speak up in a way that effects change.


 
At Monday, June 03, 2019 5:51:00 AM, Anonymous Anonymous said...

JR said:

I have been in Sephora & they seem to discriminate against older women or women they don't think looks like them. The Sephoras I have been in seem to employ all ethnic groups so it must be their attitudes. It is kind of like hospitals make judgments and pick who they are going to treat respectfully or not. The problem isn't they don't know how but rather they are allowed to choose how they are going to deliver healthcare to each & every person who walks through their door.

I think most patients when undergoing procedures where they are drugged, are left exposed bc they can get away w/ it. Saving a few extra steps or seconds justify the assault on a patient's dignity. Also, they know most patients will not remember what they have done. The patient is cooperative in being exposed bc they are drugged. Female patients, when they are fully alert are generally not exposed nor do they have usually have male techs or a male chaperone present. There is more of a purposeful effort to make sure female patients are not uncomfortable. For male patients, this is certainly not the case. It is felt they must man up and take what is directed at them.

I know that hospitals have training sessions on how to better serve patients although you would never know it from how the in fact serve patients. It is the smaller ones that I know have these sessions.

Misty,

If you are reading this has Patient Modesty ever been asked or asked to be part of a hospital's staff training? Getting before some of these hospitals w/ real patients telling about the harm they have suffered maybe might prompt one person to respect & allow patient dignity. How does one go about surveying patients on these matters & not just about the noise level or how the food is but some of these real issues? JR

 
At Monday, June 03, 2019 6:00:00 AM, Anonymous Anonymous said...

A couple of days ago I saw a woman on the TV doing an anti smoking commercial. She had horrific damage to her skin especially to her face. She had a trachea and her voice sounded metallic. I don't doubt that her cigarette smoking harmed her. I also strongly suspect that her radiation treatments destroyed her even more.
I wonder how much money was made in destroying her like was done! Somebody told me she died 2 weeks after she did the commercial.
JF

 
At Monday, June 03, 2019 9:15:00 AM, Blogger A. Banterings said...

58flyer,

My friend up north uses a standard response for this situation. After the introduction of the main provider and cordialities, the question of "how are you" (or similar) ALWAYS comes up.

He responds by saying he believes that he is delusional, seeing things that are not real. He would say, for example; "I am seeing a girl sitting at that desk and I know she is not real because if she was, she would have introduced herself, stated her purpose here, AND ASKED TO PARTICIPATE IN MY HEALTHCARE."

I very much like this method.



-- Banterings



 
At Monday, June 03, 2019 12:10:00 PM, Blogger A. Banterings said...

PT & 58flyer,

Many states like us here in Pennsylvania have laws that require ID badges. See Pennsylvania's Health Care ID Badge Requirements

Act 110 of 2010, Pennsylvania’s Health Care ID Badge law was enacted in November, 2010. The Act establishes standards for identification tags of health care workers/providers, with a staggered implementation process. Health care workers that deliver direct care to a consumer outside of a health care facility or employment agency and employees of the private practice of a physician were required to comply with the provisions upon publication of the Department of Health (DOH) interim regulation back in December, 2011. Employees that deliver direct care to a consumer at a health care facility must be issued ID badges that meet the requirements of the Act beginning June 1, 2015.




-- Banterings


 
At Monday, June 03, 2019 12:10:00 PM, Blogger A. Banterings said...

Maurice,

As to PCC, please note:

Care focuses on physical comfort as well as emotional well-being.

Patient and family preferences, values, cultural traditions, and socioeconomic conditions are respected.



Yet, we see all the excuses for NOT providing PCC:


Could consumerism hurt the healthcare system and undermine patient-centric care?

Does Consumerism in Healthcare Undermine Patient-Centered Care?

Should patients be considered consumers?

An Obstacle to Patient-Centered Care: Poor Supply Systems

Is patient-centered care part of the problem?

Healthcare professionals’ views on patient-centered care in hospitals

Advantages and Disadvantages of the Patient-Centered Medical Home: A Critical Analysis and Lessons Learned

Potential Pitfalls in the Trend Toward Patient-Centered Care


Here are 2 article that express what PCC is and why it is happening:

When Patient-Centered Care Isn't

When patient centered is no longer enough: the challenge of collaborative health: an essay by Michael L Millenson


The Victorian parliamentarian and novelist Edward Bulwer-Lytton declared, "A reform is a correction of abuses; a revolution is a transfer of power." Patient centred care began as a correction of abuses, a response to patients being treated like "imbeciles and inventory." Decades later, what’s claimed to be patient centred still too often reflects a paternalistic attitude, ironically expressed by comedian Stephen Colbert in a different context on the Late Show in 2015: "See what we can accomplish when we work together by you doing what I say? It’s called a partnership."

In contrast, collaborative health describes a shifting constellation of collaborations for sickness care and for maintaining wellbeing that is shaped by people based on their life circumstances. The result is not reform, but a transfer of power in which the traditional system loses some of its control. That system will often be part of wellbeing and care relationships—providing patient centred, person-centric, or collaborative care—but other times (and not by choice) it will be excluded.”




-- Banterings


 
At Monday, June 03, 2019 12:29:00 PM, Anonymous Anonymous said...

Biker

My point on Sephora is twofold.

If a little beauty shop that holds no real significance can hold inclusion workshops, why can’t medical facilities.

As I’ve pointed out repeatedly, medical facilities can certainly afford to hold inclusion, discrimination workshops.

At $4 Trillion dollars annually, why do you think I continually bring this up. Discrimination is discrimination.

PT

 
At Monday, June 03, 2019 12:52:00 PM, Blogger Biker said...

Banterings, I love your "I must be delusional" comment. That's one they wouldn't forget.

58Flyer, thank you for sharing your getting checked out comments. It makes me feel better knowing that I'm not the only one who doesn't appreciate unsolicited attention inappropriate to the setting. At this stage in life it makes no sense to me why any woman would still want to flirt with me or check me out, but there are older nurses and techs working in hospitals who have perhaps commensurately lowered their standards with age.

I don't expect anyone working in healthcare to somehow be capable of magically becoming an asexual automaton upon donning scrubs, but I'd surely appreciate their doing whatever they can to minimize any sexual content in dealing with patients. This includes providing same gender options and only exposing out of necessity rather than convenience. That includes the extent of exposure, duration, and to whom.

 
At Monday, June 03, 2019 1:04:00 PM, Blogger 58flyer said...

Banterings,

I like that response too, I might just use that if I get into that situation again.

Thanks for the reference to Pa law about employee identification. I will have to do some research but I don't think Fla has a similar law. If not, it's about time that gets corrected.

58flyer

 
At Monday, June 03, 2019 1:55:00 PM, Blogger Biker said...

PT, we know the answer. They could hold workshops of this nature but they choose not to. Why would they recognize a problem that they have no intention to address?

 
At Tuesday, June 04, 2019 8:40:00 AM, Blogger A. Banterings said...

58flyer,

Florida does not have such a law.

California, Connecticut, Georgia, Illinois, Massachusetts, Minnesota, New York, Oregon, Pennsylvania, Rhode Island, & Texas all have healthcare ID laws.

North Carolina also requires ID badges of any employee in a healthcare facility. The exclusion is that badges need not be worn in the practitioner's private office if his or her name can be readily obtained; for example, if the practitioner's license to practice is prominently displayed in the office.

There is pushback from providers under the guise of their personal safety. The concern raised by many providers focuses on the safety of the practitioner in the current electronic age, where a simple Google search of one's name can yield quite a bit of personal information. I suspect safety accounts equally as does being able to abuse patients and not be identified.

The reality is that the Health Insurance Portability and Accountability Act of 1996 and later amendments grant any person access to his or her personal healthcare record. Any patient can walk down to medical records, demand his medical record, and find the full name of their providers.





-- Banterings




 
At Tuesday, June 04, 2019 11:57:00 AM, Blogger A. Banterings said...

This is how screwed up healthcare is. Geisinger of Pennsylvania terminated a doctor for not following the hospital's policy; that doctors can not meet with patients for more than 15 minutes during a visit.

They then file a law suit and injunction (under a noncompete clause) when he opens up his own private practice.

See the story here:

Patients show support for doctor sued by former employer.




-- Banterings





 
At Tuesday, June 04, 2019 2:23:00 PM, Anonymous Anonymous said...

Banterings

Florida is such a unique state so much so that a 17 year old wore a lab coat with a stethoscope and walked around the hospital for a month before the ruse was discovered. This has happened a number of times in that state yet why does it take legislative to ensure the safety of patients. This youth had access to secure patient areas and asked an OBGYN physician if he could shadow him. Need I say more?

PT

 
At Tuesday, June 04, 2019 10:40:00 PM, Blogger 58flyer said...

Banterings,

Being able to find out the names of your providers is certainly true, but, while I haven't tested the theory, I suspect the names of the assistants might be harder to find out. That is especially true of observers and shadowers, I would think.

I have carefully read through Fla Chapter 450 of the medical practice act and Chapter 464 of the nurse practice act. I see nothing that requires wearing an ID badge.

My opinion, and it's just that, an opinion, is that anyone who desires to be regarded as a professional, should understand that it comes with a lot of responsibility. To have professionalism you must have accountability, and to have accountability you must have identification. No true professional can work anonymously.

In my 41 years in law enforcement it was understood that you must identify yourself as a law enforcement officer to be recognized as such. I could not hide behind anonymity. People had to know that I was who I said I was.

It's the same in healthcare.

The modern age doesn't change anything. Myspace, Facebook, Twitter, and all the others also doesn't change that. If I choose to be involved in the social media sites, I should not be able to hide my identity. I personally made the choice to not be involved with social media because of the warnings I received from my agency to not be involved in such activities. I could be identified based upon my social media choices. I therefore chose to stay away from social media so as not to be targeted.

In my recent urological experience, I did a check using my wife's Facebook account. I found that 2 of the nurses at my doctor's practice did have a Facebook account as well as one of the front office people. I discovered that those 2 nurses were a graduate of a particular local community college and that their graduation venue was held at the church I attend at this time! No, they are not among the church membership, thank God! But I did recognize the background photographs as being my church.

Rather than hide behind the idea that to not identify oneself to their patients is a safety measure, I think it best to stay away from social media as a better way to protect oneself. That way any healthcare worker could still make the proper identity to the patient without the perceived risk of the patient finding out who they really are.

Of course, if those healthcare personnel really treated their patients with the respect they deserve, would there truly be any risk to themselves?

58flyer

 
At Wednesday, June 05, 2019 4:54:00 AM, Anonymous Anonymous said...

JR said:

Probably better be careful saying you are delusional as when they insert it into your medical records they may choose to leave out the background information like you were being sarcastic.

Hospital patients are not viewed as real people. They certainly are objects. Most of the staff is only there to make money & go home. They usually do not care what happens to a particular patient as there is another to take that one's place. Having 14 yr. old females observing intimate male procedures or having a 17 yr male trying to access the ob-gyn area is not surprising as in the medical world the patients are only specimens that have no right to personal dignity while in the hospital. Sadly, most people who become patients are conditioned not to question any medical provider & will let them do as they will. They may not like it or may never seek treatment again but generally they will allow it to happen. Not only do medical staff need better education but so do potential patients. They need to learn they should actually be in control of their situation & not allow things to happen. They need to know how manipulation occurs such as the using of drugs in IVs to make them cooperative & submissive. They need to know that informed consent forms are not really "informed" consent but merely forms to protect the medical staff. Patients need to learn they can have same gender care & they can refuse intimate care or exposure. Very importantly, we are patients need to break down the medical community arguments of having secrecy during procedures & such. There should be no secret ritual of transferring patients to rooms & their advocate cannot be present nor should a patient have to be alone during any PACU time. Advocates of the patient's choice should be present. Every patient should have documentation of how they would want any hospitalization to be handled. My son's friend is returning home today to bury the ashes of her father who chose to die of a heart attack that he knew was coming rather than to seek medical treatment. Is this really how the supposedly greatest medical system in the world should work? Should people who refuse to be abused or suffer at the hands of the medical community die because the delivery of treatment is so degrading, dehumanizing, & demeaning? JR

 
At Wednesday, June 05, 2019 9:52:00 AM, Blogger Maurice Bernstein, M.D. said...

Just a personal followup. Yesterday, I had a Foley catheter inserted by the male urologist and the same LVN who first attended to me. I again was not embarrassed and the procedure was uneventful. The LVN kept my gnitals covered until the physician was fully prepared to start the procedure. The goal was to complete a procedure and it was accomplished. Though I must admit, I didn't ask either if there were male assistants in this urology clinic. I saw no males in the clinic except the physician. There was no need to complicate the preparation and carrying out of the procedure on my body by delving into the issue discussed here. And no.. there was no evidence that I was being treated as a VIP in any subtle or obvious way.

This behavior, within the clinic, was straightforward and accomplished in my best interest. Some here may feel disappointed that I didn't enter into a discussion about the issues described here. But inserting a Foley catheter without errors or complications was my personal goal at the time and I am sure it would be yours too.
Carrying out a med-surg procedure should be free from distractions and that is the concept I carried out and hopefully the same concept should apply to the others on this thread. On the other hand, those who have suffered emotionally in the past, I, of course can understand a different stand. ..Maurice.

 
At Wednesday, June 05, 2019 10:42:00 AM, Anonymous Anonymous said...

Maurice

I would never allow you or anyone for that matter to set a standard for me. If you were a black man in the 50’s and were told to mind your business and sit in the back of the bus would you expect me to do the same were i a black man in the 1950’s, seeking transportation on a city bus in that timeline. We all arrive at some point be it on that bus or another bus but I assure you, not all our experiences are the same.

PT

 
At Wednesday, June 05, 2019 11:01:00 AM, Blogger Maurice Bernstein, M.D. said...

PT, followup on your last comment:"We all arrive at some point be it on that bus or another bus but I assure you, not all our experiences are the same." And that has been my philosophy from the onset of this thread years ago when I decided to continue the topic even though, at the time, I thought the views of those who commented here represented "statistical outliers" and now I am not so sure. ..Maurice.

 
At Wednesday, June 05, 2019 11:37:00 AM, Anonymous Anonymous said...

Maurice


I want to clarify and reiterate some comments I’ve made on the assumptions of the theory that we are statistical outliers. In my experiences as a patient and those have not been many because I am a very healthy individual. I have had perhaps 10 or a few more than 10 experiences that I as a healthcare professional consider as unprofessional. If I had maybe 1 or 2 it’s doubtful that I’d be on this blog and if I were a layman I would not possess a barometer that I could use to define what or professional or unprofessional.

Yet, I am someone with 40+ years of healthcare experience and my experiences go beyond what you or many may simply define as a modesty issue coupled with the fact that I have see countless numbers of patients treated unprofessionally as well. I’m not sure what or how the definition of statistical outliers plays into this for I see it as an excuse, an excuse that greatly disturbs me.

Lastly, I have a theory that could be deemed as statistical. The fact that your providers and the medical treatment administered to you were under the knowing assumption that you are a physician and considering the VIP awareness you or many who let it be known that they are healthcare providers may not experience unprofessional behavior. Dosen’t that make you as well as others falling into this category statistical outliers in that none of you experience unprofessional behavior?

PT

 
At Wednesday, June 05, 2019 1:35:00 PM, Blogger A. Banterings said...

Maurice,

I suspect that as a physician you either practiced a healthy lifestyle (and may be lucky in the genetic lottery) and/or (just as of recent in the change of law) you treated yourself (a very common practice of physicians in days past) or have the physician "buddy" (signature where needed) that you reciprocally treat with. Now, as your body needs more maintenance, you will be exposed to more care by others thus increasing your chances of experiencing abuse.

The VIP card that you have (although you do not consciously use it) may also be a double edged sword. Where celebrity VIPs may offer the opportunity of the patient allowing a photo with the staff taking care of him, you may encounter a burned out, disgruntled provider who blames their teachers for not preparing healthcare students or see you as part of the "ivory tower" of your institution.

I truly hope that you never experience anything that your contributors have experienced. Beyond the flashbacks, PTSD, avoidance of healthcare, the obsession that it leaves many of us with. It is like a mania where we are chasing news stories, blogs, and articles across the Internet. We spend our nights posting responses on articles and blogs, trying to protect other patients, educate providers, and get our stories out.

Just look at the history of my posts, you will see that the time stamps occur at all hour of the day.

Personally, I would have cathed myself in the situation that you described.




-- Banterings

 
At Wednesday, June 05, 2019 4:40:00 PM, Anonymous Anonymous said...

JR said:

Well said Banterings! You said what we feel. Although the abuse didn't happen to me, I live w/ the effects in had on both me and my husband day in & day out. There is no way to escape the harm. There are very few spaces of time we can escape what happened as he may do something as little as his now constant cough. It may be the ever growing number of bruises or the bruises I get preventing him from falling. There is the lack of sleep when the daymares become nightmares and then there is every Saturday night into Sunday morning around 7a when the predator nurse went off her duty of abuse. Not everyone may suffer but the thing is you don't know is if you are going to be the one this time who suffers the most at the hands of some very mentally ill staff. You do know for a fact that most hospitals do not respect patient dignity. This hospitalization left us feeling more damaged than we ever imagined possible.


PT,

My husband has only had 2 instances of being ill. The prostate cancer and the heart attack of which both were very serious. The heart attack came w/o warning as he did not have indicators. We understood what the prostate care involved. When he was out, we do not know for sure what took place. During the prep, I was there and I was there when he was in PACU and in the patient room transfer. I was with him the whole time he was in the patient room never leaving him once except the next day when he was fully dress waiting to leave as I was required to fetch the car. What happened this time took us completely by surprise. I guess I knew in my mind this type of abusive behavior happens but that night it was not in my mind. Who knew that having groin wounds would mandate a man laying drugged with his penis and testicles completely exposed for around 7 hours? I appreciate all your postings bc your background shines light into the secret workings that us common people do not see. You are correct--no one should ever be mistreated even if they are the exception to the rule. I don't feel we are the exception but rather are willing to talk about it while many others cannot talk about it. JR

 
At Wednesday, June 05, 2019 5:51:00 PM, Anonymous Anonymous said...

A. Banterings

You are very correct about the VIP card being a double edged sword,however, any unprofessional or obtuse behavior that occurs to medical doctors or nurses presents itself only when they are unconscious. That VIP card gives them all an unlimited free pass although it would not stop the back talk which in my mind is just as bad. I will never as long as I live understand why medical staff feel the need to say, verbalize or operate their trap in such a negative manner about patients and their families. Remember, many of them are bullies and verbal abuse is one of the many tools of their trade. Personally though I think that Maurice is safe and most likely will never have to experience what we have for if he did, I assure you he would be posting on this blog rather than responding to us as he does as administrator!

PT

 
At Thursday, June 06, 2019 2:54:00 PM, Blogger Maurice Bernstein, M.D. said...

It is hard to defend that I was being treated by the urology clinic and staff as a VIP, "very important person". I didn't challenge the doctor or clinic staff regarding this issue and what was offered and performed appeared to me as proper medical practice to be offered to and performed on any "none VIP" patient.

As I already may have noted, potential VIP patients are "everywhere". All these years, I and other physicians have been faced with degrees of examination, tentative diagnosis and presenting some conclusion or perhaps even suggesting medication or more for friends and family. Physicians have to manipulate through how to respond to these VIPs and often they may set decisions as if they themselves were the patient (what the physicians themselves would want if they were the patient). So I know about medical behavior to so-called VIPs and, perhaps more than the friends or family members are aware.

Did we, here, ever take the view that all those writing to this blog thread, over the years, should look at themselves as a VIP, behave as one and make sure that the physician and staff are made aware? ..Maurice.

 
At Thursday, June 06, 2019 4:09:00 PM, Blogger A. Banterings said...

Maurice,

Did they ever ask you if you have any psychological trauma from something such as sexual abuse?

Did they explain the procedure to you and ask explicit permission to proceed?

Did you have your first consultation fully clothed?

As to physicians treating family and friends, I have ABSOLUTELY NO PROBLEM with that. Growing up, from 6 years old until my early 30's, a relative who was a physician took care of my health. If I needed immunizations, he brought them to our house. As I said, what ever trauma that I suffered at a hospital between 5-6, I refused to see a doctor, he took care of what I needed, and my entire family accepted this as normal (probably due to what happened to me).

If a physician does not have the ability to care for family and friends, then they should not be practicing. I understand the relationship, but are they going to be able to say no to any other human being? I would argue that there is more trust in that patient-physician relationship.

Today, I side step physicians. I have access to all the meds that I need. No BS appointments, holding antibiotics hostage because I refuse all cancer screening.

I do see a physician for my ADHD. He is old school. Does just what he has to as far as state requirements to prescribe (annual blood work). He throws some things in there that are about my health and not about the Rx. He offers PSA testing and CRC screening, all of which I politely decline, always. When I had my lump that my wife was more worried about than myself, I was comfortable enough to let him examine it.

I have already fired my previous doc because he was too insistent on dealing with issues not related to my ADHD. If my ADHD Rx were to end tomorrow, I can replace the treatment without missing a day. I have freed myself from the bonds of healthcare.


-- Banterings



 
At Thursday, June 06, 2019 10:01:00 PM, Blogger Maurice Bernstein, M.D. said...

Oh, oh.. a "bro culture" dominated by young men"?? Here is the link to the entire current article about a law suit based on the goings on (gender and age and race discrimination) within Mount Sinai Health System's Icahn School of Medicine in New York City published in the Journal Science:
https://www.sciencemag.org/news/2019/05/global-health-institute-sued-age-and-sex-discrimination.

Do you think that what is going on at Mt.Sinai is in anyway related to the gender concerns or how current medical care is organized by those writing to this thread? ..Maurice.

 
At Friday, June 07, 2019 4:20:00 AM, Blogger Biker said...

Dr. Bernstein, what I see in the "bro culture" article is an example of tribalism gone too far in that the victims are a protected class (females). I had commented recently that people by nature are tribal. We sort ourselves into groupings by gender, race, ethnicity, sexual identity, occupation, geography, interests etc. We are all members of multiple tribes given the many ways in which we might identity with others as "us" vs "them".

The bro culture scenario in the article possibly crossed the line legally in addition to violating societal norms. Women being the victims makes it newsworthy. Reverse the genders and it would not have been newsworthy in that discrimination against men in employment is a steeper hill to climb legally in addition to it not violating societal norms. Young women taking over the organization and pushing out the older men would have instead been cast in a positive "empowerment" light.

It is for these reasons that we don't see investigative articles shedding light on the females who staff hospitals and healthcare facilities prioritizing the hiring of females. It is for this same reason that we don't see articles addressing the differences in how those female-dominated healthcare facilities are less protective of the privacy and modesty of male patients than they are of females. Female patients are "us", males are "them".

 
At Friday, June 07, 2019 5:31:00 AM, Anonymous Anonymous said...

JR said:

Surely I did not read the victims are responsible for being victimized? Explain how my husband could have prevented being drugged by a sneak attack even especially since he had already told him them he refused benzos. & more pain killers? Explain how after he was drugged & rendered incapable how was he to protect himself from exposure that was not medically necessary but rather was of entertainment value to those involved? Is it like the female rape victim living alone invites a male rapist to crawl into her locked window to rape her? Because what happened to him feels no less than being raped repeatedly & for long periods of time. I understand that in office settings the patient may have more control except that many are ambushed & are concerned about the quality of medical care if they speak up or even question if they have the right to speak up as we are conditioned not to question medical providers. Is it wrong for a rape victim after the crime has occurred to speak up because the crime has already happened & cannot be undone but can only seek justice & warn others of the circumstance? My husband, as an IT professional, has been sought out by friends & family for free help, too. It is not contained to just being a doctor. If people know you have a skill, then many will seek to use it to their advantage. When I bought my longarm quilting machine, it was suggested that I not tell many as they would assume I would be willing to quilt their creations at no charge even though owning & operation a such a machine costs much money. So everyone can be guilty of wanting VIP status. However, I don't think a patient should necessarily go in wanting VIP status but rather the rights that every patient should inherently have: respect, dignity, truth, autonomy, etc. Are you saying that medical providers only give these rights to people who act as though they are VIPs when everyone is equally as important or should be without exception? JR

 
At Friday, June 07, 2019 7:27:00 AM, Blogger Maurice Bernstein, M.D. said...

JR, the medical system treating a patient who behaves or is suspected by the medical staff to be a VIP can be medically "mistreated" (inadequate workup or known to be inappropriate medical or surgical management--potentially bad medical care) because of professional failure to accept that a "VIP" is essentially a human being as are all the other patients and being acknowledged a VIP makes their pathology and management no different than a non-VIP. The alleged VIP does deserve proper diagnosis and treatment without any sort of bias. ..Maurice.

 
At Friday, June 07, 2019 7:59:00 AM, Anonymous Anonymous said...

JR said:

You are the one who said that maybe those writing on this blog should view themselves as VIP patients. So if what you said in your last post is true & I know of instances where VIP status (Joan Rivers where her VIP status actually got her privacy invaded) has resulted in bad treatment then why would anyone want VIP status? By the way, I never said having VIP status would result in different care--you inferred in your post. I was merely questioning that you made it sound like because some of us have been victimized that in was our fault. If you read my post I said all people deserve the same level of respect, etc. and that is to actually respect, etc. them. The test for how well they respect you is when/if you have a procedure & will be drugged/defenseless and how/what they do. Will they leave you exposed when not necessary? Will they bring in others to view the doctor/patient bc they enjoy this type of fun? Those are things you might not ever know unless the drugs misfunction or you have been informed you are an Internet star. None of us are porn stars who have signed a contract for such exposure or viewing. However, the medical community as a whole thinks a patient's body & medical information is theirs to use, view, & manipulate as they desire. I disagree w/ that as I am not an instrument of learning or teaching. I am a person. Those people who abuse unconscious patients are criminals. I doubt if they would treat the patient the same way if they knew the patient had an advocate, it was being filmed for the patient to view, or the patient was fully able to defend oneself. They are cowards who prey upon the helpless and sick. Not all medical staff do this but enough do. I do not know of a test to weed who might abuse you when you are unconscious or drugged? But I feel most of the medical community believes what you don't know won't hurt them. They really don't care about the patient's well-being or they wouldn't be engaging in that type of harmful treatment. PS I have no wish for you to suffer what anyone on this blog has suffered. My wish is only for those who abuse or witness the abuse(s) and do nothing to have a loved one suffer the same. JR

There is a bias existing in the medical community against men. It is silently accepted as part of the foundation upon which medicine is built. Even male doctors of today must answer to the hospital which is being ran by more & more female administrators.

 
At Friday, June 07, 2019 10:37:00 AM, Blogger A. Banterings said...

Maurice,

I suspect that Singh is of Indian/Sikh, or similar descent. He emigrated with his family from Nairobi, Kenya. All of those cultures (African and Indian) view women as second class citizenry. There may be a conscious or subconscious bias there as well as in his choice of friends.

That being said, the issue may be more of nepotism rather than gender discrimination. Just look at political appointments. In respect to what we write about in regards to gender, this bro culture is totally unrelated. The people at the level of Singh, if they were some sort os sadist or sexual predator, they do not need to abuse patients, at that level there are corporate retreats, parties, etc.

Remember former Tyco CEO Dennis Kozlowski who threw for his wife on the island of Sardinia complete with an ice statue of David that urinated vodka? This was essentially a Roman orgy.

Then there are the typical LA headlines: UCLA Professor, 47, suffers sudden death during recreational mummification bondage in sex dungeon of 62-year-old Hollywood exec's LA basement

My personal favorite, upscale suburban Philadelphia home for sale complete with sex dungeon.

People at that level can afford $1000/hour call girls (like NY Governor Eliot Spitzer).

The problem with providers is these people are so low on the food chain, they do not get invited to the parties of debauchery or can afford escorts to satiate their desires. They must prey upon the patients (the weak and vulnerable).




-- Banterings



 
At Friday, June 07, 2019 11:18:00 AM, Blogger Maurice Bernstein, M.D. said...

JR, most patients who consider themselves VIP or expect to be considered by others as VIP,demonstrate that "property" by "speaking up" their wants and rejections to the professionals attending them. The hospitalized patient might say "I don't want to be awakened several times during the night for my vital signs to be taken!" If the hospital policy, for "patient safety" requires that and if the VIP patient is not critically ill where during the night blood pressures might not be absolutely necessary, then the VIP "speak up" may well be followed by the staff.

With regard to the issues repeatedly discussed on this blog thread, in those regards, maybe patients should consider themselves VIP and, in fact, SPEAK UP. ..Maurice.

 
At Friday, June 07, 2019 11:48:00 AM, Anonymous Anonymous said...

JR said:

Again, you missed the point. During a lot of procedures and when the patient is more likely to be abused, disrespected, exposed, etc.; they are drugged or unable to speak up. Hospitals do this on purpose so as to avoid patients having a say in their healthcare or how it is delivered. Most of us can say no. Patients who are not perceived as being VIPs such an entertainer or politician , or likely to be labeled as a difficult patient and treated as such rather than a VIP. Once any type of sedation is used, this patient is likely to be punished. Although a patient may think and act as though they are a VIP, the staff will most likely not acknowledge. Again, speaking up for rights that should be standard of practice does not make you a VIP but rather a normal individual wanting the best mode of care. Too bad my husband did not have the opportunity to tell them he did not want to be sexually abused. Maybe I should have stormed the cath lab and pulled him out of there. I complained but no one listened and no one did anything so the abuse happened or maybe it worsened. I told that slimball chaplain to go away but he didn't so speaking up doesn't always work. Also, again my husband told them he didn't want the very drugs they covertly injected into him. So again, speaking up doesn't work. Maybe a celebrity would have fared differently? Why should you have to tell all nurses not to sexually exploit or abuse you? Shouldn't that be something they already know? We are talking about different things. Not be awakened for vitals every couple hours is less traumatic than the sexual abuse many of us have suffered. JR

 
At Friday, June 07, 2019 12:54:00 PM, Blogger Maurice Bernstein, M.D. said...

JR, I appreciate that you have been "speaking up" in your husband's case both here and apparently with legal action elsewhere. As amply described here "speaking up" provides understanding to some but unfortunately sometimes doesn't lead to the behavior of others as you would want. But without an attempt of the patient or family to express to the professionals what behavior is expected ("speaking up"), then likely misbehavior or worse will not be eradicated. ..Maurice.

 
At Friday, June 07, 2019 1:56:00 PM, Blogger A. Banterings said...

Maurice MY POINT is that many of these things are RITUAL and not science.

Look at late night vital sign checks.

JR's point is that providers would not do these things to VIPs unless absolutely necessary and then they would still evaluate their stance to the patient's preferences.

I believe that the way providers treat family and friends should be the way ALL PATIENTS are treated.




-- Banterings



 
At Friday, June 07, 2019 2:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Oh! I think you will find this interesting and may even
provoke some back and forth here on a different, but I
think pertinent subject to our title.

I wrote the following to a bioethics listserv to which
I have been participating for years:

Following up on comments here about "how well do patients understand current professional titles", may I add "HOSPITALIST" to the list. Are all hospitalists, by the patient's outpatient physician or the hospital itself, defined to the patient and families, with regard to education, duties, responsibilities, relationship to the hospital and, importantly the role and relationship to the patient's out of hospital physician (who may have performed the admitting exam and writeup of their patient). Are patients and families regularly told which professional is "in charge" when it comes to major decision-making?

My concerns about such understanding by the patient and family may be unique since it has been almost 20 years that I have admitted a patient to a hospital and, well, "hospitalists" were just "starting" as a in-hospital profession. ..Maurice.


A simple response quickly follow by a physician ethicist which, I think, might be stimulated to express an opinion which may have bearing on what has been written here year after year.


Hosp it al ist (n) An adherent and practitioner of hospitalism.

Hosp it al ism (n) A cult of priests who divide, objectify, quantify, and interventionalize in a human activity that is derived from an older art called healing.

How's that for a stimulus for discussion here? ..Maurice.

 
At Friday, June 07, 2019 8:07:00 PM, Anonymous Anonymous said...

Well here we go again. Marcus Welby MD would be doing flips in his grave if he saw how healthcare has evolved. Gone are the days when your family Physician no longer visits you in the hospital. Hospitalists have not been well recieved but in my opinion it only makes sense although I do see it coming on the horizon, nurse quacktitioners and physician assistants as Hospitalists. We are done, stick a fork in us.

If you are a neurosurgery, cardiac, transplant patient you will never see a hospitalist, unless of course you code. I have not seen good communication between Hospitalists and other providers on the healthcare team. Yes some Hospitalists are internal medicine and or pulmonologists but think of the burden your family practitioner would bear if he/she had to visit and coordinate all the care and tests that were ordered as well as see patients at his/her office. Impossible!

We tend to take a lot of things for granted while patients and place far too much trust in those that are supposed to advocate for us. Don’t ever expect it to happen.

PT

 
At Saturday, June 08, 2019 5:20:00 AM, Blogger Biker said...

PT, NP's are already working as hospitalists. I understand the necessity for hospitalists but am not convinced patients will be served well by NP's.

There is only one urologist in my roughly thousand square mile county of 50 some thousand people. He's been wanting to retire and the hospital hasn't been able to recruit a new one. He's had a urology-certified female NP with him for years and there was an announcement in the paper recently that they hired a 2nd NP fresh out of NP school. She currently doesn't have any urology certification. Our demographics are well older than most of the country (meaning more urology needs per capita). I doubt this staffing model will serve the needs of the men in this county very well but this is the future of rural medicine in America.

I am grateful to be able to instead drive 75 miles each way through the mountains to my hospital in NH.

 
At Saturday, June 08, 2019 6:04:00 AM, Anonymous Anonymous said...

JR said:

During my husband's stay in hell, he was seen by PAs and NPs from the large cardiac practice who staffs the hospital although he was assigned one of their cardiologists. This name changed daily on is board. The thing of interest is that some of the drs. on staff at this cardiology practice are merely internists or not having any specialized degrees in heart care. The quack who admitted him & who graduated from a foreign school of dentistry is one of them. Of course, the cardiac practice is owned by the hospital from hell. They put in the drs. who are newer to the practice or who need experience as the hospitalists. The on-call drs. are also the ones needing PCI experience so the ER patient are their learning curve. I believe this is why they mandate if you have a heart attack after hours you will have a PCI done whether or not you agree to it. It is a huge money-maker & also lets them train on you. It is a win-win for them and a lose-lose for the patient but patients are not what is important in healthcare. PCC is really physician centered control. The PAs & NAs are also writing up the a lot of the info in the MRs w/ the dr. adding whatever. They do not tend to identify themselves as such either. All at this hell hospital would wear their nametags turned around or hidden from view. The male nurses would identify themselves. Once the hospitalists get enough experience, I imagine most of them will leave although for some their schedules are more set. How much control the hospital administrators have is really frightening. I would liken a hospital to a small country that is ran by a mad, tyrannical dictator. They view patients as spoils of war or prisoners of war, treat them as such, have the ability to decide when to release from captivity, and decide what is the price of their release. All terms of the prisoner's stay is dictated by them. There is a Geneva Convention (Patient Bill of Rights) that supposedly dictates how prisoners are to be treated but is often ignored because just like any rogue country, they don't care about the consequences.

I guess w/ the way the female nurses treat male patients they feel they must hide their identity. However, patients cannot hide from those people as they know everything. We only give our POB as our address. We are now working to change what history & other personal information is given as it is really not needed but only adds to them being able to sell it. I have always given them a fake SSN as they do not need it & now Medicare has issued another number to use so them having the ssn is not needed but provides trackability for them to follow you.

If you look at healthcare, there are very little in the way of real cures. There is an overwhelming majority of cures that have major side effects or measures that require constant healthcare interactions. "Cures" are big money-making ventures & a real cure would end the continuous money train ride they now enjoy. JR

 
At Saturday, June 08, 2019 7:57:00 AM, Anonymous Anonymous said...

Biker
Maybe it's too expensive to go to school and too time consuming. Could it be that the teachers/schools are overcharging?
JF

 
At Saturday, June 08, 2019 6:18:00 PM, Anonymous Anonymous said...

With all the complaining about the opioid crisis and lawsuits directed at Big Pharma let’s place blame exactly where it should be, with the providers. After all, they have many choices to prescribe. Morphine, oxycodone, Vicodin, dilaudid, Percocet, fentanyl, Demerol and the lists goes on and on. I’ve just read about physicians prescribing pain meds in exchange for sex from their patients and all of you might be shocked at the extent this has occurred over the last 5 years.

Does Big Pharma get blamed for this too? Maybe there will be a blog for patient’s loss of modesty and dignity issues with these exchanges and maybe the physicians could complain that the sex was not what they expected. What do you think? I’m being sarcastic as usual but if there were such a blog it would be just as ridiculous as this blog in that nothing like this should exist. Should there be a nurses blog where they gossip about how many patients they have had sex with? What about the number of penises they see each day or that they will see a million by the time their career is over, Opps, my bad. That’s already been done.

PT

 
At Monday, June 10, 2019 9:01:00 AM, Blogger Maurice Bernstein, M.D. said...

You all have presented the symptoms and the clinical course. You all have presented the pathology that could be the basis for the symptoms. And now, it is appropriate for our readers and contributors here (after all it is Volume 100 representing about 14 years of considerations) to come up with a treatment and permanently a cure, a plan for initiation, advertisement and distribution and use to treat this frank disorder within the medical system. Start now!

"Moaning and groaning", which I have always felt is potentially of some therapeutic value, it is useless for a cure.

For your own personal benefit and for the benefit for a host of other patients and potential patients, not just yourself, publish and carry out your approach to treatment. ..Maurice.

 
At Monday, June 10, 2019 12:55:00 PM, Blogger NTT said...

Good Afternoon:

For healthcare to first truly recognize a man's right to his dignity and privacy they way they recognize a woman's right to her dignity and privacy, three things must initially happen.

First & foremost, ALL you closet males out there, yes YOU know the ones that would love having male caregivers for their intimate medical needs but are afraid of being seen as a wimp, MUST SPEAK UP NOW when intimate medical situations come into play. NO MORE hoping that the next guy will say something. YOU DO IT!

It isn't, it is what it is ANYMORE. You open your mouth & tell them "YOU WANT SAME GENDER CAREGIVERS or don't go forward."

This is the critical element to this whole movement. NOTHING will go forward unless guys start talking and talk LOUD & CLEAR and DON'T STOP.

Okay, now that we've got ya talking up a storm, the next element we need, is new blood in Washington. The current makeup of the congress has shown without any shadow of a doubt they have been, are now, and always will be in bed with healthcare & big pharma. These are the people that have been there for YEARSSSSSSSSSSSSSSSSSS.

One way we can influence this is by going to town hall meetings when the candidates are available for their constituents to ask questions. Bring up the subject of male healthcare to the candidate in front of an audience. Ask direct questions & see what answers you get. If nothing else from the exercise you have the public thinking about male healthcare because you planted the seed by bringing it up.

The third element we need are lawyers and elected prosecutors that are NOT afraid to go after healthcare from a legal standpoint. WE need PITBULLS! Here. If we've been violated, we want legal people that will stand with us and go after these people and make an example of them. It's the only way to stop it from continually happening.

If we can bring those three elements into play & keep talking about the issues to anyone that will listen we can make a difference and bring change to a broken system.

Regards,
NTT

 
At Monday, June 10, 2019 12:56:00 PM, Anonymous Anonymous said...

Dr B
I don't think there is a once for all time cure. I have sometimes talked about that I don't think anybody law abiding will get anywhere with our issue. I was partly serious, but I don't intend to do anything criminal.
Different people posting here have written to newspapers only to be ignored.
Some of these posts are so frustrating. I have felt frustrated by the blanton disregard by doctors and medical staff. Also by patients inability to speak up. But I'm no different.
Maybe we all need to introduce people to this blog to raise awareness but even that would probably have to be done anonymously. We're coming from such a place of weakness. Avoiding Healthcare seems the best option for too many people.
JF

 
At Monday, June 10, 2019 12:58:00 PM, Blogger BJTNT said...

Dr. B.
The follows tactics won't work to change the medical community.

Arbitration is useless because the medical institution gets to select the arbitrator.

Lawsuits are ineffective because, relatively speaking, the medical institutions have unlimited resources while the plaintiff can only obtain an average lawyer.

Convincing existing lawmakers of the need to change the medical community is a waste of time and money since the AMA has enough money to buy every politician that we might gain some sympathy.

My approach to change the medical community follows:

Use social media to enlighten the public on the problems with the medical community. Then during candidate's campaigning ask [in the way of informing] the candidate's position on specific medical community's failure to extend respect and dignity to patients. If we can elect members of Congress before the AMA can get to them we have a chance. Of course one Congressman is insufficient, so we will need patience while we wait to elect a number of them supporting our agenda - undoubtedly a number of elections. Better late than never.

In addition to social media, we can educate individuals. During the prep for a recent ophthalmologic exam, I carried on a conversation with the MA/tech/whatever. It was formal until I mentioned my recent hip surgery where I was given propofol so that I would be compliant and not remember. When I told her that date-rape drugs are given before surgeries so that patients are compliant and don't remember, she introduced herself by name and the conversation turned friendly rather than just formal. I suspect that if/when she has surgery she may ask a question or two, not to mention an educated vote.
BJTNT

 
At Monday, June 10, 2019 2:06:00 PM, Blogger Maurice Bernstein, M.D. said...

I strongly agree with the suggestions of laying this issue out to the public via the legislative system and voicing out the issue at upcoming "town hall" political meetings may be an important tool. It not only tells something to the politician up front, it also tells about a problem to the voters in the back..many may not have been aware it is a problem (like I did at the outset of this blog thread) or were afraid to bring it up in such a political gathering. And you know often there is "media" present at these meetings and your voice may be heard far beyond the geography of the "town hall". I have a feeling that the "Me Too.." pressures by the females in our society had an affect on the 2018 house elections. But the men who write here should also deserve the power of a "Me Too" movement. How about "MeN Too!" ..Maurice.

 
At Monday, June 10, 2019 7:24:00 PM, Anonymous Anonymous said...

Maurice

You said “ You have all presented the symptoms and the clinical course. You have all presented the pathology that could be the basis for the symptoms.”

Regretfully, we have not. To be truthful, I don’t believe we have even scratched the surface, at least I don’t. I believe we have spent a considerable amount of time describing how things are and the associated discrimination that exists. I do not think we have adequately described the logistics and we have not completely described all those who are at fault. Yes, you have spent what? 14, 15 years reading about this subject. There are not enough ethicists in healthcare who I believe will fully recognize this problem let alone making an achievable solution or putting it out there that there is a problem. When the solution eventually does arrive there will be a lot to answer for.

PT

 
At Monday, June 10, 2019 7:31:00 PM, Anonymous Anonymous said...

There is currently an article on Allnurses titled “ challenging the Joint Commission.” I’ve made my point many times here why I hate the Joint Commission. Read this and you might be enlightened. Read it again and the key is on that thread how we all can effect change.

PT

 
At Monday, June 10, 2019 10:11:00 PM, Blogger 58flyer said...

The problem I see is that getting the word out about the issue and at the same time educating medical staff with each encounter about the modesty needs of male patients will have an ever so slow effect. Just yesterday I was at my family practice doctors office for a follow up and talked at length with his nurse about what men encounter in health care. I also presented my doctor with a letter describing my most recent dermatology experience and he promised to take it to management. We will see how that goes. Maybe this time management might actually contact me.

While I have often said that legislation will have the most profound effect, there are some first steps to get the message out. We need for a talented writer to produce a book about what is discussed here. I would volunteer but frankly I think the subject deserves the talents of a professional writer, and I am definitely not a professional writer. I would be happy to present my experiences, but I don't think my meager talent as a writer would do the subject justice.

In my experience, when you get men to open up about a difficult to discuss subject like male modesty needs, you would be surprised to learn how many men feel the same way. They just haven't had the opportunity to talk about a difficult subject with an audience they are comfortable with. As an example, the attorney that my wife works for had to have a hip replacement. Having had 2 such surgeries, I was in a position to talk to him about it. I loaned him my walker and discussed what he was about to go through. We even had the same doctor and the same hospital. He listened very attentively to my discussion about having had a total male team for my most recent hip replacement. He was shocked, and asked, how did you do that? He then related some past unfortunate experiences with modesty issues and he wanted to know how I was able to even bring up the subject with my medical staff. I told him of my telling my doctor about my concerns and arranging a meeting with the OR coordinator. I don't think he had the success that I did but he was pleased that he made the effort.

I bring this up because many of the people we will have to approach will have their own medical experiences to relate to. If they are men, and most legislators are men, we may find a willing audience who will jump at the opportunity to enact legislation to prevent what happens to all men from happening in the future.

The FIRST step is present a book on the real reason men don't go to the doctor. Thoughts anybody?

 
At Tuesday, June 11, 2019 5:44:00 AM, Anonymous Anonymous said...

JR said:

I think there are many ways to get things done. All will be met w/ resistance from the medical industry.

First of all the public needs to be educated. That is why I have my website. I want to get as many people as I can on it. I will be working w/ a web person to enhance my standing in search engines. I have some suggestions from Banterings that I will be implementing too. A book is also a good idea. I haven't given up on newspapers but will be trying different approaches. The public will have to be rallied to make anything happen. Dr. B. had a catchy tag w/ MeN Too. He is also right about the press being present. However, we need to be ready for the press by having info. and a contact card to give them. I have said many times before that we should be organized. It would be easier if we pooled our knowledge. We are from different parts and can work in our areas but we need common talking points and info needs to be easily accessed.

Attending townhalls for candidates is also a good idea and I will be watching and attending. Locally, I am watching for hospital heads to attend Chamber of Commerce sessions so I can ask them pointed questions. Wherever they are at, I want to be there w/ my questions. I also think that writing these different hospitals offering them our point of view may give them something to think about. Most hospitals have training for their employees. I am working on a power point presentation for such training. I will continue to call different legislators and leave them talking points like I have been doing.

Although female patients seem to have it better, just this morning there was another news story about a dr. in Calif. acting in a sexual manner w/ 2 females patients. Of course, no one's modesty is safe in a hospital setting especially for procedures. Male patients don't have the luxury of having same sex for most x-ray (ultrasound) procedures as do women. Male patients do not have male nurses taking care of them in their hospital room like females do. From what I have read, male nurses generally do not do intimate care of female patients whereas females nurses do intimate care of males like there is no reason not to. Therein lies the problem. Of course, once drugs are administered or one is in a nursing home, the rules change and anything goes as far they want. Drugged, they figure what you don't know won't hurt them and for the nursing home, you're old and don't matter anymore. For all the talk and hype, healthcare is centered around the needs of the medical industry and the patients is just a means to the end and that of course is control, power, and money. Maybe the book should be titled: The Internal Workings of the Medical Industry: Control, Power, and Money


Dr. B.,


Are you willing to have someone from this blog to address your group? With remote access, it is easy. Banterings and PT have a wealth of knowledge from different viewpoints and the same. JF also has a viewpoint from the nursing home point of view as well as many common sense points. NTT & Biker have really good patient points of view. And the rest of us also have patient points of view and ideas. JR


 
At Tuesday, June 11, 2019 9:41:00 AM, Blogger A. Banterings said...

Maurice et al,

There is NO HOPE for the healthcare system to change. There is too much money at stake.

As PT points out, healthcare accounts for $4 trillion annually. Nobody is going to rock that boat.

One of the first cases we studied on the ethics of using risk/benefit analysis used to weigh the cost of fixing a defect in the product or system was the Ford Pinto. (Grimshaw v. Ford Motor Company, 1981)

...Based on the numbers Ford used, the cost would have been $137 million versus the $49.5 million price tag put on the deaths, injuries, and car damages, and thus Ford felt justified not implementing the design change...Based on this analysis, Ford legally chose not to make the design changes which would have made the Pinto safer. However, just because it was legal doesn't necessarily mean that it was ethical. It is difficult to understand how a price can be put on saving a human life.

There are several reasons why such a strictly economic theory should not be used. First, it seems unethical to determine that people should be allowed to die or be seriously injured because it would cost too much to prevent it. Second, the analysis does not take into all the consequences, such as the negative publicity that Ford received and the judgments and settlements resulting from the lawsuits. Also, some things just can't be measured in terms of dollars, and that includes human life. However, there are arguments in favor of the risk/benefit analysis. First, it is well developed through existing case law. Second, it encourages companies to take precautions against creating risks that result in large accident costs. Next, it can be argued that all things must have some common measure. Finally, it provides a bright line which companies can follow.



Universities and their medical schools are at risk for the loss of BILLIONS of DOLLARS!. University of Southern California is ranked 21 of the 100 richest universities being worth $5.1 billion.

Now let me demonstrate that medicine and medical education does NOT care about patients, they only care about the almighty dollar:

Educational pelvic exams on anesthetized women continues in 2018...

Viewed in hindsight, it is difficult to see how the conduct of unapproved pelvic examinations by medical students could have been rationalized, let alone condoned.

Men too, face nonconsensual rectal examinations by medical students when undergoing prostate surgery.

Has medicine ever apologized for its "CRIMES AGAINST HUMANITY???
book that an abused patient can hand a district attorney or malpractice attorney so that they can implement legal proceedings against the providers. It should be a step-by-step how to, with checklists. It should have scholarly references on the psychological harms that patients endure. When the attorneys taste the blood in the water, the feeding frenzy will change the system.



-- Banterings





 
At Tuesday, June 11, 2019 2:51:00 PM, Anonymous Anonymous said...

One aspect of healthcare that I’ve not touched on much is the interrogation tool. Now if you are a male patient you may experience this when you encounter a female nurse for the first time say in endoscopy or pre-op or some medical procedure that you are about to undergo perhaps for the first time with them. Realize that you have already pre-registered in which they already have your insurance information and so on. Now, if you are a female patient and encounter a male nurse in this scenario you will not be interrogated because this would come across as creepy. There would absolutely be no reason that the male nurse would ask you, what is your occupation? Where do you work and where do you live, however, if you are a male patient and the nurse is female, you can expect this line of questioning when there is no medically needed reason.

If you are an inpatient at a hospital and one of these pieces of information is not on your face sheet, often the techniques is that the cna will ask you, so what kind of work do you do and where do you work? She will then relay this to the female nurse. If you don’t think this happens and/or you don’t see or experience this then usually they already have it when you pre-registered. Identity theft happens more in healthcare than in any other institution. No, you don’t need to give them your social security number, no you don’t need to tell them where you work or what kind of work you do. Wouldn’t it be professional and demonstrating some form of advocacy by rather asking you, do you have any concerns?

PT

 
At Tuesday, June 11, 2019 9:46:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, your prognosis was set as "There is NO HOPE for the healthcare system to change." So now what?

And 58flyer, I don't think that writing a book will change the medical system's behavior.

I think the solution must be political, strongly political leading to legal changes. Maybe this all could be incorporated in a "Medicare for All" legislative production. There has to be laws and laws which must be obeyed.
Tell me if I am totally wrong in this identification of the method for change. ..Maurice.

 
At Tuesday, June 11, 2019 10:48:00 PM, Blogger 58flyer said...

Maurice,

Correct, the book alone will not change the medical system's behavior. That's not the point. The point is to get the message out there. To educate people that there is a problem and that it needs to be addressed.

Once that is done, make the approach to legislators for action, preferably at the federal level.

The book would make the news media aware that there is a problem, and they would hopefully broadcast it across the nation. Male patients would see this as a chance to find their voice, to speak up about an injustice that has gone on for far too long to be ignored. The book would be a spark for change. I see that as an essential first step. To get the message out there.

If I were to be elected to a position of public office, I would definitely be interested in making changes to benefit the healthcare of male patients, given my own past abuse experience. But, it wouldn't have to be the result of past abuse, just the experience alone of having been subjected to the overabundance of female medical staff when it come to the intimate care of men. I have no doubt that many of our elected officials have found themselves in that position. They would be our friends in bringing about change.

That is the political means by which change would occur.

58flyer

 
At Wednesday, June 12, 2019 4:29:00 AM, Anonymous Anonymous said...

JR said:

There are laws now covering some aspects of medical encounters. The problem is they choose not to obey the laws and the legal system does nothing. I liken the medical system to a criminal syndicate. They know what is right and wrong but are in it for the money, power, and control. On the surface, it looks like a legit, ethical business but underneath it is rotten. The government knows this and looks the other way. Medicare for all? We have an industry out of control and the answer is to make it bigger? Who is going to pay for this? If the current Medicare clients cannot get proper care then how will Medicare for all fix that? The Medicare investigation mechanism is laughable and pathetic. Medicare for all will just give the medical industry more power, control, and money because they will be secure in their future and be able to grow their empire even bigger and stronger.

Reading Banterings Twitter articles make me wonder even more about the craziness associated w/ the medical field. What other service do we pay for that we have unknown to us and w/o clear consent practicing on us? Beauty school comes to mind but even then you purposely go there because they are cheaper. You are not drugged by them so you remain alert. But the most important item is that you clearly consent to having a student use you for experience. In the medical field, this is not the case. Usually the experimenting occurs when you are drugged and unaware. The consent forms are usually misleading and vague offering protection only to the medical field. Unseen & unknown students may view & prod your naked body like cowardly criminals in the night. There is no reduction in your bill for providing them a service. You have no idea who has poked & prodded you and you really have no idea if you have been filmed or what nasty, personal comments that were made. I don't disagree they must learn but it is the mode in which they seek that learning that's the problem. Unless permission has been clearly stated and the patient has all info. needed this type of molesting should not be done. Having the patients drugged perhaps gives the medical community the courage to do what they know is wrong as it would take more courage to ask permission & perform the exams on a victim that first they must look them in the face. Maybe that is why they prefer their victims to be drugged. They are just weasels.

As I have said, the medical community operates as if it is a criminal entity. It is shrouded in secrecy and operates on the fringe of being unethical and unlawful. Government is like that too so maybe that is why they are in bed w/ another and nothing can or will be done. JR

 
At Wednesday, June 12, 2019 5:03:00 AM, Anonymous Anonymous said...

JR said:

PT,

My husband never gave them his SSN this last time but it was plastered all over his Cath Lab records. The cath lab in turn w/o his permission sent this info including his ssn to the NCDR for cath lab & chest pain. That way they could track him forever as they had his ssn w/ all his personal information. Supposedly, they have recalled this info. They didn't need to ask it bc they already had it. The EHR takes care of that & having Medicare in the past using that number sealed it. Yes, I have heard him being asked over & over again about personal info. but he tells different stories as it is really none of their business. I agree the medical field lends itself to being a hotbed for identity theft. Some even ask for your mother's maiden name. Why do they need this? For the practice owner, it is bc they like having the most info they can get so they can sell it and have additional revenue. For anyone else working there, it is a goldmine of info they can also use or sell.

While a book would not directly change the medical community, it would help educate the public. Hopefully, having a better educated public would put pressure on the medical community and the government to bring about positive change for the patient/consumer. What many of us have talked about on this blog is not talked about in public. It is a taboo subject especially for men. No one likes to talk about being controlled; made to feel powerless; sexually intimidated, molested, or abused; treated like an unruly, unintelligent child; etc. Most people will have or know someone who has experienced something similar as it is a widespread but little talked about aspect to just about all medical care. Most men are treated badly by medical staff. Having no respect for male patients seem to be the gold standard of treatment. Most men accept that as they know no different. Most will accept it is as the compromise you must accept in order to get medical care. For others, they will avoid medical care as they cannot accept it. For most though, they will remain silent. My husband does not like to talk about his experience bc he feels like he somehow is less a man bc they victimized him while he was at his weakest point. However, that does not make him less but it does make them less as they are the cowards who prey on victims while they are vulnerable and ill. Predators rarely pick victims who can defend themselves. Most like to remain anonymous and like to have their victims as helpless as possible. This is where Versed comes into play just as other date rape drugs help out during frat parties, etc. Without educating the public, no one who can bring about change will have the motivation to bring about change. Maybe that book should have one who does the intro but it should tell stories from some of those on this blog? That should be an easier route and would give personal, relatable accounts along w/ facts & stats. JR

 
At Wednesday, June 12, 2019 8:59:00 AM, Anonymous Anonymous said...

Definition of Harem

1) a usually secluded house or part of a house alloted to women in some Muslim households.The separate part of a Muslim household where wives, concubines and female servants reside.

The medical industry seems to have adopted this model ( no pun intended) well. Just visit any physician’s office and you will see exactly what I’m referring to.

It’s obvious discrimination on many levels yet, it seems to be looked at as “ well that’s just the way things are mentality. Does CMS look at this the same way or should they? What about health insurance companies, wouldn’t they or should they be concerned that their patients or half of their patients are discriminated against.

Look at every single GOVERNMENT FORM out there. At the bottom it clearly says

It is the policy of the government of the United States to provide equal employment for all persons to prohibit discrimination in employment because of race, religion,sex, handicap or sexual orientation through a continuing affirmative program in each agency.

CMS is the government and why would they continue to support an American business, medical facilities that engage in blatant discrimination?

PT

 
At Wednesday, June 12, 2019 9:30:00 AM, Blogger A. Banterings said...

JR,

Healthcare writes their on rules, guidelines, and they self regulate.


Maurice,

How do you see ANY HOPE when we are still dealing with the issues of med students doing nonconsensual PEs and other intimate exams) on anesthetized patients in 2019???

My solution is that we need to tear it down and start again. My plan is to let the lawyers gut the system.

From an anthropological point of view, what is the most realistic outcome will be that it is replaced with another system. Just as NPs, PAs, and others are given more responsibilities. Chiropractors have more authority. This is very common in liability lawsuits in the greater Los Angeles area where applicant attorneys use chiropractors to diagnose injuries.

Then you have the foreign and black markets. My friend from up north recently did surgery in Mexico. He was on the table for 8 hours. The surgeon told him that he would need to be cathed for He told his surgeon that being cathed while awake would be traumatic and waking up with a catheter in would be traumatic. He woke up WITHOUT a catheter. Here in the US he would have been told that they needed to keep it in because the bladder would still be paralyzed from the anesthesia.

When in LA or San Diego, I think nothing of hopping over the Mexico boarder to pick up meds.

Then you have private doctors. Michael Jackson had Dr. Conrad Robert Murray.

I personally see the corporatization of healthcare as a good thing. Doctors may be self regulated by medical boards, but the SEC and other government entities (beholden to the citizenry) regulate corporations. A physician may not have done anything inappropriate by doing unnecessary genital exams (in the eyes of the boards), but it can be considered fraud under SEC rules (punishable by imprisonment).



Again, I ask, how do you see ANY HOPE when we are still dealing with the issues of med students doing nonconsensual PEs and other intimate exams) on anesthetized patients in 2019???





-- Banterings



 
At Wednesday, June 12, 2019 9:43:00 AM, Blogger A. Banterings said...

Maurice,

Here is another example of society making traditional healthcare irrelevant:

LGBTQ youth are turning to online networks for mental health support.


-- Banterings


 
At Wednesday, June 12, 2019 8:38:00 PM, Blogger Maurice Bernstein, M.D. said...

One could say as a response to virtually all the posting on this thread subject: "ON THE OTHER HAND..."
How about Epidemic of Violence against Health Care Workers.

I know, I know: a June 3 2019 article on KevinMD. That site sends some shivers down the backs of some of our readers here and they will definitely comment here. But read the article and its documentation.
This maltreatment in medical care is obviously a "two way street" and the cross traffic to us patients and them medical people is apparently present. ..Maurice.

 
At Thursday, June 13, 2019 5:32:00 AM, Anonymous Anonymous said...

JR said:

Violence is not just isolated to being directed at medical workers. I have had 5 & 6 yr old kids become violent. There have been many times where I could have pressed assault charges against them but didn't. Now, knowing what I do I kind of regret not pressing against at least 2 of them as one of the parents were healthcare workers. The mother of one was so violent herself that she was banned from school property but she worked at a local hospital so I guess patients received her abuse. The other was a mental health therapist.


I know when they were in the process of torturing me (I didn't know at that time what was happening to my husband), I thought about trying to storm the area where they were holding him captive in order to find out what was going on. But I didn't bc I knew the result would not be good. However, some do not have that thought process and just react. I can see why people might become violent as the healthcare industry fosters an attitude that encourages people to lose control. However, violence is not the answer. I am not above wishing only the worst things in life to happen to each and every one of those workers involved. Every time I hear a helicopter has crashed, I have high hopes it may be the helicopter crew that medically assaulted and lied. Every time I hear there is an accident near the hospital from hell, I have hopes it may be one of those involved. So yes I understand why violence is used but I do not think it is the answer.


If a patient becomes violent, oftentimes it is bc of an injury or drugs the medical staff have given or drugs the patient may have taken. I don't consider that to be violence but rather an involuntary act that is caused by a medical reason. Versed can cause violent reactions but they still use it as they love that it destroys patient memories of the abuses they commit. Fentanyl can trigger violence but they still use it knowing that. So to cry foul over knowing certain medical conditions or procedures they do may cause a patient to physically react is ridiculous. The abuse I saw the nurse committing on my husband deserved a violent reaction. She was committing a crime on an very ill & defenseless man so why wouldn't she have been deserving of a reaction?


As for the ER, if they have a gun or knife on them it is bc they were probably doing criminal activities to start with & further crime is just standard procedure & not necessarily directed at the medical people but anyone in general who stands in the way of what they want. As for families, with the way hospital staff dealt with us, I can see them being upset and reacting.


There was an article in MedPage about a whistle blower who was singled out by other medical staff members. They knew she took care of a colony of feral cats. They cut up & multiated 6 or 7 of the cats to send her their parts in the mail. What fine examples of the caring, compassionate attitudes of healthcare workers abusing yet another segment of society who is defenseless and innocent. They would rather have an abusive social worker on staff than respect the right of all to have life without fear or torture. I hope those involved have a special place in whatever "hell" is. May they rot there!!!!!!!!!!!!!! JR

 
At Thursday, June 13, 2019 5:36:00 AM, Anonymous Anonymous said...

JR said:

With medical staff like those mentioned above involved in patient care who obviously think it is okay to torture and kill, then is it no wonder that things that have been mentioned in this blog happens. Knowing how they respond when someone does see something wrong and tries to do the right thing, it is scary for anyone to be a patient. I imagine if we could educate the public, we would have so many stories it would amaze even us. The right to torture, abuse, and kill is not an isolated thought or action in the medical community. The medical community does indeed think of itself as a tyrannical country who rules itself & anyone who dares to enter its perimeter. JR

 
At Thursday, June 13, 2019 5:58:00 AM, Blogger Biker said...

Going back a couple days to the post copying part of the discussion on the studentdoctor forum about non-informed consent vaginal exams, the sense of entitlement is astounding. Threads dealing with that specific topic, scribes, shadowing, and anything else that touches upon patient privacy are very telling. What patients feel or think are irrelevant; the students that post tend to be pretty self centered. It would seem that the dehumanization of patients begins fairly early in their pursuit of medical careers. Doing some related searches their could be informative in this regard.

 
At Thursday, June 13, 2019 10:40:00 AM, Anonymous Anonymous said...

Violence against healthcare workers, yes it happens. Violence against patients, yes it happens. This is why hospitals employ security staff, this is why hospitals have restraints. There are a lot of reasons why patients become combative, head trauma,etc. The number one reason from what I’ve see is patients undergoing opioid withdrawals and who is responsible for getting many of these people hooked on opioids in the first place? No, it’s not Big Pharma.

But what is the reason, excuse for violence against patients? Violence comes in many forms, physical assault, verbal assault, sexual assaults. You don’t read about patients suddenly raping the nurses and physicians. If there is consensual sex between patients and providers then whose fault is that. You can’t blame the patient, nurses and physicians are to respect boundaries, it’s in their code of ethics.

In most states it’s a felony to assault a healthcare worker, is it a felony to sexually assault a patient? Articles like KevinMD and others fail miserably in relaying the true story and facts. For the most part it’s another feel sorry for me poor healthcare nurse or physician. You wouldnt feel sorry for them when you read on state nursing, medical boards instances of ridiculous abuse against patients who did nothing but try to get well.

It’s beyond pathetic when an orthopaedic surgeon who is pulling down $500,000 a year feels the need to exchange opioid scripts for sex not only from his female patient, but her female cousin as well. It’s beyond pathetic when a female trauma resident can’t handle the pressure when a male patient spits up blood and some lands on her pretty clean white lab jacket. That she loses it and starts beating the shit out of him.

It’s beyond pathetic when a male respiratory tech repeatedly rapes a comatose female patient on a ventilator. The female patient delivers the child 9 months later and no one, nurses doctors were even aware she was pregnant from this rape as recently reported in Arizona. I’ll get bored if I were to go on and on with all the instances that’s occurred at hospitals I alone have worked at. These are the stories they dont want you to hear. They don’t want you to know what their salaries are, but rather how incredibly difficult their jobs are.

PT

 
At Thursday, June 13, 2019 12:44:00 PM, Blogger A. Banterings said...

Maurice,

As to violence against healthcare workers, that is like saying there is an epidemic of feral animals because animal control workers are being bit.

Furthermore, the statistics are skewed (purposefully by healthcare workers) to make them seem more like the compassionate, self-sacrificing victims. What we need to do is validate exactly how many incidents perpetrated by patients are preventable. Here is how the data is skewed:

First, we need to take out incidents where the patient is medicated, inebriated, or in an altered mental state. Metal detectors and security guards will not prevent this. Furthermore, there is no intent. This means also removing any attacks in emergency situations (where patient consent is not needed).

By the nature of an emergency situation, either the patient is not competent to make the decision (altered mental state), or the doctor is simply ignoring the patient's wishes. The case of Brian Persaud vs. NewYork-Presbyterian Hospital comes to mind.

Any physiatrist, phycologist, or physician, will tell you that fight or flight (also known as the hyperarousal, or acute stress response) is a perfectly normal, physiological reaction (reflex) that occurs in response to a perceived harmful event, attack, or threat to survival.

That being said, when providers are ignoring the wishes of someone of a sound mind, then they must expect to deal with fight or flight. It is interesting to note:

When the threat has been removed — either by running away from it, or by defeating it through fighting — it can take up to an hour for the body’s sympathetic nervous system to return to its normal level.

Is a proper investigation of these instances, which includes root cause analysis. If a proper investigation was done, you would remove many instances of healthcare violence that would be considered NOT preventable. Some preventable instances where the provider causes the agitation would have to be removed as well, because the providers are the cause.

If providers feared for their safety, I bet that would change the system and patients would be treated with more dignity.




-- Banterings

 
At Thursday, June 13, 2019 1:06:00 PM, Blogger A. Banterings said...

I forgot one last thought; look at what patients endured when providers provided security:

It's Time to Stop Strip Searching Psychiatric Patients

Boogie Jack

Protecting Safety, Preserving Peace: A New Standard in Mental Health Security Screening




Strip-searching patients is a form of sexual abuse. See how

a lawsuit against the State of Colorado at the Pueblo Regional Center, lays out that strip searches and genital manipulation of residents is abuse.

Yet, providers do not want to be strip searched (in the name of safety) and have even sued over the practice. The PATERNALISTIC, DOUBLE STANDARD in healthcare.



-- Banterings


 
At Thursday, June 13, 2019 1:27:00 PM, Anonymous Anonymous said...

https://mynews4.com/news/local/rpd-releases-detailed-report-on-renown-shooting

Look at this paragraph in particular:

"A medical assistant said she interacted with Frazier twice on the phone, and on the second time, was advised to hang up on him. This was about one year before the shooting."

REL

 
At Thursday, June 13, 2019 2:30:00 PM, Anonymous Anonymous said...

PT.
How about the second doctor at UCLA charged with sexual assault . First they had doctor George Tyndall , Now it's doctor James Heaps . 2 doctors at the same university . What the hell kind of shop do they run down there ? Some think because it never happens to them that these woman must be lying . Wrong . These scumbags belong in jail . These universities pride themselves with being so politically correct , where are the female doctors at . In the men's locker room taking care of the boy's ? Something needs to change but good luck getting that done . AL

 
At Thursday, June 13, 2019 3:18:00 PM, Anonymous Anonymous said...

Today's posts are almost like an "us them" mindset. Of course certain patients are physically abusive. Sometimes the patients are more at fault than the medical staff. Overtimes not. Which way happens more often? I don't have any idea.
But if I offend a hospital worker and it's my fault, is it justified for that worker to retaliate on JR or Biker?
As a person who works at nursing homes and Assisted living homes, I don't have a right to retaliate against Mrs A for something Mrs B did or didn't do or say. I don't even have a right to retaliate against Mrs B.
SOME of the violence against healthcare workers happens outside of the facility LONG after the fact. A patient has been robbed of his/her peace of mind because of some real or perceived abuse from the healthcare worker. The healthcare worker may or may not make a connection as to why this former patient is harming them or their family. The healthcare worker may not even especially remember the patient at all.
Some violence against healthcare that I would like to see happen is when medical staff humiliates patients, that patient looks up their abuser on Facebook and private message Abusers significant other and report to them the abuse inflicted.
JF

 
At Thursday, June 13, 2019 8:46:00 PM, Blogger Maurice Bernstein, M.D. said...

Al, a correction to your posting: George Tyndall was associated with USC (University of Southern California) whereas James Heaps was associated with UCLA (University of California at Los Angeles).

However, added to the two USC medical school deans fired, associated with sexual misbehavior, unfortunately there is a total of 4 ongoing USC stories:

From the Los Angeles Times: Troubles at the cardiovascular disease program came to public light in 2018, when The Times reported that Dr. Meena Zareh alleged in a lawsuit against USC and L.A. County that when she was a medical resident, Dr. Guillermo Cortes, a fellow, cornered her in a hospital room, reached under her scrubs and violated her. After The Times reported on the lawsuit, two other female colleagues came forward and made sexual assault allegations against the physician, according to state medical board filings.
And.. I am sure that there will be more news stories coming out from around the country about sexual misbehavior of university physicians. ..Maurice.

 
At Friday, June 14, 2019 6:38:00 AM, Anonymous Anonymous said...

JR said:

Banterings,

I believe what you have said about the fight or flight scenario is true. I believe that is why many people are drugged w/ fentanyl or and/or versed so they are less likely to fight/flight. Many patients, like my husband, have not or will not agree to procedures so they drug them so they can gain control and thus make the big money. Sometimes, in using these drugs, make some combative while most others like my husband it totally wastes them or incapacitates them. He was of sound mind when he told them that he would decide his treatment option once the 2nd hospital had evaluated him & discussed it w/ us. In the phone between the doctors of the two hospitals, they must have decided since he had given them the info. about how painkillers affected him to use them against him & delete the info he had given them. With my husband, the flight/fight took longer as the drugs took longer bc he existed in a fog but he did plan his escape as we call it. By Monday morning, he had put a plan into place. He didn't share that w/ me right away bc he was scared after everything they had already done to him they must catch wind of his escape plan. He told me he just knew he had to get out of there as soon as he could whether he really was fit to leave or not. This may be one reason why readmission rates are so high as patients will lie about how they are really feeling just in order to escape the abuse. My husband's story is a clear example of how they use power & control for greed w/ abuse thrown in as additional entertainment. Perhaps the title of the book should be The Gold Standard of Medical Treatment: Power, Control, and Greed. You are correct, if they started treating patients as if they were human beings, some of the perceived violence would stop. Some cannot stop as it is a result of an injury or drug reaction.

Maybe everyone on this blog should write their story. Then someone could take these stories along with additional information and data/stats to comply a book. PT and JF can provide an inside view of medical workings as well as the patient perspective. Banterings and Ray have a lot of data/info. We would be able to send copies of the book to media to get our story out. We also might be able to get speaking engagements. JR

 
At Saturday, June 15, 2019 1:20:00 AM, Anonymous Anonymous said...

My opinion about what keeps the dignity violation abuse going.
If it could be known how much the humiliation is a factor in patients avoiding Healthcare then the medical staff would have to admit to themselves that THEY are at fault for more suffering and death than they want to admit to.
It was the same when male doctors started delivering babies instead of midwives.
Pointing out to them that handwashing or lack of it was killing the patients.
JF

 
At Saturday, June 15, 2019 3:13:00 PM, Anonymous Anonymous said...

Maurice

You know, in all these volumes over the years there has never been advice given on what to do or say if you’ve been groped, assaulted or molested during an intimate exam or are we still viewed as outliers? Is it that those patients are the ones with the problems? Is this problem ever to be addressed by ethicists or does it still fall under the see, hear and speak no evil.

Did you ever see that little dust collector, what not. It was around in the 50’s, 60’s which were 3 monkeys with the caption below it, see, hear and speak no evil. It was a brain washing tool for society not able to grasp, comprehend and speak to issues that presented. Here we are 50 years later and people are still under its spell.

Oh, you are just an outlier not able to grasp, comprehend and speak to the ugly issues that are often presented and thus you should learn to shut up and get on with the way the rest of the stupid population does. News stories of physicians molesting their patients and as the investigation depends more victims come out of the woodwork.

It makes you think well, we’re these additional victims under the three monkey spell by never saying anything in the first place as real victims or are they just opportunists seeking attention? Have we as a society just taught not to question those in authority despite whatever ugly behavior occurs in the process of the medical system.

Here we are at the hundredth installment of this blog and you can appreciate that many here who relay experiences are not fully opening up about the real ugly experiences they have been through, I doubt they ever will, I know I won’t. It’s all really fit for real time therapy with trained therapists, don’t you agree?

PT

 
At Saturday, June 15, 2019 6:09:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, another worthy posting. First of all, only "50 years"? Take a look at this from what I wrote in a June 2007 blog thread: If you look at the June 6th 2007 issue of the Journal of the American Medical Association (available by subscription only) you would find reprint of two 100 year old editorials (June 1 1907). The one pertinent here was written as follows: "The second editiorial ("A Legal Opinion of the Medical Profession") involved the report of a malpractice case from Ohio where the judge "after listening to the evidence of several local physicians, took the case from the jury and instructed the verdict for the defendant." The judge stated that never thought even for a moment that "any physician would perjure himself on the witness stand to shield another." The attorney for the plaintiff, in protest, said "that it is impossible to to make a case against a physician because members of the medical profession are under obligations to endorse each other's statements." and then I wrote the following: Golly, that is exactly what many of my visitors have been writing currently on a number of threads why they feel doctors' alleged misbehavior are getting off with no punishment and changes in standards of medical behavior are not being improved for the patient because of this "club"-like attention by the "members" toward the self-interest of the physicians.



Some issues, even in medical practice, never change. ..Maurice.


Good luck, PT, with the therapists too.
From the National Psychologist: "Therapists Vulnerable to Sexual Misconduct Accusations
By Mindy B. Mechanic, Ph.D.
March 6, 2018"


My advice is that ventilation is for "now" but for the "future" what is needed is ACTION. On the other hand, you see from the above 100 year old editorial, change is hard to come by. But at least start! ..Maurice.

 
At Saturday, June 15, 2019 7:09:00 PM, Anonymous Anonymous said...

Maurice


Notice at the end of the narration, “ practices and education are key to successful risk management “. Now where have I heard that phrase before!

PT

 
At Saturday, June 15, 2019 7:31:00 PM, Blogger Maurice Bernstein, M.D. said...

PT,for virtually every occupation, consideration of "practices" being carried out but then integrated with occupational "education" is the best approach to prevent injury to the worker and to others. Even those who supervise others must face the very same evaluation of performance. ..Maurice.

 
At Saturday, June 15, 2019 9:35:00 PM, Blogger 58flyer said...

A gentleman by the name of Doug Capra has a blog site and used to post on his site as well as Joel Sherman's blog site. I haven't seen him post in some time and I was wondering if he is still active.

http://patientprivacyreview.blogspot.com

Hopefully he is still around as I find him to be very articulate and a great information source. He may have posted on this site as well but I can't remember. I mention him because some of our more recent posters might not be aware of him.

I bring him up as he is a writer according to his bio. That brings us back to my earlier suggestion of our first step being a book to get the information out there to news sources and the public in general. Many men just don't know they are not alone and don't know who to turn to or to even ask. I think once you get the discussion going we would be amazed at the amount of displeasure men have with their healthcare experiences.

58flyer

 
At Saturday, June 15, 2019 10:09:00 PM, Blogger Maurice Bernstein, M.D. said...

Doug, continues his life in Alaska and from what I understand continues to occasionally view our blog thread but has not in the recent years written here, for personal reasons..though, of course, I wish he could.

58Flyer, you are correct, of course, that publicity is necessary to get the views here out to the public. If a book would do the job as some books which have been written and reviewed about Trump may be later found to be effective in changing the views of his public and lead to getting him out of the office of President. Writing about; misbehaviors of President Trump may be more effective these days than writing about misbehaviors in the medical system. ..Maurice.

 
At Sunday, June 16, 2019 4:26:00 AM, Anonymous Anonymous said...

Unlike all of the lies and exaggerations being told about President Trump, the patient abuse experiences being told here are actually true.

 
At Sunday, June 16, 2019 5:46:00 AM, Anonymous Anonymous said...

JR said:

This past week, my husband talked to someone he knew was going to see a cardiologist connected w/ the hospital from hell. He told this man his whole story so this man would be forewarned about what could happen. He said the opinion of this man was he felt they had acted this way bc they thought he was gay & thought they had the authority to "punish" him as they are a Catholic hospital. The man he talked w/ said he now had a lot to think about w/ the info he now knows. My husband said once he learned this man would be going to the same practice & having something done in the cath. lab, he felt obligated to share his story of what could happen & how they treat men in general. My husband, was like many men, didn't know he was being treated differently by the drop your pants & bend over while my nurse and I watch syndrome. He never realized he had a choice in gender care. He didn't realize until it happened to him that female nurses get their kicks out of leaving male patients exposed unnecessarily & for prolonged periods of time even inviting an audience to watch & no one has the professional or moral backbone to defend a defenseless patient.


Banterings,

The story I referred to other day about the nurse whistleblower who was sent mutilated parts of cats from a feral colony she was knew to care for from her angry co-workers, doesn't that qualify those sick co-workers as a sociopath or psychopath? Isn't aninal mutilation one of the signs of a serial killer in learning? If these people have so little disregard of life, why would we trust them w/ our lives? Just imagine what those very same female nurses would do to a defenseless patient who may incur their wrath? It is indeed dangerous when there are no protective mechanisms in place to protect patients from nursing harm while in the hospital or once out of the hospital & the patient brings it to the attention of the administration. It would seem that some working in a hospital may be serial killer, torturers, abusers, etc. and they are given free rein to terrorize any patient of their choosing. JR

 
At Sunday, June 16, 2019 7:41:00 AM, Blogger Maurice Bernstein, M.D. said...

Anonymous, clearly presidential change is open for possibility in less than 2 years. I have a feeling that changes in the medical system especially issues that are being discussed here are going to take much longer, books or not. ..Maurice.

 
At Sunday, June 16, 2019 8:09:00 AM, Anonymous Anonymous said...

You have rose colored glasses regarding Trump. I'm not saying nobody ever lies or exaggerates but even he said " I could stand in the middle of 5th Avenue and SHOOT somebody and it wouldn't cost me any voters, OK?
I'm more inclined to think he could empty a machine gun into a crowd and it would be told around Trump just delivered us from a criminal group of refugees. JF

 
At Sunday, June 16, 2019 10:44:00 AM, Anonymous Anonymous said...

JR said:

Just as all medical "professionals" lie so do politicians. However, it would seem that it has been made a full time job to belittle this President when others of the past have done just the same only didn't get the media coverage. Crimes, like in the medical field, have been committed and will go unpunished like w/ Hillary who was the worst candidate ever. In my younger days, I supported Bill Clinton until I grew up & saw him for what he was. There is always a double standard. If you don't like Trump, just wait it out like I did w/ George W. and O'Bama. The medical community is much like politics. A few have the say & make all the rules. Criminal acts are only punished if it is convenient. Political opponents (patients) are bullied & are not listened to because they do not matter. Political opponents (patients) have no rights, can be jailed, isolated, & have things done to them against their will. If medicine is socialized, there will be no patient rights or choices. The medical community will have absolute freedom to offer treatment as they please w/ absolutely no recourse for patients. It is almost like that now. There was an article on Bing last week about Bad Patients. It said that US patients almost the worst patients as they do not totally comply w/ their dr.'s orders. In other countries, it went on to say that drs are viewed as deity. US drs would like that to happen here. Imagine how much worse healthcare would be delivered if this would come to be. In most things, we as Americans are more free to pick and choose what advice we follow from experts. Although a mechanic will say to change your oil every 3000 miles, we do not. Our Lexuses can go 250,000 miles or more w/ only a total of about 8 or less oil changes. When sold, they are still going strong. Imagine if drs were had absolute authority? It is almost that way now. Speaking from experience, they will covertly override a patient's stated treatment to do as they please to make sure that patient will forever dependent on medical care by performing procedures against a patient's consent & using drugs refused by the patient. It is like a North Korean prison where they practice medical torture & deny it. JR

 
At Sunday, June 16, 2019 6:16:00 PM, Anonymous Anonymous said...

There will be no change in the presidency two years from now, besides, the issues here are irrelevant to that office. This is a payer issue and the solution is with more responsibility and accountability with CMS, health insurance companies.

PT

 
At Sunday, June 16, 2019 6:46:00 PM, Blogger Maurice Bernstein, M.D. said...

PT et al: the reason, as Moderator, I am permitting discussion of the upcoming Presidential election is because I thought political views from the RIGHT and the LEFT (red and blue), destroying Obamacare, returning to more classic insurance by one side or replacing it with Medicare for All by another side may provide basis for discussing the role of politics in the solution of the problems involved in the medical system;s with its partners behavior to the patient, either male or female.

If you think that changing the political colors are not pertinent to the needed changes in behavior of the medical system then we should leave current politics alone and write about other approaches for change. ..Maurice.

 
At Sunday, June 16, 2019 7:28:00 PM, Blogger A. Banterings said...

JR,

Part of this sociopathic behavior is learned in the undergraduate education. Biology lab kills empathy for animals, the first step before killing empathy for human beings. The medical school cadaver is the last step before dehumanization (like other medical procedures) is practiced on real patients.

I have 7 cats that I rescued, and the thought of what you wrote about made me sick. I purposefully avoided responding.

Imagine if we prove that providers are prone to being sexual sadists and sociopaths at a much higher rate than the general population, then retaliation by patients would be justifiable homicide. Juries would assume providers were guilty.

The profession works hard to keep the image of caring and compassion. They spend billions in PR and lobbying on K Street. This is because (as PT points out) healthcare accounts for $4 trillions annually; $1 out of every $5 of GDP.

The profession has survived the Holocaust (the physicians' trial), the #MeToo movement, and pelvic exams on anesthetized (repeatedly).

What do I think will change the profession?

Some student searching for research ideas come across this blog and reads it. They latch to something and do a proper study and come up with recommendations that change the profession from med school through end of life care.

The other possibility is that a liability lawyer presents psychological harms as preventable side effects and extracts a large verdict. Other liability lawyers hope on the bandwagon and this becomes a cottage industry.



-- Banterings


 
At Monday, June 17, 2019 10:23:00 AM, Blogger Maurice Bernstein, M.D. said...

Here is a topic which I found on a bioethics listserv to which I subscribe. It was written by a nurse ethicist but could apply to physicians and other professionals who are with a patient when some life threat to patient and professional occurs.


Employers are finding it advisable and necessary to provide "active shooter' training for employees. This training seems to be commonplace in hospitals. One popular training technique is the "run, hide, fight" training. In such a scenario the employees are taught to run from the vicinity of the shooter to a place of safety, hide if they cannot run, and fight the aggressor as a last resort. As a board of nursing member who sits on the disciplinary hearings for nurses, I was recently asked whether a nurse would be disciplined for abandoning her/his patients if she/he ran? I can imagine a scenario, such as an ICU (or dialysis, surgery, NICU...) where if the nurses left the unit, significant patient harm may occur. This issue has many facets, legal and moral.

Given a situation with immediate and life threatening consequences, do nurses have an ethical obligation to remain with their patients? Some surveys have indicated that the public has an expectation that the nurses would remain with patients, does this public expectation create a moral imperative to do so? What are the known legal duties in this (hopefully novel) situation?


So, if you were the nurse or the physician or tech in this situation what would you do? Or, if you were the bed patient, what would you do or request? Yes, this does have to do with patient dignity. Should you be left alone to to killed, your attendants having run away to protect themselves? ..Maurice.

 
At Monday, June 17, 2019 10:54:00 AM, Anonymous Anonymous said...

Dr B, Sorry for arguing about Trump on this blog. I can do that on Facebook and this blog is about our issue, an issue that is important to us. PT and JR. Sorry to you also.
JF

 
At Monday, June 17, 2019 11:24:00 AM, Blogger A. Banterings said...

Maurice,

This is very interesting. I can point to the 'Coward of Broward' sheriff's deputy arrested for inaction during Parkland mass shooting as a recent case.

You have a couple issues here, essentially falling on the legal question what is required of physicians, nurses, or other providers? There is a certain requirement for first responders, but does any of these requirements cover healthcare workers?

One might read some provisions of the Emergency Medical Treatment and Labor Act (EMTALA) being relevant to the issue.

Most first responders are government employees where the employer has the benefit of sovereign immunity. Even though, many provisions for first responders apply to all, including private ambulance companies and volunteer fire departments.

Some of OSHA's safety requirements may be in conflict with state mandates that further confuse the issue.

Perhaps the best place to start is to look at the requirements of providers for weather emergencies (hurricanes, blizzards).




-- Banterings



 
At Monday, June 17, 2019 11:48:00 AM, Blogger Maurice Bernstein, M.D. said...

And another factor to consider in a response to a "terror" event is HOW ILL IS THE PATIENT? DEADLY ILL? Remember HURRICANE KATRINA and the professional behaviors in that potentially deadly for all hospital situation? ..Maurice.

 
At Monday, June 17, 2019 12:02:00 PM, Blogger Maurice Bernstein, M.D. said...

I can't get the above link to work but I originally got the article from the New York Times Magazine by Googling about hospital and Hurricane Katrina. ..Maurice.

 
At Monday, June 17, 2019 4:52:00 PM, Anonymous Anonymous said...

JR said:

JF,

Don't worry about it. If we could not have dialogue about issues then nothing would ever be solved. Compromises cannot be made if neither side can listen & take criticism. You more than have the right to voice your views about this President or any other just as I do & have. The issue today is everybody gets mad & won't listen. You can't learn anything new if you close your ears & mind to what others are saying. It is just like what we are talking about on this blog. The medical community has their point of view & think it is the only correct point of view. They will not listen nor will they change. It takes something drastic to shake things up like this last election did to make people start caring, talking, and hopefully they will listen to all others again and try to work together for compromises instead of sticking to their point of view--right or wrong. Close minded people are the most dangerous people in the universe. Just look at different countries who stifle its citizen's freedom especially to disagree. Look at how hospitals treat their patients by not allowing patients their freedom to dignity, respect and to choose their treatment from viable options. They will use drugs to guarantee the patient has no choice but to suffer from whatever the medical community has in store for them.


I would make sure I would take care of my loved one myself bc relying on the medical community to protect them didn't work out this last time at all. They did only harm & abuse so why would I expect them to protect life when that is not their ultimate goal? The only lives they will protect are their own. They care nothing for patients as far as I have seen. They didn't protect when there was no emergency situation so why would any patient expect anything but cowardice otherwise? It would be up to the patient to get out of there bc the hospital would have no intention of protecting the patients only the staff. Patients do not matter to them except as specimens & paychecks. They care nothing about real human life. Isn't it ironic that teachers are required to stay w/ children bc they are vulnerable but medical staff would not? Guess how much less a teacher makes than a doctor? I had to stay for hours about the real end of the school day bc I lived close so that every single child could be picked up. This was after bad weather such as tornados, snow, & flooding. For educators, it is a no brainer as there is a deeper responsibility to protect the vulnerable. Why would people who supposedly are in the business of saving lives get an excuse card? Teachers must be more compassionate & just all around better human beings than medical people? JR

 
At Monday, June 17, 2019 10:23:00 PM, Blogger 58flyer said...

Maurice,

Good question. Having freshly retired from 41 years in active law enforcement, I have an uniquely qualified background to answer your question.

No, medical personnel do not, in my opinion, have a duty to stand by with patients with an armed shooter situation. They do not have the training, and most importantly, the firepower to deal with an armed shooter.

I know what's involved with that training. I am a nationally certified criminal justice instructor when it came to firearms issues. Police tactics evolve over time, as experiences dictate.

The current response is to charge the shooter. The training for that is counterintuitive to what was trained in the past. The training is intense. The officer goes into the scenario knowing he/she WILL be shot. The ammunition used for the training is what is known as simunitions. It is a loaded down round using a plastic projectile in a special firearm simulating the officer's actual weapon. The plastic bullet travels at about 400 feet per second. When it strikes flesh, it does damage. Mostly bruising and abrasions, but some officers have had to go to the hospital to have the plastic bullets removed. As a trainer, I have sent many of these rounds to the trainee. As a training responder, I have been on the receiving end. Of course, you wear protective gear during the scenarios, but blood is often spilled.

The training is geared so if the officer does what is right, he/she will win. But if they screw up, they will have to repeat the scenario. The officer trains until they win. Winning is the only acceptable outcome, for if you constantly lose, that will become your expectation. You train as if you expect to win, otherwise you will never win, and then you will die, along with those you are charged to protect.

Continued.

 
At Monday, June 17, 2019 10:55:00 PM, Blogger 58flyer said...

Prior to Columbine, the accepted response was to take up a position of advantage, then set up a perimeter, so responding officers could take up positions in safety. Then formulate a response, which usually involved a hostage negotiator.

After Sandy Hook, the mentality changed. That involved rushing the shooter. All kinds of statistics were investigated, such as when and how the arrival of law enforcement affected the shooters ideas of response. The experts agreed that an armed shooter thought that the situation was over when police arrived. That might be partially correct as events have shown. In most of the situations police arrival caused shooter suicide, but that was not always the case. Police still had to confront the shooter.

I am not at liberty to say what drives the current response. But it sure doesn't involve taking a defensive position.

As to the issue of the Broward Coward, he will not be convicted. He is an older officer, trained to the older standard of taking a defensive position. I am not defending him in any way, but I know what the older standards were, as I was taught that way back in the day. I have no idea what he was taught as to the more recent response ideology, but he is certainly in a defensible position, if his legal counsel is competent.

 
At Tuesday, June 18, 2019 4:28:00 AM, Blogger Biker said...

Concerning politics in relationship to what we discuss here, a parallel can be drawn in the sense that most politicians represent their own interests and that of their major supporters rather than the interests of society as a whole. This is how they generally become wealthy far beyond what their public sector salaries might otherwise indicate is likely.

Big Pharma, hospital systems, the AMA, nursing associations etc similarly represent their own interests and that of their members before that of patients.

In both cases, this is human nature at work. Their own tribe before that of others.

To the extent that those who control healthcare are major contributors to political campaigns they become part of the politician's tribe and in the end one hand washes another as they say. This is why I don't think it would be very easy to find much political support for the kinds of legislation discussed here.

I would add that for the past century women have organized to advance their interests and gain rights previously denied them. These groups have made themselves part of politician's tribes through their donations and ability to deliver votes. It would be a brave politician indeed who advocates anything that would give a priority or mandate for male patients to have the right to male staff for intimate matters in healthcare settings. Women's groups would make their objections known.



 
At Tuesday, June 18, 2019 5:35:00 AM, Anonymous Anonymous said...

If a criminal seeks retaliation by showing up at a hospital with a gun, then I'd say that's a criminal who isn't trying to avoid capture.
A sneakier criminal might blow up cars and homes. Maybe even clinics.
JF

 
At Tuesday, June 18, 2019 8:59:00 AM, Blogger Maurice Bernstein, M.D. said...

58Flyer, you state "medical personnel do not, in my opinion, have a duty to stand by with patients with an armed shooter situation. They do not have the training, and most importantly, the firepower to deal with an armed shooter." But medical personnel do have the responsibility to protect the life of the patient they are currently attending, don't they? That is why "code blue" calling outs are made for CPR in patients who are not DNR. How can protecting the life of a patient in "shooting situation" be attained who cannot jump out of bed and run to a more protected site with the employee?

You know, the concept of "professional self-interest" may be the basis for much of the professional "misbehavior" or worse which has been described on this blog thread. There, apparently, is a point where concern about the interest of the patient is trumped by the professional's self-interest and it may not take something as extreme as a "shooter" in the hospital to demonstrate this. Could that be the view of those writing here? ..Maurice.

 
At Tuesday, June 18, 2019 10:26:00 AM, Blogger Biker said...

Hospital staff are under no obligation to shield patients from a shooter with their own bodies. Their job is to provide medical care rather than be unarmed guards. What medical staff are responsible to do is to follow the established protocols for such events whatever that might be. Those protocols might vary depending upon child vs adult, ambulatory vs not and so forth.

 
At Tuesday, June 18, 2019 5:03:00 PM, Blogger NTT said...

Good Evening Everyone:

ANY women's groups that would dare object to men having the same right to their privacy that women have been FREELY given for over 50 years now, I WANT TO KNOW ABOUT.

I WILL be THERE to answer their objection.

They have NO RIGHT nor REASON to even open their mouth.

Regards,
NTT

 
At Tuesday, June 18, 2019 6:35:00 PM, Blogger Biker said...

NTT, women's groups have already been doing it for years by claiming women are being discriminated against anytime men push for intimate privacy. This is how they got into locker rooms, men's prisons, boy's detention center/halfway houses etc.

 
At Tuesday, June 18, 2019 6:55:00 PM, Blogger Biker said...

The "publish a book" suggestion has come up several times, most recently using the anti-Trump books as an example. It wouldn't work for the same reason the anti-Trump books are ineffective. Such books are only bought and read by people living in the same echo chamber as the author. The books serve to affirm what their buying audience wants to hear. Nobody else reads them.

What is instead needed are more scholarly articles written by healthcare insiders that will be read by others in healthcare. People within healthcare aren't interested in what patients have to say, especially male patients. They need to hear it from their peers.

The other part needed are studies in which staff gender is a factor. It rarely is. I recall one study that concluded something like 90% of male urology patients were OK with scribes being present during their appts. The gender of the scribes wasn't a variable in the study nor was whether the appt. was just talking vs being an intimate exam or procedure. It turned out that most of the scribes were male medical students but some will point to the study as justification for female high school graduates serving as scribes during male patient intimate urology exams and procedures. I saw another study that concluded only a small minority of patients having urodynamic studies are very embarrassed by it. The study didn't differentiate by gender of patient or staff, but you can bet it has been used to justify hiring only female staff for male urodynamic studies.

I have a hard time believing that the people designing some of these studies are that oblivious to gender as a factor. If so, then such studies are purposely misleading so as to reach a pre-planned conclusion.

 
At Tuesday, June 18, 2019 9:23:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, here is a study where "gender is a factor", published online in May 2016 but presented in the American Journal of Men's Health in September 2018 with the title "Do Urology Male Patients Prefer Same-Gender Urologist?" Here is the Abstract from the article:


Abstract
There are several studies on patients’ preference for same-gender physicians, especially female preference for same-gender gynecologists. Data regarding the preferences of urology patients, of whom the majority are males, are scarce. The objective of this study is to assess provider gender preference among urology patients. One hundred and nineteen consecutive men (mean age 57.6 years) who attended a urology clinic in one university-affiliated medical center were prospectively enrolled. A self-accomplished 26-item anonymous questionnaire was used to assess patients’ preferences in selecting their urologist. Of the 119 patients, 51 (42.8%) preferred a male urologist. Patients exhibited more same-gender preference for physical examination (38.3%), or urological surgery (35.3%), than for consultation (24.4%). Most patients (97%) preferred a same-gender urologist because they felt less embarrassed. Four patient characteristics were identified to be significantly associated with preference for a male urologist: religious status, country of origin, marital status, and a prior management by a male urologist. Of these, religious status was the most predictive parameter for choosing a male urologist. The three most important factors that affected actual selection, however, were professional skills (84.6%), clinical experience (72.4%), and medical knowledge (61%), rather than physician gender per se. Many male patients express gender bias regarding their preference for urologist. However, professional skills of the clinician are considered to be more important factors when it comes to actually making a choice.


What does this research tell you? ..Maurice.

 
At Tuesday, June 18, 2019 9:46:00 PM, Blogger 58flyer said...

Maurice,
I do agree that medical personnel have a duty to do what they are trained to do in saving a life. That involves the proper response to a "code". However, most medical personnel do not have any background in responding to an active shooter situation. That is a totally different situation.
If I were in a situation as a patient where I was not mobile enough to get away on my own, I would not expect my caregivers to sacrifice themselves just to stay with me. It would be a needless loss of life.
58flyer

 
At Tuesday, June 18, 2019 10:21:00 PM, Blogger 58flyer said...

Maurice,

In response to your reference to the article in the American Journal of Men's Health regarding " Do urology male patients prefer same gender urologist?" I do find it interesting that this is an Israeli study. I am more interested in a study in American urology patients experience. Some of the Israeli responses are no doubt related to religious beliefs. Much of my personal experience is related to an abuse past experience. My current religious beliefs play a major part of my gender preferences, but I cannot downplay that my previous abuse experience drives my present gender preference.

Simply enough, I prefer a male urologist.

I am more interested in any study about the preference of male patients as to the gender of assistive staff. They really do most of the hands on care of male patients. My male urologic physician was not present for my urodynamic study. The ONLY reason I was able to complete this study was that he honored my request for the male nurse practitioner to attend me for the procedure. Otherwise, there is no way I would have been able to accept a female to do that procedure.

I do have to ask the question that if a male patient who would have no physician gender preference would find it acceptable for the female assistive staff. I think that most female physicians would think that if the patient is OK with a female doctor then that patient is automatically OK with female assistive staff. That would be a bad assumption.

58flyer

 
At Wednesday, June 19, 2019 4:37:00 AM, Blogger Biker said...

58Flyer clarifies the "studies" issue better than I did. One cannot automatically assume that conclusions reached in other countries equally apply in the US. I don't know anything about modesty norms in Israel but in Europe the culture is far more open with nudity than in the US, thus European studies are of limited value in this regard.

Studies that ignore the staff gender piece as 58Flyer noted is a real puzzler as well. I'd be OK with a female physician doing an intimate exam or procedure long before I'd be OK with female staff in the room observing or female staff doing the prep. This is because I see the female physician as a professional whereas the staff almost universally are not. That the staff has been trained to be polite is irrelevant.

Also on the staff issue, the medical community knows that female patients that are OK with male physicians are generally not OK with male assistive staff. It is not too much of an intellectual leap to assume the same for male patients, yet they seem oblivious to how male patients feel about this.

Again, what we need are scholarly articles by physicians and others in the medical community and we need studies that actually take staff vs patient gender into account.

 
At Wednesday, June 19, 2019 5:29:00 AM, Anonymous Anonymous said...

58flyer
Judging from our blog, it's automatically assumed that male patients ( assuming for a brief moment they even care ) will be ok with female supporting staff anyway. Even if the doctor/caregiver is MALE.
LOTS of these accounts demonstrate this.
I guess I'M kind of an outlier here in that I don't want to be displayed to ANY extra person of EITHER gender. Also in that I don't want to be seen by patients or staff out in the hallway because somebody opened the door and no screen nor curtain blocked the veiw. The mindset here is so long as the door isn't left open that everything is as it should be and so long as privacy is provided while the patient is undressing or dressing, why should that patient care if somebody in the hallway sees them if the door opens at a wrong moment.
JF

 
At Wednesday, June 19, 2019 5:31:00 AM, Anonymous Anonymous said...

JR said:

I think there would be a larger percentage of males answering they would want an all male staff if they knew they had the right. Many men do not know they have the right to gender preference in intimate care. If men knew they had rights, the survey results might be different.

My husband has been suffering anxiety as he needed to go to the derm. dr. for suspicious spots probably due the massive amounts of radiation from the PCI he didn't consent to have. He wanted me there w/ him bc the thought completely stressed him out. Prior to what happened w/ the hospital from hell, he like many men didn't like the female invasion but tolerated it as he didn't know better. The dr. is a very nice, older guy who belongs to no hospital as he doesn't believe a hospital should own him. He is very common sense. His nurse wears her nametag w/ her full name & is in there to help. My husband only took off his shirt bc he will no longer tolerate any female to be involved in intimate care as he doesn't know which ones may be potential abusers so he can only assume that all may be. The nurse was also very nice & talked about how bad medical care has become while she was helping the dr. w/ his equipment needs.


Hospitals have a duty to protect patient while in their captive state. If there was an active shooter, then each patient area should have doors that automatically lock w/ the push of a button to provide patient safety. If staff is locked in a patient area, they must continue to give care to the patients. Prisons if I am not mistaken have such abilities & hospital resemble prisons by the concept in which they operate & take away basic human rights while in captivity although the ACLU will represent prisoners whose rights have been trampled on. For patients, no one cares when their rights have been trampled upon. Many professions do not sign on to put their lives on the line but do so when the situation arises & medical should be no different or more special that they cannot also sacrifice if needed. JR

 
At Wednesday, June 19, 2019 6:30:00 AM, Anonymous Anonymous said...

JR said:

While a book might only appeal initially to those who are on the same team, it could generate enough talk that others might also become interested. I have read books about topics or persons that generally I am not interested in or like but I read to get more information. I think others might do this too.

As for the medical community doing research on this topic--the really big question is why would they? They are not interested in change. Also, they slant their research & studies to prove whatever they need. Look at the all the heart studies. The egg is bad--no it is not. Everyone needs statins & stents when in fact that is not so. Their studies are only done to back up their latest & greatest money-maker. There have been studies & research done on this topic but it has been hushed.

To get anything done through legislation will take a lot of public pressure as the medical lobby is very powerful & well funded. However, as we have seen in the last presidential election, a dissatisfied public can wield a lot of power too. Whether you like Trump or not, you would have to agree that the public wanted change from status quo & got it. That same level of dissatisfaction w/ status quo in how medical care is delivered will be what could force change. They are not going to do it themselves as why would they give up any power & control when most of them are narcissists going on to become sociopaths. Most of the medical community feel that when someone seeks medical treatment they lose their basic human qualities & rights & should be subjected to being in total control of the medical community. The less the patient is thought of as being human, the more satisfied is the medical community. They can brag about "saving" & "curing" w/o ever realizing the patient is a human being w/ basic human rights. However, for the medical community, most will want those basic human rights as witnessed by most not wanting to receive care from anyone they know or work with. They value their personal privacy bc it does matter after all but only they should be afforded such privacy. On the totem pole, patients rate so low they are not even touching the totem pole of importance.


People like us are going to have to be the ones to get the info out before the public. The medical community has no reason to whistle blow on itself but they do have every instinct for not to for self-preservation. As Banterings has mentioned in many of his posts, group pelvic exams are still performed on anesthetized women & rectal exams on anesthetized men. The medical community feels they are perfectly entitled to these violations as the patient is under their control. As I have stated before, the informed consent forms are merely added protections for the medical staff & not to serve as protection to the patient. Medical records also are manipulated to protect the medical community & not be a true representation of what really happened but rather a blanket, vague statement of what is the standard for that procedure/treatment. Details are discouraged as that is where people find out what really happened. JR


 
At Wednesday, June 19, 2019 9:57:00 AM, Anonymous Anonymous said...

If you don't know your rights. ....then you don't have any!
JF

 
At Wednesday, June 19, 2019 11:51:00 AM, Anonymous Anonymous said...

JR said:


I agree w/ what JF said & am having trouble understanding some of what has been said here too. I agree that I don't want other genders involved even as the dr. or observers when there is intimate care involved. When I used a gyn/ob, she was female as was the FP. My husband chose male drs. but always was intruded upon by female staff. Now my husband knows he can have same gender care, he will demand it or leave. There is also no reason that I cannot accompany him bc if I can't he will leave. He would rather die than be victimized by the systems & its community as he was the last time. I don't understand how a medical asst. who had been trained for certain work in a medical office makes being naked in front of worse than being seen naked by someone w/ a college degree. Some medical assts. may have a college degree. What if a male dr. brings in a female dr. to help him is that okay? As far as rights, we now know our rights but still can't get them enforced or respected as patients flat out do not have any rights as far as the medical, legal, or government is concerned. Maybe if a patient dies but even then it is an uphill battle. Sexually molesting a patient by exposing them unnecessarily or group exposure is not an issue of concern to anyone but the patient. Even if they kill a patient, if the medical records says they didn't the government doesn't care. As far as attorneys, if it is not easy money they do not want the case bc it is too much trouble. I don't understand being okay w/ a female dr. but not being okay w/ female assts. You don't have to hold a college degree to be a professional in your field. That attitude is just downright snobbish & demeaning. Also, it is more publicized that about drs. molesting than office assistants. Drs. also do not value covering a patient as they deemed ownership of the patient while in their presence. I have known many w/ college degrees who I would not call professionals in their profession but rather had enough money to get the little piece of paper saying they are now a college graduate. With that type of attitude of viewing who is professional than having the female nursing staff present w/ the dr. should not be an issue bc many of them are 4 yr. grads or more which makes them a professional entitled to see any patient naked. My feeling is that only I have the power and consent to say who can see me naked as I have not lost my basic human rights this country is supposed to guarantee me. Being sick should not automatically void my basic human rights but it does. Somehow the medical community has not or care not to make the connection between how they deliver their treatment is as important or maybe more so than their actual medical treatment of drugs & procedures. If they demean, abuse, exploit, dehumanize, devalue, etc. their patients, then they put the patient at a mental disadvantage to get well. The mental frame of mind is just as important as the physical state of a patient. JR

 
At Wednesday, June 19, 2019 6:00:00 PM, Anonymous Anonymous said...

Maurice

The abstract you presented says “ Many male patients express gender bias regarding their preference for urologist.”

In this regard male patients predominantly select male urologists and therefore the patient’s are biased. Appreciate this poll was taken in one urology office in the country of Israel. The article was presented by 3 physicians of whom one I believe is female, it dosen’t matter.

Nevertheless, men on that poll, the patients that is, are biased. Now in the United States all mammography techs are female, therefore the medical industry itself is biased, correct? Do you think this is an ethical issue? That in this country the medical industry itself is biased.

It must be since men in another country at one Urology office are biased solely because they selected a male urologist. Would women in this country who select a mammography clinic that employs only females be considered biased, NO. Why, because the industry employs only female techs thus it’s the industry that is biased.

There, I fixed the subject heading of the abstract for you.

PT

 
At Wednesday, June 19, 2019 9:08:00 PM, Blogger Maurice Bernstein, M.D. said...

To all our participants here: Yes, I admit that the example of patient gender selection in urology was limited in over all scope but also represented the views within a country other than United States.

So what I am asking you to do is Google, Google or use some other resource to find more extensive studies in which the United States population view has been studied on this subject. Also, hopefully, the study is from recent years.

I want you to provide studied evidence that will readily support your argument that the views you express here are NOT those of some population of "statistical outliers".

I think we should support each other with statistical evidence, if such evidence is available. Best wishes on your research.

..Maurice.
..Maurice.

 
At Wednesday, June 19, 2019 9:11:00 PM, Blogger Maurice Bernstein, M.D. said...

Oops! I sound like a first year medical school teacher giving orders to my class! ..Maurice.

 
At Wednesday, June 19, 2019 10:22:00 PM, Blogger 58flyer said...

Maurice,

I think there are few, if any, studies of male patient preference on the gender of assistive staff. I'm no expert on research but I haven't found any studies in this regard. Banterings seems like an awesome researcher, maybe he can discover some studies.

JR,

A book would be very valuable as a means of getting the subject up and on the radar. I still think it is the best means of attracting attention to what I think is a crisis in men's health. Who knows what can happen when the right person(s) finds their voice and become a leader in effecting change.

Biker,

Yes, scholarly articles are a must, but the audience is limited to those in the medical community. That is good, but there needs to be a wider audience.

58flyer

 
At Wednesday, June 19, 2019 10:31:00 PM, Blogger 58flyer said...

JF,
A simple solution to those wrong moments when a door is opened at the most inopportune time is a curtain drawn across to prevent visual access to the undressed person inside. The cost is minimal, but the protection would be very welcomed by the patient. When I had my most recent hip replacement surgery and I was up on the floor in my room, there was a curtain that separated me from the door. Anyone who came into the room first announced their presence at the door, then only came in when I said that is was OK to do so.

58flyer

 
At Thursday, June 20, 2019 9:03:00 AM, Blogger A. Banterings said...

Maurice,

In regards to professional self-interest, I have consistently described it in terms of John Emerich Edward Dalberg-Acton, 1st Baron Acton's quote "power corrupts; absolute power corrupts absolutely."

The profession of medicine points to its self governance (AMA, speciality associations, state boards, etc.) as the means of protecting patients. But, as the Romans put it, because of man’s predatory nature; homo homini lupus ("man is a wolf to man"), thus self-governance is intrinsically contradictory.

What is to prevent the guardians from giving in to the temptation and preying on the people they are supposed to protect? Have we not seen this with the issues of doctors requiring women to submit to cancer screenings (PAPs) and pelvic exams to get birth control pills?

Yet, there is only the requirement of medical history, blood pressure check, and smoking history.

In some states with an online app or you can get them directly from a pharmacist (see list of states here).

When we look at the science, we find that pelvic exams have no proven medical benefit.

The largest medical specialty group in the U.S., The American College of Physicians (ACP) finds PEs are more ritual than science .

Some argue that the exam is so unpleasant that many women avoid their doctor’s office rather than undergo it.

So how would the guardians prey on the people they are supposed to protect?

In 2010, doctors performed 62.8 million of these routine pelvic examinations on women across America. In total, gynecological screenings cost the U.S. $2.6 billion every year.

I think that the Roman poet and satirist Juvenal (c. 60–140) posed the best question asking: "Quis custodiet ipsos custodes?" (Who shall guard the guardians?)

As I and many others here advocate for, medical boards should be comprised of a majority of non-providers. History supports that professions are incapable of self-regulation. The banking and accounting industries are now subject to more federal oversight, at least in part because of their failure to effectively self-regulate.

A good reference on how medicine may abuse self-regulation at the expense of patients and payers is SJ Gross's "Of Foxes and Hen Houses: Licensing and the Health Professions"



-- Banterings




 
At Friday, June 21, 2019 10:00:00 AM, Blogger Biker said...

I came across this article about a urology clinic in Olympia, WA that purposely left a male patient fully exposed for an extended amount of time as part of an initiation prank for a new employee. It doesn't appear that there were any serious consequences for the staff involved. Sadly the patient in question was a sex abuse survivor and was severely traumatized as a result of the staff getting their kicks at his expense.

https://www.king5.com/article/news/investigations/disturbing-staff-behavior-investigated-at-providence-clinic-in-olympia/281-e2333b8a-bcd3-4e28-ab00-043a01f684c9

It appears nobody got fired and nobody is losing their license over this.

 
At Friday, June 21, 2019 3:01:00 PM, Anonymous Anonymous said...

On their website their core values say “ compassion, dignity, justice, excellence, intregity. Can anyone who is a medical ethicist explain to me what these words mean in an ethical setting?

PT

 
At Friday, June 21, 2019 6:35:00 PM, Blogger A. Banterings said...

Biker, PT, Maurice, ,

This is how you deal with this situation. You hit them where they are pushing their core values say “ compassion, dignity, justice, excellence, integrity: on THEIR social media.

I responded on THEIR own Twitter account:

Congratulations to Melissa Ebben, RN for receiving the 2019 #Nurse Innovator Award! She is a true #inspiration with her innovative ideas to improve the care of #victims of crime and #sexualassault.

SEE MY COMMENT BELOW

Another person on Twitter criticizes Providence Healthcare System:

@PSJH the one result from a search of "LGBT" in 4 years of Prov health news stories is an article about the Holocaust. https://www.psjhealth.org/news/search-results?keyword=LGBT … … You won't celebrate Pride month nor include LGBT people in your Nondiscrimination notice. http://providence.org What's up with that?

AGAIN, SEE MY COMMENT BELOW


Then I share the story on my Twitter feed with my hashtags ( #MeToo #DoctorsAbuseToo #NursesAbuseToo #DoctorsAreDickheads #PatientChoice #NeedTo #sexualassault #PatientAbuse ).

The more they try to promote how caring they are on social media, the more that I pop up and give a reality check.

Those who point out their hypocrisy, I throw gasoline on that fire.


THIS IS HOW YOU CHANGE THE SYSTEM! YOU MAKE A PUBLIC RELATIONS NIGHTMARE THAT NEVER GOES AWAY!




-- Banterings







 
At Friday, June 21, 2019 6:50:00 PM, Blogger Maurice Bernstein, M.D. said...

PT, what "ethical setting" are you suggesting? An "ethical setting" is really in the eyes of the beholder. ..Maurice.

 
At Friday, June 21, 2019 7:30:00 PM, Anonymous Anonymous said...

Maurice

Oh, I see. Therefore when facilities hide their core values or they don’t stand behind or give value to their core values then what you are suggesting is that we, the patient make up our own? That is an interesting concept! I could say that the employee has intregity only because they showed up for work today because the patient is paying their salary. I never looked at it from that perspective.

PT

 
At Friday, June 21, 2019 10:35:00 PM, Blogger 58flyer said...

This situation in Washington shows what you can get when unlicensed or minimally qualified females have unfettered access to male patients. I bet that if they were required to have a male chaperone present the whole thing would not have happened.

I have to wonder what the doctor thought when he/she came into the room to find an undraped patient. Maybe the doctor was in on the prank. I checked the Providence website and they do show 2 female urologists in the practice so it wouldn't surprise me.

I do hope that the promised corrections included those 2 medical assistants finding new work, at the very least.

Thanks for posting, Biker.

58flyer

 
At Saturday, June 22, 2019 7:52:00 AM, Anonymous Anonymous said...

58Flyer, Biker


The family has retained an attorney. Hmmm, I see opportunities here for our cause.


PT

 
At Saturday, June 22, 2019 7:57:00 AM, Blogger Biker said...

58flyer, my presumption is that nobody was fired. I didn't see the phrase "is no longer with us" anywhere. Male staff doing the same to a female patient would have been fired on the spot. Yet again we see the double standard at work.

That nobody was fired speaks to the clinic itself and their corporate masters not seeing what happened as a big deal. It was just an exposed male childhood sexual abuse victim is all. There are always going to be bad apples amongst the millions of healthcare workers. The larger problem is the acceptance of egregious violations such as this example by the people who run these health practices. How they could not see this as a termination level event defies credulity.

 
At Saturday, June 22, 2019 3:49:00 PM, Blogger Biker said...

Dr. Bernstein, when you were in practice for yourself, if any of your staff pulled a "prank" such as occurred at the urology practice in Olympia, would you have fired the perpetrators? I am asking given the under-reaction on the part of the people in charge in this case. Are those managers outliers in not thinking actions of that nature rise to the level of termination? Or are they in the mainstream thinking what those women did wasn't that big a deal? I say they didn't think it was such a big deal given the rather lukewarm apology the victim got and the fact that nobody has been fired.

Fast forwarding to your present role as a med school professor, if any of your students pulled a "prank" like this, would you seek to get them tossed from the school? If you did, would the school agree with you and toss them?

As an aside I put "prank" in parentheses in that this choice of words is perhaps purposeful so as to minimize what really happened and make it all seem so innocent and trivial rather than the malicious act it was. It staggers the mind to think that those women thought this was an OK thing to do to a patient as a form of entertainment for themselves.

 
At Saturday, June 22, 2019 5:09:00 PM, Anonymous Anonymous said...

JR said:

At least this victim got the acknowledgment that something happened. Too many times like in our case, it is not acknowledged. I don't believe it was a prank as why would it be a prank to a staff who deals with the male genital region as part of their ordinary job. It was only a prank on the victim and that type of behavior to victimize a patient is not what I consider to be a prank. What they did to my husband was entertainment because there was really no other reason for it and considering the laughter I heard and what he remembers hearing. They thought it was funny to leave him uncovered and cold so his anatomy could react especially considering he had just had a heart attack. Some people get nervous when I liken what he felt like as he felt as he were being raped and unable to prevent it from happening because of the administration of the date rape drug. For this young man and all the other men who have suffered from this type of sick "entertainment", the pain and suffering will never go away or even lessen. That this young man had already been a victim of sexual abuse makes me just want to cry for him and I don't know him but I cry for him, others, and my husband. They will probably find out this is a "common prank" done in this office by those sociopathic females. But to them, a patient being naked is not a big deal unless it is them or their loved one. Abusing a patient is no big deal unless it would be done to them or someone they love. Indeed, they would be the first to cry foul. This is type of behavior is why Banterings works so hard to get the message out there and why I too am trying. Something has to change because becoming a patient should not automatically qualify you in becoming a victim of medical or sexual assault. I have posted some new articles on my blog at Issues4Thought that talk about the lack of patient protection. There really is no one or anything that protects patients. It is beyond horrible to think protection is only extended to medical providers but not their patient victims. JR

 
At Saturday, June 22, 2019 5:21:00 PM, Anonymous Anonymous said...

Biker

I appreciate you finding this article and bringing it to the attention of the readers of this blog. I am reaching out to Mr Kirschner and will ask him to join us on this blog. Additionally, I want him to share with us what action, if any his attorney will be taking against the medical facility provided that he is willing to discuss the matter.

PT

 
At Saturday, June 22, 2019 6:12:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, a "mischievous act" has no place in medical practice where a patient is involved and not fully and knowingly and accepting the role of a participant (a rare exception). A "mischievous act" has no place in medical education when a patient is involved under the same circumstances. Pranks directed at the patient or directed at anyone participating in the care and attention to a patient has no ethical support. There must be a significant penalty applied to those who suggest or participate in such behavior so it is clear to all professionals that such behavior is unprofessional and in fact may leave permanent damage, physical or psychological upon the patient. I hope this Comment makes my opinion clear. ..Maurice.

 
At Saturday, June 22, 2019 6:30:00 PM, Anonymous Anonymous said...

Biker
Maybe the doctors hands were tied by the fact that he or she knew about the prank in advance and went along with it.
The staff couldn't very well be dislipined then. To me that makes as much sense as anything. Most staff don't take actions in front of supervisors that they know they're allowed to do, or even suspect they're not allowed to do. But this doctor walked in to find a totally naked and undraped patient?
JF

 
At Saturday, June 22, 2019 7:44:00 PM, Anonymous Anonymous said...

This behavior at the Urology clinic only affirms the culture, the feministic behavior so dominant in healthcare today. How many times do you think this occurs at Urology clinics or other healthcare facility? Is this case only obvious because it made the news? How many don’t make the news. If only he was a VIP this never would have happened. If you have a VIP card, don’t leave home without it.


It took a month to respond to this patient’s complaint, is that appropriate? From the video you see they documented by registered mail letters to the board. But this is the kind of care you get when you pay into a system that costs $4 Trillion annual dollars. This patient was paying their salaries and this is how he was treated, the object of a prank, initiation. You get what you pay for.

PT

 
At Saturday, June 22, 2019 7:51:00 PM, Blogger A. Banterings said...

PT,

Please feel to pass on to Mr Kirschner both my Twitter and my blog as there is research to validate the trauma he suffered and the fact that healthcare providers should be aware that PTSD is a side effect of such actions.

I am sure that his attorney will be interested with that along with the information on this blog.



-- Banterings


 
At Saturday, June 22, 2019 10:00:00 PM, Blogger Maurice Bernstein, M.D. said...

Oh my! There should be no excuses or explanations of the obvious---it is all there, all there.. in writing.. by the National Council of State Boards of Nursing 2009. It's all there..all there.. everything but everything that can be looked upon as misconduct, mismanagement and worse by the nursing profession. And it is all there in black and white and blue text. No ifs, ands or buts. No way the nursing profession can twist and turn an explanation. And it is all very detailed and there is no excuse by nursing in any institution which can be made with a rational explanation. And the impact of this "professional" misbehavior is clearly defined:
"EXTENT OF THE PROBLEM
In NCSBN’s analysis of 10 years of Nursys® data (NCSBN, 2009), 53,361 nurses were disciplined; of those,
636, or 0.57 percent, were included in the following categories: sexual misconduct, sex with client, sexual
abuse, sexual language or sexual boundaries. Therefore, sexual misconduct is not a common complaint
to a BON. The actual prevalence, however, is not known. Indeed, 38 to 52 percent of health care professionals report knowing of colleagues who have been sexually involved with patients (Halter et al., 2007).
The impact of sexual misconduct on patients is serious. The Council for Health Care Regulatory Excellence (2008) cite the following disorders and complaints as being resultant of sexual misconduct by a
health care provider to a patient/client:
ƒ Post-traumatic stress disorder and distress;
ƒ Major depressive disorder;
ƒ Suicidal tendencies and emotional distrust;
ƒ High levels of dependency on the offending professional;
ƒ Confusion and dissociation;
ƒ Failure to access health services when needed;
ƒ Relationship problems;
ƒ Disruption to employment and earnings; and
ƒ Use and misuse of prescription (and other) drugs and alcohol.


Please, everyone, go to this link and read the presentation in whole:

https://www.ncsbn.org/Sexual_Misconduct_Book_web.pdf

It's all there... including page after page on how to handle the misbehavior or worse along with case examples. NO EXCUSES possible unless an institution has failed to read or followup on this document. It's all there. No excuses! ..Maurice.

 
At Sunday, June 23, 2019 12:18:00 AM, Blogger 58flyer said...

PT,

In reaching out to Mr. Kirschner, please advise him to consider contacting his elected officials to press for legislation. He is elderly, and a sex abuse victim, 2 areas that deserve special attention when it comes to protective legislation. He is in a unique position to bring about change.

58flyer

 
At Sunday, June 23, 2019 4:01:00 AM, Blogger Biker said...

That booklet is a wealth of info Dr. Bernstein, though interestingly in the 4 case examples they gave, the offending nurse in 3 cases was a male and in the 4th it was a female nurse responding to sexual solicitation from a male patient. Apparently it doesn't occur to them that female nurses are capable of independently committing sexual misconduct.

What happened to Mr. Kirschner in Olympia would fall in the lower end of their misconduct scenarios with the suggested penalty basically being re-training and monitoring for a period of time.

I worked for a highly ethical corporation for 40 years where ethical misconduct would get you promptly fired. They'd work long and hard to re-train and mentor those with job performance issues, but had no tolerance for bad behavior. Lie, cheat, steal, or engage in other gross misconduct and you'd be gone that day. Over the years I fired far more people for bad behavior than I ever did for poor performance. Our strong ethical base always striving to do the right thing dealing with employees, customers, and community served us well in attracting and retaining high quality staff. The way I see it, if Olympia Urology tolerates that kind of behavior (as evidenced by nobody being fired), what other ethical lapses do they tolerate? Were I a physician or nurse it is not the kind of place I'd want to work.

 
At Sunday, June 23, 2019 4:12:00 AM, Anonymous Anonymous said...

Maurice

Worthless, absolutely worthless. Not worth the paper it’s written on. Did it benefit the patient abused by the Denver 5, what about the operating room staff of Dr Twana Sparks? Better yet, let’s elevate the stakes to arson, murder and gross negligence.

The nurse who violated the 10 rights to safe medication administration and killed her patient still has her license. The nurse who was an accomplice in the murder of his ex-wife still has her license. The nurse who had sex with the inmate under her care attempted to get him released from prison, killed her husband and burned their house down to cover the evidence still has her license.

Do you think we are going to be swayed, regain confidence in the medical industry by some article you pulled out of a dusty corner of the web written by some clueless nurses somewhere. We have seen and read that worthless crap and it’s such an embarrassment to some bon’s across the country that they have actually blotted out the disciplinary page completely.

PT

 
At Sunday, June 23, 2019 4:35:00 AM, Anonymous Anonymous said...

Maurice

Why would a medical institution follow this document? They don’t even abide by their core values let alone know where they are.In your words would they as the patient view this document as some obscure guideline of some obscure supposed ethical setting “ that is in the eyes of the beholder.”

When staff are terminated immediately, loss of license occurs and the facility is heavily fined and sued maybe just maybe will you get my attention.

In the meantime can you see about getting us one of those fancy VIP cards.

PT

 
At Sunday, June 23, 2019 7:14:00 AM, Blogger Maurice Bernstein, M.D. said...

I think that the sexual misconduct in the Washington case is covered by the following from the NCSBN document:
2. Unnecessarily exposing a patient’s body
or watching a patient dress or undress,
unless for therapeutic purposes or the
patient specifically requests assistance.


The individual(s) who purposely set this order for "initiation" of a new member of the urology team should be investigated for unique misbehavior or, if this is a systematic order, the rationale for such system and unethical behavior be investigated. The events described in the news article represent wrong institutional behavior and should be emphasized and prevented for the future. ..Maurice.

 
At Sunday, June 23, 2019 7:18:00 AM, Blogger Maurice Bernstein, M.D. said...

PT, there are no VIP cards. The designation is only in the minds of the medical and/or patient participants. ..Maurice.

 
At Sunday, June 23, 2019 7:51:00 AM, Anonymous JR said...

JR said:

It is interesting that Mr. Kirschner is also older and his wife was a witness. It just goes to show they know no fear of being abusive because they have such a narcissistic or sociopathic frame of mind. For an clinic worker to call them saying if was just a "prank" showed how little concern they had for the sexual abuse they had committed. It would seem that to them explaining it was just a prank should have made it okay to have happened. I wonder how they decided to straw calls on the one who had to make the call. It really goes to prove Banterings' theory of the medical field being full of sociopaths and since they make the effort to blend in, you don't know you have one until something like this happens. It is sickening! Disgusting! I have a question though. When a female is sexually abused her identity is usually kept hidden. Did Mr. Kirschner decide to go public. My husband hasn't pressed charges as he does not feel he could withstand having something so vile that was done to him being made public with his face for everyone to see and make comments about as many will say it was his fault as he is a man, should have prevented it, and nurses don't do things like this. I read Mr. Kirschner is in counseling but how can he trust them is another question as you can never be quite sure what they are putting in your medical records? Is there some magic test to help decide if you will become a victim of sexual abuse by them? How can you be sure when you are not able to protect yourself that they won't abuse you? This happened in a doctor's office so what chance of not being molested do hospital patients have? This type of behavior probably occurs more than imagined at hospitals because they have more freedom to do this time of thing as the patients are made to be unaware and unable to prevent such abuse. It is indeed a scary world--the world of how healthcare is delivered. Why does it have to be such an ordeal would be the question I would like answered. JR

 
At Sunday, June 23, 2019 8:06:00 AM, Anonymous JR said...

JR said:

Found this article about how backwards Indiana is:

http://doctors.ajc.com/states/indiana_sex_abuse/?find_your_state The paragraph of interest is at the end under the Quoted section where it tells about what happened to a dr. convicted of having child porn.

Apparently, in Indiana, drs. who have been convicted of child porn charges can retain their licenses bc of being committed to lifelong recovery. However, a private citizen who does not have deity credentials would face a longer prison term than 6 months, lose everything including their home and employment, have to stay around from minors forever including being near schools, etc, been on a list, etc. Look at Jared Fogle who is still in prison. Subway promptly fired him even before the allegations were proved. However, bc a man may be a dr. somehow he has magical powers to reform from such behavior when apparently non-medical people do not have their ability. Is it a DNA thing that dr. have in their biology that makes their ability not to be a pervert again? Are they born w/ it or is it an injection they receive at medical school only he didn't get all the boosters? Why is Indiana so stupid and backwards to think one type of profession can magically be cured when all others cannot be? Apparently, no one has told the medical profession there are no cures but at best temporary measures to ease severe afflictions and the tendency to be a pervert is not curable and certainly not when he is allowed to have free access to commit sexual crimes again.

 
At Sunday, June 23, 2019 3:27:00 PM, Blogger Maurice Bernstein, M.D. said...

NOTICE: AS OF JUNE 23 2019 THERE WILL BE NO FURTHER COMMENTS POSTED ON THIS VOLUME. COMMENTS CAN NOW CONTINUE ON VOLUME 101.
..Maurice.

 

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