Bioethics Discussion Blog: Preserving Patient Dignity (Formerly: Patient Modesty):Volume 106

REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.

TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com

IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice

FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD

Tuesday, October 29, 2019

Preserving Patient Dignity (Formerly: Patient Modesty):Volume 106





The Graphic starting out Volume 106 came from a British doctor blogger blog titled "Dr. Grumble" presenting views of medical life within Great Britain in a series of posting topics with
reader responses from 2006 to 2015. Many issues discussed are what we have discussed and are discussing on my blog here.. but from a British experience. Go to the above link for a bit of insight into Dr. Grumble's grumbling but return and go ahead and "grumble" here.   p.s.- Doesn't the Graphic fit with our current discussion?  ..Maurice.

74 Comments:

At Tuesday, October 29, 2019 2:11:00 PM, Blogger A. Banterings said...

Maurice,

Here is a question of ethics that I would like your opinion on. (Perhaps you may want to present this on Listserv.)

What obligation do physicians have to the patients and society, who learned medicine in ways that treated patients without dignity, were deceptive, or were just downright abusive, and common sense dictates they should have known better or witnessed such behavior and said nothing?

Moral distress or superior orders (Befehl ist Befehl is NOT an acceptable excuse. Remember, it was decided at the Nuremberg trials the fact that a person acted pursuant to order of his Government or of a superior does not relieve him from responsibility under international law, provided a moral choice was in fact possible to him.


I will give some examples:

Pelvic exams on anesthetized women without their consent.

Medical students being introduced as doctor.

Witnessing abusive behavior and saying nothing.


Participating in repeated genital exams of intersexed children as a student.

Forcing patients to undergo intimate, humiliating, and (potentially) assaultive exams when NOT necessary.

Ignoring patient preferences or autonomy.




-- Banterings











 
At Tuesday, October 29, 2019 2:36:00 PM, Anonymous JF said...

Wow Joe,
They insisted on giving you a shower? Where I come from it's the exact opposite. When our elderly patients are sent to the hospital and stay for extended times, they come back unbathed. When I had my surgery and was in the hospital for 8 days I got exactly one shower and I had to request it. Then I had to do it myself. I was fine with doing mine but the elderly patients I mentioned were completely unable to do their own.
I wonder if you were charged an extortional price for that shower. I heard that our patients pay $60 dollars for one shower. $60 dollars is roughly what I earn for one shift (take home pay )
I'm a med tech where I work. We do what CNA's do at nursing homes but we don't have to be CNA's. We also pass out meds, including narcotics.
A few months back we got a new patient and she had a foot brace. We med techs put it on her when we helped her get dressed. Then OCHA showed up and fined our facility and said the nurses have to do it. My bet is so the patient can be charged more.

 
At Tuesday, October 29, 2019 6:24:00 PM, Anonymous JF said...

Doing the right thing for someone else vs doing the safest thing for ourselves often conflicts and if we make selfish choices it's something that will never disappear from our lives because it's a spiritual battle.
No such thing as an accident didn't originally mean what people have made it into. It meant that whatever comes our way Heaven knew and permitted it to come our way.
The cowardly way out is very much ingrained in our human nature. It's HARD to go against the flow.

 
At Tuesday, October 29, 2019 9:59:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, you asked me: What obligation do physicians have to the patients and society, who learned medicine in ways that treated patients without dignity, were deceptive, or were just downright abusive, and common sense dictates they should have known better or witnessed such behavior and said nothing?

Answer from me: Silence is wrong and incomplete.
Those physicians should 1. publicly admit their professional/personal misbehavior or worse or silence about those of their colleagues and 2. make an effort to disclose to the public those medical teachers and medical schools and institutions who directly or indirectly contributed to the development of the physician's behaviors.

There has to be some unethical atmosphere in those physician's learning years which definitely contributed to their later behaviors.


..Maurice.

 
At Tuesday, October 29, 2019 10:13:00 PM, Blogger 58flyer said...

Joe,

I know what you mean! It's very hard to speak up for yourself in a healthcare setting. I think that is a big reason patients are treated the way they are. In more recent years, I have been able to advocate for myself. Then, just when I thought I had things under control, I got bit again! That's what happened at my last derm visit that I detailed here. Of course I wrote management a letter, and of course got no response.

Joe, when I was able to speak up successfully, I was VERY glad I did! I think the more you do it, the easier it will get. That's why I think you should get after that Urology practice that you had the recent experience with. Do it while it is still fresh on your mind. Write a letter. If you don't get a response, go there in person and ask to speak to a supervisor about some unprofessional behaviors of their staff. Speaking of hard, it's hard for them to ignore you when are looking in their face. You will get their attention for sure and make them rethink the way they do things. You won't change what happened to you, but you may have a part in making things better for the next male patient. In fact, at this point, don't bother with the letter, just show up at the front desk and ask to speak to a supervisor.

At my wife's most recent mammogram, the tech (female) asked my wife if she was fine with just removing the gown entirely as it would be quicker to do it that way. In the moment, my wife went along not wishing to be any trouble. Later, she felt bad about it. After she told me, I just went to the clinic and asked to speak to the staff supervisor and made her aware fo the situation. The supervisor agreed that that was not the way things were to be done there and agreed to check into it. Maybe it was addressed and maybe it wasn't, we will find out at the next exam. Maybe I helped other women avoid a bad experience with a tech who may have allowed herself to become a bit too casual about patient modesty.

What's for certain, if you don't speak up, nothing will change. They will continue to think that men are fine with excessive exposure if they are not confronted about it.

I spent 41 years in law enforcement. In my youthful piss and vinegar days, I made a few mistakes. I was called upon the carpet to be told to not let my new found authority affect my judgement. I took those talks seriously and toned things down. Some of the complainers probably never heard back from my agency, but it sure changed the way I conducted myself.

Some folks just need a little talking to to make things better. Give it a shot!

58flyer

 
At Wednesday, October 30, 2019 4:38:00 AM, Blogger Biker said...

Very eloquently stated 58flyer. Not speaking up essentially is taken by the staff in question as condoning their behavior. It took me many years to muster the strength to speak up, and as you say it gets easier the more you do it. Far too many who work in healthcare think their personal comfort is all that matters.

 
At Wednesday, October 30, 2019 5:20:00 AM, Anonymous JR Issues4Thought.com said...

Joe,
It seems like all heart patients are left exposed even though the textbooks say otherwise. Please read my blog at Issue4Thought.com for my husband's story. Even Cath Lab Digest has articles outlining that patients should not be exposed unnecessarily. For operating room procedures, you can find article after articles saying the genital area should be covered to maintain patient dignity. During shaving, all they have to do is readjust the towel. Once they start the antiseptic prep, it usually takes less than five minutes for it to dry and then they can drape. I was wondering if you remember when when the MA covered you up again after the prep if it was the same towel or a new one? For heart patients, I think it is important to regain control of your body again bc you are basically treated like they have total control of you. We think since my husband's heart cath, that medical providers have the attitude that he should be fine with any exposure they want as they know how most heart patients are treated with being unnecessarily exposed. Take for instance, for males during a stress test they are told to strip from the waist up and are generally not given a gown like a female patient. They don't leave the room for a male like they would for a female. As a show in taking back his autonomy, my husband refused. He turned around and unbuttoned his shirt, let them place the patches, and rebuttoned his shirt. He unbottoned again for the ultrasound. He did this as a token gesture of control. The female tech started to unbutton his shirt but he told her to remove her hands from him. She did. His exposure in the cath lab turned into sexual abuse in the patient room although any unnecessary exposure should be pursued as sexual abuse. It is bc of this that I am working so hard to get things changed so all patients can have dignity and respect during medical care. Patients should not have to be dehumanized, demeaned, devalued, and degraded during healthcare treatment. For heart patients, this is especially true as your mental state can a lot to do with your physical recovery. It is no wonder that depression is often the result of heart procedures. Could it be related to how the method of healthcare was delivered?

Hopefully during your shower your wife was able to shield you from the nurse's view. I understand why she needed to be close if you had of fallen but she should have let you maintain your dignity or the right to bodily privacy. Getting back your natural right to privacy is part of the healing process especially if they have been so callous as to not protect your dignity and shown you respect during the process. They know they should as it is a part of their oath and they are supposed to be taught how to advocate and protect a patient in their care. However, even without being drugged, many don't object to medical providers being negligent with their dignity and showing a lack of respect bc the medical community has been made to command an automatic response of control, power, and respect. Most will not question but will suffer silently but just to make sure this happens is why they give drugs like versed and fentanyl pre-op.

On another related turn, today in Outpatient Surgery Magazine, there is a small article that a patient's own music can be just as effective for calming pre-procedure anxiety as versed. Europe has known this for years. The only real reason why versed is used here so widely is bc of the amnesic effect as they don't want the patient to remember all the mental harm they are inflicting. It is also interesting that many people are not aware that versed is not actually a painkiller. It floors them for many request it for dental procedures not knowing they will feel pain during the actual procedure but if the versed works properly, they probably won't remember it. I totally disagree w/ any mind altering drugs to be given. Does it make it less of an abuse/assault if you can't remember it? No, it makes it worse wondering what happened?

 
At Wednesday, October 30, 2019 10:15:00 AM, Blogger A. Banterings said...

Maurice,

I totally agree with your answers, except there is no mention about what form of atonement they owe society. These are not only ill-gotten gains in their education, but are also crimes against humanity.

The other issue that I have is no where have I seen in ANY medical education text or syllabus to owning up to past transgressions.

Do you teach this to your students?

You can NOT say the profession of medicine is unaware, just look at the history of PEs on anesthetized women without consent.

But why would ANYONE expect a physician to own up to past transgressions when the profession can NOT even do away with the practice of PEs on anesthetized women without consent.




So no let us all be adults and honest. EVERY physician will fall back on the excuse of superior orders, patients consented by going to a teaching hospital, they were only a lowly student (superior orders), students NOT responsible for consent (command responsibility, that was acceptable back then, BLAH, BLAH, BLAH, BLAH, BLAH... ad nauseum.

That is if they even acknowledge their wrong doings (if they even realize that they have committed a wrong doing).

With the knowledge of how prevalent those practice examples I listed above and other practices, statistically there are many physicians practicing today that are guilty of "crimes against humanity.

So why does the profession NOT address this?

Probably the same reason they do not address PEs on anesthetized women without consent: sociopathic tendencies OR retardedness.

power corrupts...




Society needs "provider hunters" that seek out those guilty of these crimes against humanity (much like the "Nazi hunters").



With states passing laws that extend the statute of limitations for institutional sexual abuse (aimed at clergy SA), AND with the WHO labelling medical practices that were once (and STILL) considered acceptable (such as repeated genital exams on intersexed individuals) as cruel, inhuman behavior (torture), patients have new weapons to extract justice.





-- Banterings






 
At Wednesday, October 30, 2019 11:54:00 AM, Anonymous Joe said...

JF:

I'm not sure if your being sarcastic or not with your comment that a patient is charged $60.00 for a shower. If you ever spent a day in the heart surgery ICU you would understand how preposterous that theory is. Imagine your ability to get out of bed get into a shower and bathe yourself after having your chest cracked open like a chicken breast, your heart removed from its position and grafts, taken from cutting open your leg, sewn into the heart. And after spending 6-7 hours under anesthesia. After all that, you can barely take a decent breath. And, if you take a breath and then cough you receive a sharp pain in the breastbones, that do not diminish until you stop coughing. The fatigue you feel is overwhelming. I would bet a dollar to a hole in a donut that there is no hospital in the USA that charges heart bypass patients for assisted showers.

JR

1. No, the MA placed the exact same paper towel over my mid-section.

2. My wife stood between me and the open door. I have to admit I was a bit wobbly upon standing.

 
At Wednesday, October 30, 2019 12:09:00 PM, Anonymous Joe said...

RE: Scrub and Prep

Here is a link to a commercial video, It was prepared by Hitex, (drape company), showing how extreme a patient is exposed during heart surgery. Please note, this video is not representative as to the gender of staff or the number of staff participating in the pre-op procedures. Also the time lapse in the video is not indicative of the actual time period for the scrub, paint and catherization. As I mentioned previously, it was at least 20 minutes for my first surgery, at St. Joseph's.

Joe

Link: https://www.youtube.com/watch?v=dVPWKig8BDk

 
At Wednesday, October 30, 2019 2:21:00 PM, Anonymous JR Issues4Thought.com said...

Joe,

Perhaps when or if you talk w/ this urology group you should ask them what the purpose of the prep was since the MA laid the same "sterile" towel back on your genital area after she supposedly prepared the area. What was the purpose of creating a sterile field if you use an unsterile drape? It also is interesting they did not use the regular drape for the procedure which has the whole so nothing else is exposed. I wonder w/ your history of being a heart patient they made the choice for you that exposure no longer mattered although for many survivors of heart procedures it is getting control back of their life that is really important. My husband had prostate cancer before he had the PCI and the exposure during the prostate procedure was done with more compassion and dignity than the procedure that really didn't involve the genital area.

You were a victim of sexual assault by the medical community. They have standards they are supposed to follow and for whatever reason (there is no justifiable reason) they chose to totally disregard your right to dignity and respect along with the sterile field . So does this female urologist treat her female patients differently? Probably. The MA was present to protect the doctor from you but who protected you from them. Furthermore, if they would just be decent and do procedures w/ full consent and disclosure along with making sure not to point blank rob patients of their human dignity and respect, than more patients would seek medical care sooner and outcomes would improve due to less damage to the patient's mental image of their human traits. We are taught in this world to cover private parts of our body, to recognize good touch/bad touch, etc. but what happens during medical procedures defy our basic principles. Sure we understand that some exposure is necessary but we should decide who and how once everything has been fully explained. But clarity and transparency are not strong traits of the medical profession. What happened w/ you clearly illustrates the contempt the female medical community has for its male patients.
I have watched some of the Hitex videos and others on heart cath., and they do not show what happened to my husband. The literature that some facilities put out paints a very rosy picture of patient dignity and respect but that is not how it happened going on to say the genital area is always covered which is a blatant lie as some labs foley cath patients to make their job easier. Cardiac care is big business and they actually have no fear of being reprimanded or sanctioned about their actions bc they do not document their abuse and no government agency is willing to dig deeper. So this is why this is my mission to change things bc sexual assault/abuse should not be an accepted result of medical treatment. I have written and written letter after letter. I have contacted talk shows. One day I will find someone willing to investigate how patients are dehumanized, etc. during their course of treatment especially at some facilities. In my opinion, no one should go to a teaching hospital or a Catholic hospital as these facilities are even more self-justified in what they do. The local Catholic hospital here is especially brazen and offensive. And yes, both hospitals here will tell you if you don't like how they treated you, find another hospital bc they are entitled to operate as they see fit. I don't imagine they are alone in this type of thinking.

 
At Wednesday, October 30, 2019 5:19:00 PM, Blogger Al said...

Hello Everyone .
I need to defend some in the medical profession . I will explain a bit . I haven't posted much in the past years . Some long time people here might remember me with my wife's journey through lymphoma . There are only 3 hospitals in my state for her to choose from . She chose a teaching hospital that was about a hours drive away. The first 8 rounds of chemo did not kill the cancer , and her only hope would be a stem cell transplant . The treatment would start with 5 days of round the clock chemo . She spoke to numerous people that she prefered female care . The first night her nurse asked if I was going to spend the night . I said can I . She said I could stay as long as I wanted , then went and got a bed and bedding to sleep on . The next morning the nurse came in and asked if she wanted to get cleaned up . My wife asked if my husband could help me . She thought for a moment and then said sure . She returned with a couple extra towels and a bar of soap . She handed them to me and with a smile said here you go . You might get wet helping her . No one will bother you for a hour , so I showered while cleaning her up . The nurses would also bring in the extra food trays and would ask if I would like it . One time she had a reaction to the chemo . ( overdosed ) . The nurse asked if I would help catheterize her before the room filled up with people . It was during that time that I noticed my wifes name at the nurses station was written in red . I then noticed that they had the Mars symbol in red with a circled X for no males . During her stay they assigned 2 female residents to provide her care . During the stay it became necessary to do a spinal tap . The 2 residents came in with a male doctor . They explained what they were going to do then he left and told me to come and get him when they are ready . They prepped her and I went and got him . On the way to her room he told me that his wife prefers care from female caregivers too . My point for all this is sometimes a teaching hospital might have a advantage as well as being on the cancer floor . Side note . This hospital also employs several male nurses and techs in their Urology , GI and Imaging departments . I'm no fan of the medical field but they do know how to do things right when they want to . AL

 
At Wednesday, October 30, 2019 6:09:00 PM, Anonymous JF said...

Joe, I don't know what HOSPITALS change for showers. The $60 for a shower was at assisted living. They also continue to charge if a patient is absent from the facility because they're at the hospital.
I don't know if it's the full price or not and I could see it if them holding the room for the patient was preventing somebody else from getting the room but otherwise I can't justify it.
That person is also paying to be in the hospital.

 
At Wednesday, October 30, 2019 6:18:00 PM, Blogger Biker said...

Al, thanks for sharing how accommodating they were of your wife's wishes and also of you too while there. I hope the treatments proved successful.

Yes there are some in the healthcare world that get it. The teaching hospital in NH where I get all of my scheduled care seems to get it too. This is especially fortunate for me given how few full service hospitals there are in Northern New England due to our sparse population. Thus far I've had male staff and/or appropriate privacy in several depts, urology & ultrasound included. I have not been an inpatient there which I suppose would be the ultimate test when it comes down to basic dignity issues such as showering, catheters etc.

 
At Thursday, October 31, 2019 11:29:00 AM, Blogger Maurice Bernstein, M.D. said...

Al wrote: "I'm no fan of the medical field but they do know how to do things right when they want to ."

I would rewrite that statement a bit differently for discussion:

"..but they do know how to do things right when they need to ."

"Doing things right" is part of medical education both in school and residency or supervised nursing. But what is learned is the "needs" usually part of diagnosis, treatment and institutional organization. However some "needs" are missing in physician or nursing education. And it is those "needs" which the patient expresses or should be expressing that should be given more attention in teaching and professional supervision.
One of the many of those "ignored" needs of the patient, I think was implied in the above graphic I selected for this Volume. What do you think? ..Maurice.

 
At Thursday, October 31, 2019 11:41:00 AM, Anonymous JR said...

I don't think it is up to each and every patient to express the need for dignity or respect. That should be a built-in part of any curriculum in a medical teaching school. Putting additional responsibilities of on the patient to remind the professional that they need to use dignity and respect is just ludicrous. Every medical provider should know that every patient is a human being this they should be treated with dignity and respect. Personal privacy is part of dignity and respect. Having the feelings of dignity and respect is what sets human beings apart from other living things such as plants trees Etc medical providers are very much aware of respect and dignity as they think that they are deserving of respect and dignity such as addressing them as a doctor, following their orders, and scores of other things. So yes they know how to use dignity and respect that they choose when to use it or even if they want to use it. Not all patients are treated badly that's true. However enough are that it makes it an issue.

 
At Thursday, October 31, 2019 2:51:00 PM, Blogger Maurice Bernstein, M.D. said...


This should raise a few moans and groans from readers in our current blog thread.

Upcoming is a satirical takeoff on a My Fair Lady lyric by Steven Miles, MD, a physician ethicist who has contributed much in the earlier years of this bioethics blog
(from thread titled "Why Can't a Patient Be More Like a Doc" (Aug. 5 2004) ..Maurice.


A HYMN TO HIM

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

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

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

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

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

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

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

 
At Thursday, October 31, 2019 3:35:00 PM, Blogger Biker said...

JR is right. Patients should not have to ask to have their dignity and privacy respected. For most patients the power differential is more than they can overcome in order to even broach the topic.

Quote honestly if instructors have to teach medical and nursing students to respect the dignity and privacy of patients it is perhaps a reflection of something flawed in the selection of who makes it into medical and nursing schools. Perhaps there needs to be an ethics and morality test as part of the admissions processes?

Until such point as medical and nursing school applicants are better screened the onus remains with the instructors to repeatedly stress these issues using concrete examples, many of which could be gleaned from this very blog.

 
At Friday, November 01, 2019 10:35:00 AM, Blogger A. Banterings said...

Maurice,

Did you write that? (Have never personally experienced the abuse of patients at the hands of other providers.)

It should be titled "The Doctor with His Head in the Sand"

At first I was thinking that this an affront to patients. The poem espouses all the virtues of the doctor and asks "why can't patients be more like me?" One can only assume that this doctor's view of ALL patients is that they are the opposite of him: dishonest, unfair, unthankful, immature, unpleasant...

Does this person NOT read this blog? He/she is living in La-La Land. There is a reason that patients do not trust doctors. The profession has rendered them guilty until REPEATEDLY proven innocent in the public's eye.

This must be an old poem because the doctor does not lament EMR, administrators, or insurance companies.







-- Banterings







 
At Friday, November 01, 2019 4:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, what you read was sarcasm written by a physician-ethicist Steven Miles who truly knows about and is well known to have written and spoken out about the criminality of those physicians and health care professionals working for our U.S. government with regard to detained war prisoners.

Read this interview with Dr. Miles just before his book "Oath Betrayed: Military Medicine and the War on Terror"

A sarcastic poem is one thing but all the research and years of presentation regarding medical professional misbehavior tells a different story about Dr. Steve Miles. I have been very proud to know and communicated with him. ..Maurice.

 
At Friday, November 01, 2019 4:29:00 PM, Anonymous Anonymous said...

Hello,
A humble offering follows:


A HYMN FOR THEM

Why can't a doctor be more like a patient?
Patients are so dishonest, so thoroughly hiding their tear;
Eternally humble, historic'ly in fear;
Who, when you lose, will always help to empathize.
Well, why can't a doctor be so wise?
Why can’t they view you as someone set apart?
Can't a doctor learn to use her heart?
Why do they do ev'rything other doctors do?
Why don't they grovel- well, like their patients do?

Why can't a doctor take after a patient?
Patients are so nervous, so uneasy to be sure;
Whenever you are with them, they’re looking for a cure.

One patient in a million may cry at his prospects.
Now and then there's one with puzzling defects;
One, perhaps, who dissembles to protect his fragile self.
But by and large each patient is a truly submissive elf!

Why can't a doctor take after a patient?
Cause patients are so fearful, disheartened and full of woe .
A patient needing compassion you will always know.

Why can't a doctor be more like a patient?
Patients are so downtrodden, in such terrible disarray.
Always needing assistance through any hospital stay.
Ready to suck it up whenever their dignity’s undone.
Why can’t a doctor respect us, each and every one ?

Why is compassion something doctors always hide?
Why has humility never ev’n been tried?
Ordering me to take their silly pills.
Why don't they try to help me cure my ills?

Why can't a doctor behave like a patient?
If I was a doctor who'd been offered no hope,
Received as a heartbreak to all within my scope.
Would I walk casually to the next case?
And act as if the prior man didn’t really need an embrace?
Would I begin the next exam and really never see?
Why can't a doctor just care, for ME?

Reginald

 
At Friday, November 01, 2019 4:42:00 PM, Blogger Maurice Bernstein, M.D. said...

Here is one portion of what Dr. Miles wrote and allowed me to publish on my blog


Clinical objectivity is not truth. It is a temporary expedient, a tool, in service of the patients’ humanity. Our patient’s trust that we do not really believe that they are objects leads them to submit to procedures which in other circumstances are assaults (with knives), and poisonings(with carbolic acid or curare), and sexual crimes, and to questions which are beyond the most intimate family conversation. Patients become angry and frightened and even leave medical care when we forget ourselves and take our tools to be the essence of our compassion.


..Maurice.

 
At Friday, November 01, 2019 5:25:00 PM, Blogger Maurice Bernstein, M.D. said...

Wow! Reginald, that takeoff was great! Did you compose it yourself? I think that the two hymns characterize what this long running blog thread is all about. I have a feeling I know which of the two is best accepted by those speaking up on this thread theme. ..Maurice.

 
At Friday, November 01, 2019 6:37:00 PM, Anonymous JR Issues4Thought.com said...

MedPage has had some good articles of late. One has dealt with the lies by Medicare insurance plans that give patients more serious (LIES) illnesses to collect bigger payments from Medicare. This I know to be a real practice bc my husband's medicare advantage plan has tagged him as diabetic although he is not and has not ever been diabetic but they refuse to erase this label. With this false label, they can collect more money.
Also, they did an article about how air ambulances are bankrupting patients. We too know by experience about air ambulances how corrupt they are. They talked about how at one accident scene 7 air ambulances arrived bc they wanted to be the one. Also, they talked about how one trip cost around $600,000 when the helicopter itself only cost $500,000. It talked about how a lot of the times the costs of air ambulances are not covered.
There was also another article about bigoted patients where a health professional said in the comments section that "What would help a lot in reducing these kind of incidents is steering patients away from a "customer" or "consumer" mindset and reinforcing the belief that healthcare frontline staff are qualified and licensed PROFESSIONALS." This person's little paragraph tells all that needs to be said as to what is wrong with the medical industry.
First it is a consumer driver market. Medical care is not free nor is it done for only compassionate reasons. All who are in the healthcare industry are not necessarily qualified nor professional. How are they reinforcing the belief--by lies, pressure, and/or drugs?
Next, news for statins are not good. Fractures, memory loss, diabetes, heart failure, liver issues, kidney failure are just a few of the more serious issues. FDA is going to be issuing a warning on the label. Drs. need to be honest about statins. We were told that even told my husband's numbers were well within the normal range being very close to 100 w/ LDL well within the range and HDL being well within the range that he needed the high dose of statins. When questioned why, once we got past their silence and hostility, they said because. Because what? Because it is the standard procedure after a heart attack. But what does it do that a natural one didn't? Well there is something that natural ones can't address. Do statins address it? Not exactly but it lowers all the numbers. But if the number weren't high to start with, then what exactly is the statin protecting against? He just needs to take it. However, with some research, we found out it was the LPa and had it tested w/o the dr's knowledge and are addressing the LPa. It is this type of lie, omissions that create the distrust for medical professionals. RX drugs are not always the answer and in fact, may cause more harm than good. Honesty would be refreshing. LPA has been making the news too lately.
I am thinking more and more that my android phone and Google listens quite a bit. It is uncanny that most the these things are getting attention now. If only there was some spotlight on how male patients are treated.

 
At Saturday, November 02, 2019 2:37:00 AM, Anonymous JF said...

That's a cute poem. I like it.

 
At Saturday, November 02, 2019 3:02:00 AM, Anonymous JF said...

Biker, It's true that patients SHOULDN'T have to speak up to have our/their dignity respected but somehow the disregard got started up and stuck. Some of it had to do with being rushed
( in the beginning ) some was patients helplessness ( unable to clean themselves up after an accident. Women needed help to deliver their babies...
I don't believe for a minute that some of it isn't because of umpure motives on staff's part.
Yeah sure. Staff justifies their own misbehavior. Generally ANYBODY can and does justify their misbehavior!

 
At Saturday, November 02, 2019 10:16:00 AM, Blogger Maurice Bernstein, M.D. said...

JF: "That's a cute poem. I like it."

JF, which poem? Steven or Reginald?
..Maurice.

 
At Saturday, November 02, 2019 11:50:00 AM, Anonymous JF said...

I was referring to Steven's poem but I like Reginald's also.

 
At Sunday, November 03, 2019 7:14:00 AM, Anonymous JR Issues4Thought.com said...

There also was an article this past week in Outpatient Surgery Magazine that using music of the patient's choice has the same anti-anxiety effect as midazolam (versed). This is what is done in Europe. However, how many of us think that US medicine will start this practice? Probably very few will as versed gives them control and allows them to take away patient autonomy and dignity.
It is also true that many US doctors haven't realized or maybe even been instructed that how a patient receives the treatment is just or maybe more important as the treatment. If a patient is mentally distressed about how they were disrespected, sexually violated, or treated as if they were an object to be ordered about it has a negative overall affect on their recovery and how they proceed with subsequent treatment meaning they will be less likely to follow treatment recommendations or again seek treatment. Medicine, in general, needs to be humanized.
I have been checking into how to picket and from what I have found, it seems the hospital has the upper hand. Lawful picketing is mostly defined as done against an employer. The court seems to side with businesses if they are picketed. I am going to keep checking bc I think it is a good idea. Maybe I should picket at the Statehouse instead. I am also going to check into a billboard around the vicinity of the hospital to list some general items wrong with hospitalization care. I know from what several attorneys I have spoken w/ that the hospital in question is very aggressive and does not tolerate anyone questioning their authority but something needs to be done. I just have to find the right way.
In the meantime, we have written a letter to send to Pro Publica with his story. One of the points we wanted to make is what constitutes sexual assault and sexual assault of male patients by female hospital employees does happen but is often goes unreported by the male victim and when reported is ignored. We wanted to emphasize there is discrimination in care for male patients ie it would immediately raise a red flag if a drugged female patient was placed in isolation in the midst of only male staff. It also needs to be said that for males they often don't have a choice in who performs care involving intimate aspects and often they are not advised beforehand such in an office setting. For example, why is it acceptable like in Joe's case that he was alone w/ a female tech prepping him and doing so she didn't seem to know how and then later he was alone w/ 2 females. How often would a woman having the same type of procedure be alone w/ a male prepper and then w/ 2 males during the procedure? There is blatant discrimination in care which the government needs to address as they have addressed other discriminatory practices. Also, why must someone remind medical providers to treat them w/ dignity and respect--isn't that part of what this country built on? We also want it brought to attention about the use of drugs such as versed and fentanyl which in many cases are used for convenience of the medical staff rather than for the need of the patient. Another area is how easily medical records are manipulated especially since they are electronic boilerplate creations. Most people never read those records so they have no idea how many falsehoods are in a MR. These are just a few of the things that need attention bc if it happened to us, I imagine it happens to a lot of unsuspecting people. Does anyone know of other investigative avenues bc we have to get someone interested who has some media power in order to bring about change?

 
At Sunday, November 03, 2019 9:13:00 PM, Blogger Maurice Bernstein, M.D. said...

Relative to the graphic starting this Volume: How about all hospitalized patients be allowed to wear lower body attire or even their own home clothing? Does anyone find clinical arguments against this attempt to maintain patient dignity? ..Maurice.

 
At Monday, November 04, 2019 2:36:00 AM, Anonymous Anonymous said...

"Relative to the graphic starting this Volume: How about all hospitalized patients be allowed to wear lower body attire or even their own home clothing? Does anyone find clinical arguments against this attempt to maintain patient dignity?"

In the old days (as late as the 1980s) patients wore their own clothes in the hospital. I've wondered why they started mandating that all patients be in a hospital gown all the time.

I am probably viewed by the staff as a "difficult patient," because I do wear my own clothes.

I understand the need for a gown going into surgery, but the minute I am out of surgery I change.

I had surgery about 10 years ago. I was told I would be in the hospital 2-3 nights. The surgeon suggested that I pack pajama bottoms or sweat pants to wear under the gown. He suggested drawstring waists would be more comfortable.

He wanted patients to ambulate, and thought patients would be more agreeable if they had on pants. He said they would have to be emptying my drains and checking my incisions and that pants with a gown would preserve my privacy while they provided care.

All patients spoke very highly of him. I think his concern for his patient's dignity contributed to his outstanding reputation.

Other Drs spoke very highly of him too.

After surgery I put on pajama bottoms, a bra, and a loose t-shirt. My nurse had a fit. She insisted I had to be in a hospital gown and that I could not wear a bra.

Her arguments were that I might get blood on my clothes. I said that was not a problem.

She said that my bra might irritate my incision. I pointed out that my incisions were in my navel and abdomen and my bra came nowhere near my navel.

I don't remember her other arguments.

I also put on my athletic shoes. The nurse insisted I had to wear the hospital provided non-slip socks!

I put an end to her arguing by saying, Dr. B wants me to ambulate. I will not step foot out of this room in a hospital gown. You can explain to Dr. B why I am not walking.

I found out on POD 3 that all the staff were talking about "The Power Walker." They were asking my nurse if she would send The Power Walker to motivate their patients.

I would not have been The Power Walker if I had been in a hospital gown and slipper socks! In my own clothes I walked (very slowly pushing 2 IV poles) 10,000 steps every day. (I had my pedometer to motivate me.)

You can't put a t-shirt on while the IV is connected to a pump, but the nurse can disconnect the IV long enough for a patient to put on their own clothes.

I've worn heart monitors while wearing my own clothes.

Even with a foley catheter, the patient could wear a leg bag and lower body attire.

Requiring patients to all wear the same humiliating attire is dehumanizing and demeaning.

Even worse is that a lot of hospitals now put patients deemed a fall risk in bright yellow gowns. That's like putting a scarlet letter on their chest.

Hospital gowns are not just humiliating, they are very uncomfortable.

They get wrapped around you and tangled up while you are in bed.

They are too big and/or too long on some patients and too small and/or too short on others.

Hospitals are stingy with the gowns too. They will leave you in the same dirty gown for a week because laundering gowns costs $.

I freeze when I am in a gown. Hospitals are kept at a temperature comfortable for the fully dressed, active staff not the ill, barely clothed, inactive patients.

A lot has been written about ICU psychosis. Researchers are now arguing that a milder form of hospital acquired psychosis affects less acute patients particularly the elderly. One recommendation to prevent or minimize this is to keep things as normal as possible. I wonder if keeping these patients in their own clothes might help?

I'm sure there are some situations where gowns are clinically necessary, but many patients would BENEFIT physically and psychologically from being in their own clothes.

- CG

 
At Monday, November 04, 2019 9:11:00 AM, Blogger BJTNT said...

JR,
You are so on target with your boilerplate comment.

Thirty-eight years ago, I had kidney stone surgery. The insurance co. asked me to review the detailed medical costs. I found errors, but didn't respond for the wrong reason. I regret that to this day.

Now I request detailed medical costs for my hospital stays. I realize that the billing clerk does indeed have a boilerplate [since I'm a software guy, I say prototype] in which the clerk only has to entry the patient's dates for the hospital stay and the procedure[s]. The software just fills in the items and costs, independent of the patient - not that the billing clerk can't add to the costs. In reviewing the items, it makes me understand that either I'm not a typical patient for that procedure or the hospital couldn't care less about accurate billing [just submit the prototype with some creative additions]. Insurance companies themselves no longer ask me for my review of the cost items.

If Dr. B. opened a blog thread on the lack of integrity in the medical community, he would have 100+ volumes in probably seven instead of 14 years.
BJTNT

 
At Monday, November 04, 2019 10:33:00 AM, Anonymous Anonymous said...

Hello,

The following is a sad commentary on a previously unquestionably, noble profession. This doctor has had 32 yrs of experience.

Friday, November 1, 2019
Montgomery County Doctor Agrees to Pay $1.4 Million to Resolve Allegations of Improper Opioid Prescribing After Pleading Guilty to Related Criminal Charges


https://www.justice.gov/usao-edpa/pr/montgomery-county-doctor-agrees-pay-14-million-resolve-allegations-improper-opioid

Reginald

 
At Monday, November 04, 2019 10:42:00 AM, Blogger Maurice Bernstein, M.D. said...

I want everyone to know I fully agree with CG's analysis and conclusion.

Please read this article in Reuters.com which describes a study regarding wearing their home clothing as a hospital patient.

I would suggest that patients remind doctors, nurses and techs to wash their hands in the patient's hospital room sink before coming over to the patient's bed to "do whatever". ..Maurice.

 
At Monday, November 04, 2019 10:46:00 AM, Anonymous Anonymous said...

Hello again,

JAMA has recently published a comment (to an invited commentary) which is germane to the blog. Please see below:

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2753419

November 4, 2019Invited Commentary
October 28, 2019
Confronting Bias and Discrimination in Health Care—When Silence Is Not Golden

Comment:

"Implicit Male Patient Bias/ Discrimination

R Rozak, MA | University Education

Does bias or discrimination in health care include bias or discrimination towards the male patient? Is the male patient’s request for all-male care respected with the same urgency as that of a female patient requesting all-female care? Are male patients afforded the same dignity regarding bodily exposure as female patients? Is there evidence-based criterion for having female nurses for male urology but, absolutely no males in mammography? Why are these issues not addressed as correlates to bias and discrimination in health care? "

Reginald

 
At Monday, November 04, 2019 10:53:00 AM, Blogger Maurice Bernstein, M.D. said...

Another comment.
Though I was not always confident with the massive amount and directions of conclusions PT presented presumably based on his own professional experiences, I still felt that the subject matter presented was a personal experiential understanding and viewpoint and worthy of integrating into the discussion on this blog thread. Therefore I do miss his current absence from participation. ..Maurice.

 
At Monday, November 04, 2019 2:31:00 PM, Blogger Biker said...

Following CG's comments about clothing I will add another piece of input. I haven't been an inpatient since I was 11 years old but twice I was sent home from day surgery (bladder cancer) with a catheter that I was to keep in for a week. It was "shorts" season both times and so I slipped on a pair of pajama bottom shorts over the catheter. A catheter is thus not a reason to not be able to wear pajama bottoms or something similar when an inpatient.

I only checked the urethral opening for signs of infection once per day when showering. My understanding is that inpatients are subjected to frequent checks. If I could do it myself at home it would seem an inpatient could be empowered to do the same. Its not like most people can't tell if something is infected.

I will also note that both times I removed my own catheter. Again, why can't an inpatient remove their own if they so choose?

 
At Monday, November 04, 2019 4:31:00 PM, Anonymous JR Issues4Thought.com said...

I think while you are inpatient, they have to check as it would be for liability purposes. Some might consider it negligent if they didn't check. As I had stated before, after prostate surgery my husband was told to check the catheter site daily to watch for infections. He was technically an outpatient who was in-patient for less than 24 hours but yes they checked the catheter at once during that time and then showed us how to care for it as we weren't familiar with a catheter. He was supposed to return at 10 days to have it removed but at that point was tired of being a "patient" and removed it himself. Of course, he had the surgery done out-of-state and didn't want to have to put up with their attitude of him not having it done locally. But as a consumer, he shopped around to where he would feel comfortable having it done. Unfortunately, a heart attack didn't allow for that and it seems acceptable that ER patients do not have to be treated as humans that also should have dignity and respect.

As for the hospital gown, I have read the main idea "behind" the gown is like in prison they strip you of your identity and you become easier to manage. Banterings has said a lot how torture involves stripping the captive and leaving them exposed to make them submissive. I think hospitals have taken this for their own. On the other hand, some people have questionable cleanliness and they could be an issue. I have seen hospital wear that offer pajamas for comfort and bodily privacy. This would be a better solution for some. To me, the gown is just another way to control and have power over the patient as they fully know there are better alternatives to those gowns.
For some, the EHRs may be so false that you cannot use them as medical records. That is what has happened in m husband's case. We have had to cut and paste what procedures we think he had done as the records are so falsified. They are an absolute mess. We had had to have other tests done to see what was actually done. This is part of the lack of respect and dignity afforded to a patient that a patient cannot even determine from their medical records what really happened to them. The accepted answer seems to be that patients don't have the right to know--just be glad they "saved" your life. That's nonsense! They are merely doing a job which is to help prolong your life like a mechanic prolongs the life of my car, etc. There are maintenance repairs and emergency repairs which are part of the mechanics job.

Reginald,
Am I to understand they want comments from people like us who actually have something to say?

 
At Monday, November 04, 2019 5:53:00 PM, Blogger Dany said...

Biker,

If a patient requires a urinary catheter, I've been led to believe the nurse assigned to this patient will want to check it every time they do rounds on the patient. I'm really hoping someone will tell me I got this wrong because that seems like a lot of times. And there is also the daily catheter care routine that needs doing because, apparently, patients are to stupid to do this for themselves.

(in all fairness, there probably are some instances where a patient cannot do this for him or herself. But I would wager it is not that common.)

Catheters should only be used when absolutely necessary. Sadly it is often not the case in many hospitals. Given the odds of developing a UTI (which is more of a when then an if - they even have a name for it: CAUTI), it is amazing they are still so wildly used. Might be a way to increase billing fees.

Dany

 
At Monday, November 04, 2019 10:51:00 PM, Anonymous JF said...

Maybe a way of keeping Courts from using medical records as evidence about whether or not something is done would be lawsuits accusing staff of false documentation. As a nursing home worker, I can tell you that not everything that gets documented as done actually is. The biggest thing would be mouth care. When there is much to be done and little time to do it it's the first thing to be skipped. After that, it will be documented that the patients have been repositioned in bed 4 times a shift where it's usually 3 times.
Otherwise if there is really problems with workload some of the showers that were allegedly done, won't be done. But it will be documented as being done.
It's because it's unsafe for the CNA to say they were unable to get something done. Occasionally the nurses will help out in that kind of circumstance but oftener, they'll just get all over the CNA.

 
At Tuesday, November 05, 2019 4:44:00 AM, Blogger Biker said...

Yes I suppose hospital protocols are going to require catheters be frequently checked for liability purposes given there are people who wouldn't alert the staff to a developing problem. I'll accept that hospitals need to protect themselves in this regard, though it is a valid question as to how frequently they really need to check. I suspect the frequent checks are more habit than medically validated. I also suspect male patients have their catheters checked more frequently than female patients.

 
At Tuesday, November 05, 2019 10:16:00 AM, Blogger NTT said...

Good Afternoon:

I hope everyone is well.

Most of us know that the American healthcare system lost its humanity long ago.

They traded it for the almighty $$$.

The only people I can think of that don't know this are those that have not had any interaction with the system.

Once in a "blue moon" one might find a situation like Al's wife found but those are few & very far between. I wonder sometimes if that hospital would have acted the same if Al was the patient asking for male caregivers only.

Getting humanity back into the system has to start from the top & work its way down thru the ranks.

In today's healthcare system the culture is such that they want things done their way or don't seek medical care. Patient-centered care are just words with no real meaning for healthcare workers.

I've been thinking about the draping issue and men's privacy & would like to ask Biker some questions as he seems to have the most experience with cystoscopies. He has more experience with this than me.

1. If they really wanted to respect a man's privacy & dignity could a urologist do the prep & cystoscopy without any assistance whereby just the doc & patient are in the room?

2. Patient is laying on the table or in the gynecological chair with his legs up in stirrups. Couldn't one put a drape covering the guy's abdomen & up over his legs falling down over the sides. Then the doc sits on a stool at the end of the table/chair & do the scoping? By draping over his legs over the side if there are any females in the room, they wouldn't see anything whereby letting the guy relax a bit.

Dr. Bernstein, I read that study about letting patients wear their own clothing. That study was done in a Quebec Canada hospital.

95 percent of American hospitals only use the Johnny gown. They do it because it gives the doctors & especially nurses a huge sense of power over the patient as the gown is degrading & humiliating. One of their best methods of keeping the patient under their foot.

For months now I've been writing & speaking with people about male issues. I'm being told what I already knew. Not enough guys are speaking up to make healthcare listen.

Until more guys come out of the closet & start talking, this issue won't go mainstream.

I have friends in Chicago looking into taking out ad space in in the tribune & a couple of medical magazines but they are getting push back so far because of the topic. They don't want to offend their bigger advertisers.

58Flyer is correct in that congress will have to legislate change if we are to make things right for men.

On the catheter issue, I don't need nor would I allow a female healthcare worker to check my catheter. I've lived with the part all my life & I know looking at it if something is wrong or not. I don't need female healthcare workers pushing their power trip on me trying to embarrass me as often as possible.

That's all for now.

Regards,
NTT

 
At Tuesday, November 05, 2019 1:24:00 PM, Blogger Biker said...

NTT, yes I've had a couple dozen cystoscopies over the past 14 years, split between two hospitals.

In every case when I am being prepped the doctor is with another patient, there essentially being two nurses assigned to him, one prepping the next patient he'll see and one "assisting" him with the current patient. When he is done, the one who assisted then moves on to prep the next patient while the doctor moves to the room where the next patient is prepped and waiting. He sees twice as many patients as he would if he had to do the prep himself. No hospital is going to change that system.

Both hospitals vary a bit in their protocol but both are totally consistent in following their protocols. Both are large teaching hospitals, one in Boston and one in rural NH.

In both I am asked to remove pants and underwear in a private changing room and don a gown. In Boston I would then get on a chair/table where my legs would be spread and raised. Before my legs are positioned I was covered by a sheet so that nothing is exposed when I am positioned. Standing at my side the RN would move the sheet down and my gown up so as to expose my penis and then she'd immediately put a small cloth with a cutout in the center over my penis so that only my penis is exposed. I say she because in all my years going there I never saw a single male staff person. The prep would consist of a cleansing of the penis and insertion of lidocaine. She would then stand at my side right at my hip until the doctor came in. Note my penis was always left exposed while we waited. When he arrived she'd put his gown on him, assist him readying the scope, and then return to my side until he was done. He'd stand between my legs to do the scope. He'd then leave and she'd start the cleanup while I returned to the changing room to dress. When dressed she'd give me a cipro and one to take home for later and we'd be done.

In NH most nurses in urology are female but at my request I've been assigned male RN's these past few years since I switched to there. There has never been any push back or hostility by the female schedulers or check-in staff over my requests for males.

In NH I am on a table but with my head raised so that I can see what's going on. A drape is put on my legs extending up to my chest and a second on the other side. The RN pushes it aside and lifts my gown to do the same prep as in Boston. That process exposes me more during the prep than was the case in Boston but I don't mind given it is a male RN. When he is done he adds a couple cloths and positions the drapes so that only the penis is exposed and then he covers it over with a cloth while we wait for the doctor. The doctor arrives, is readied, and does the scope standing at my side. While he does that the RN busies himself elsewhere in the room rather than stand there watching. The doctor leaves, I get dressed, and the RN gives me a single cipro.

On your comment about newspaper ads, in my local paper the local hospital is probably the largest advertiser they have. I doubt they'd be receptive to any ad that puts the hospital in a negative light. I will note that the local hospital is clueless when it comes to male patient dignity which is part of the reason I drive 75 miles each way through the mountains to get to the hospital in NH.

 
At Tuesday, November 05, 2019 1:47:00 PM, Blogger Biker said...

On the topic of getting patients out of their clothes and into gowns, though I don't really count it as being an inpatient I was admitted for an overnight maybe 16 years ago or so for observation after a bad concussion after going over the handlebars and into a tree in a mountain biking accident. I didn't get there until 6 or 7 at night and after a scan of some sort I was admitted and sent upstairs. I was OK in the morning and released and so really only there for a matter of hours overall, so not really an inpatient in my mind.

In the ER everything came off except my underwear and I was put in a gown. I was awake but pretty out if it and theirs to do with as they chose. In the morning a nurse checking on me didn't say it specifically but she was clearly not pleased that the ER staff sent me upstairs with my underwear on. Their protocol must have been they want patients naked except for a gown when sent up from ER. How often would that even be warranted medically? At the time I didn't understand her reaction, but now I understand the "control the patient by making them feel more vulnerable" approach to healthcare.

 
At Tuesday, November 05, 2019 2:39:00 PM, Blogger Biker said...

Sorry to be so talkative here but I thought of another piece concerning NTT's comments about the doctor doing his own prepping. After my initial bladder cancer surgery I had a year's worth of BCG & Interferon treatments. I don't recall exactly how many in all. The mixture gets inserted into the bladder, left there for 2 hours, and then you urinate it out.

A female NP did all of these treatments, the same NP each time. She did her own prep which is essentially the same as for a cystoscopy: cleanse the penis & insert lidocaine. A catheter is then inserted to push the BCG/Interferon mixture into the bladder. There was a very big difference however. She would have me just hop onto a table and with her standing there I'd pull my pants and underwear down to my knees and she'd proceed with the prep and the procedure with no draping whatsoever. When done she'd remove the catheter and give me a cloth to wipe myself and then I'd pull my underwear and pants back up.

The 1st time was pretty humiliating with my only solace in subsequent treatments being it was the same person vs a different nurse each time like I had with the cystoscopies. Alas I hadn't found my voice yet back then. Given the procedural & prep similarity to an actual cystoscopy the difference in approach was significant.

 
At Wednesday, November 06, 2019 4:52:00 AM, Anonymous JR Issues4Thought.com said...

Biker,

From what you have described and what has happened in the past w/ my husband's uro visits, it is clear there is a difference between how men and women are treated. JF, I think you could probably help verify this. For me, when I did visit over 25 years ago for female related checkups, I was left to undress and gown with no one in the room. I was draped before they would put my legs into the stirrups. I was covered completely when the dr. would come into the room. The nurse would find something else to do and not have a direct look. When done the dr. would again cover me up. I would be handed a cleanup towel and they would leave the room to I could dress. During my husband's visits, he would be told to drop his pants & underwear. The dr. would do the front exam first & then w/ pants on the floor tell him to turn and bend over the table. When finished he would hand him a towel & tell him to clean himself. He would & pull his pants up all the while they were still in the room. For the prostate, it was the same in that the nurse was there while he undressed and cleaned up and redressed. Although at the time, we didn't think much about this until he was actually sexually assaulted, this demonstrates how the roadmap to assault can be made so easily. There certainly is a clear lack of respect for male dignity and absolutely no respect of the male patient as a human being. While it is clear that how healthcare is delivered to women is not perfect, it is better than how it is delivered to men. Both female & male patients are sexually assaulted but only female patients are able to get any action taken and even then it is a slow & painful process. For male patients, there is no help.
Before his assault, neither my husband or I thought much about how he as a male patient wasn't allowed dignity or respect. I, as a female patient, demanded it and got it. He didn't necessarily like how it was done but it had always been done that way so having modesty choices never was a thought. It was the necessary evil for male medical care bc unfortunately we weren't educated enough in that manner. But now, it goes beyond modesty as he was a victim of medical sexual assault coupled with medical consent assault. But I don't think most medical systems acknowledge trauma informed consent for male patients. They don't even acknowledge there is a difference in the way treatment is delivered for male patients.
As far as the catheters, I read a piece on Quora about catheter usage and clearly they are overused mainly for the convenience of staff. They should not be used bc a patient is incontinent but often are. They should not be used for procedures lasting less than 3 hours. As we know, the chance of UTI is increased w/ catheter usage. However, that being said, diapers are just as problematic. When my sister was in a rehab facility which was actually a nursing home, her roommate was a large women in her early 60's who had broken a hip or leg. Anyway she didn't want to walk. She was diapered. They wanted her to get up to use the bathroom but she didn't want to so they made her sit in her dirty diapers as punishment thinking she would be prompted to get up & walk. My sister said they would leave her in dirty diapers all day. My sister spent her time out of the room bc of the smell. I don't know if there was diaper rash as a result of the dirty diapers or not. My sister left there asap. That was a clear example of how they exert power and control that overrides decent medical care. How they treat male patients is another example of how they exert power & control by trying to make each male that comes into their orbit be powerless and defenseless. Although it has always existed, I think it may have worsened w/ the MeToo movement bc now they feel justified & are likely to be more bold.

 
At Wednesday, November 06, 2019 7:37:00 AM, Blogger NTT said...

Good Morning Everyone.

Biker, NEVER apologize for being too talkative as hearing your experiences helps many.

Here's what I find very telling about what Biker has said.

In Boston, when he arrived, the (FEMALE) RN put the gown on the doc, assist him readying the scope, and then returned to Bikers side until he was done.

In NH, the doctor arrives, is readied, and does the scope standing at my side. While he does that the (MALE) RN busies himself elsewhere in the room rather than stand there watching.

Why did the FEMALE RN have to stay at Bikers side when the MALE RN didn't?

Because there was something to see. Bikers privates. She like her male counterpart should have walked away to another area while the doc did his thing.

And they say there's NOTHING sexual about healthcare. BULL PUCKY

These are the kind of issues that MUST get resolved to the PATIENTS satisfaction. It's time to change some protocols if men are forced to do these tests with women present.

Thanks for helping me Biker.

Regards,
NTT

 
At Wednesday, November 06, 2019 9:40:00 AM, Anonymous JF said...

JR. I agree that male patients dignity is violated oftener than female patients. Something I wasn't aware of until I found this blog.
For one thing there's more female staff than male. And of the female staff a much smaller ratio of them will get pleasure from seeing another female exposed. But it does happen.
One of my complaints that brought me to this blog. I was getting a pelvic exam for some symptoms I was having. I was actually given privacy to undress, however I was in that position and my gown was pulled up already when the door was opened up. There was no screen blocking the veiw from people in the hallway. No curtains were pulled around us. A scribe was pushing a portable lamp and she was actually seeing everything. So what exactly was accomplished that wasn't unaccomplished by the later disregard? I didn't see anybody in the hallway when she came in but I didn't want to see her sneering face so I closed my eyes. She left while I was still uncovered. I don't know if people were in the hallway that time because my eyes were still closed.

 
At Wednesday, November 06, 2019 10:14:00 AM, Blogger Dany said...

Hello all,

It seems apparent to me that, unless a patient has done his own thorough research - and that's assuming one would know what questions to ask, you're more likely to fall victim of inappropriate if not abusive behaviours from staff. And even if you think you know what's going to happen, you might still get screwed (if I may be so bold).

I can't claim to have as much experience as Biker (thank you, btw, for speaking of your experiences) regarding urology care but I also needed a cystoscopy a few years ago and, to be absolutely frank, it left me with a bitter taste. I had the proverbial wool pulled over my eyes in a major way. I have posted my experience here in the past so I won't go over it again but it's interesting to note the similitudes and differences.

- The nurse preparing me was female (first shock for me).
- As if one wasn't enough, I had the dubious pleasure of having two nurses being present, both females (yay for me!). More on why later.
- Once I was lying down, I am the one who lifted my gown. There was no draping other than the sterile field.
- The nurse "assisting" the urologist stayed at my side for the entire procedure.
- The other nurse conveniently stayed out of my field of vision but it's not like I didn't know she was there. This nurse did absolutely nothing. Nada.

The reason why there were two nurses is because I had somehow been ropped into a training program and the nurse who did the work was in training. The other one was there to make sure she didn't make any mistake (and probably to assess her).

Was I informed of that? Nope. Was I talked to about this by my GP, Urologist, or even the hospital staff? Nope. Was I given a chance to think about it and give my informed consent? Of course not.

(Apparently in the medical world not saying no holds as much weight as saying yes, especially if you do not know or understand what is going to happen.)

I will only close this by saying I won't be caught like that again, that's for sure.

Dany

 
At Wednesday, November 06, 2019 10:54:00 PM, Blogger 58flyer said...

"I will only close this by saying I won't be caught like that again, that's for sure.

Dany"

Dany,
I know where you are coming from brother. I too, decided that I would never be caught again. But I was. Just when you think you have it all under control, you can still be taken advantage of. They are experts at getting their way. I was an amateur at protecting myself. Too bad that this is the way it is. As I have said before, it is going to take legislation, not the good intentions of female professionals, to fix the problem.
58flyer

 
At Thursday, November 07, 2019 7:30:00 AM, Blogger Al said...

Hello Everyone .
NTT . In regards to your question about if I was the patient . The best answer I have is I don't know . I would hope , but you never know . Don't think that her journey was without problems . We left several different healthcare systems because of their lack of caring or listening to the patient . We heard all the usual BS . Don't have any female's or what is the difference . We would just leave them . We chose this certain hospital for several reasons . First was their patient bill of rights . In it it says " patients have the right to designate visitors and people involved in their care . " If you designate no male or female caregivers would that be covered under their bill of rights ? We also checked if they employ male techs and nurses in urology , imaging and GI . All have several males and they said yes you can choose to get male care . Most other places we called kind of laughed at you and said NO . I have said before it is the culture of that particular hospital . If you choose one that doesn't care or respect the patient you can almost guess what to expect from them . Like Biker , we chose to make the long drive . ( over a hour 1 way ) . This all took place 13 years ago . Do you think things got better or worse over the past 13 years ? If you don't ask and push back you will get whatever care they want to provide . So to NTT . I will never know how things would have been if I was the patient . I do know that if you just go with the flow things might not go to your liking . Best wishes to all . AL

 
At Thursday, November 07, 2019 7:52:00 AM, Anonymous Anonymous said...

In 2016, my PCP referred me to a urologist for a cystoscopy. When I met the urologist I told him I would only consent to the procedure if no females were involved. He said that was not a problem and he performed the test alone in his office. I realize not all doctors would be so accommodating, but if they say it’s impossible to do without an assistant they are lying. By having a nurse doing the prep they can do more procedures thereby increasing their income.
MG

 
At Thursday, November 07, 2019 7:58:00 AM, Anonymous Anonymous said...

In February of 2019, as a result of taking antibiotics for an infected hand injury, I developed a case of C -Diff. It causes serious diarrhea as result of the “good" bacteria in your gut being destroyed. My PCP said this was serious enough that I need to be hospitalized. Reluctantly, my wife and I packed a bag and went to the local medical center.
Because of the C-Diff, I could not share a bathroom so I was fortunate to be given a private room. After being shown to my room, an RN came in, handed me a gown and told me to take everything off including my underwear and that she would return to do a new patient evaluation. I did remove my shirt and jeans and put on the gown so it would easier for them to start an IV; but I left my underwear on and also put on a pair of cotton sweat pants. Then I got into bed and pulled the covers up to my waist.
When the RN returned she asked some questions, took my vital signs, and listened to my heart. Then she asked me roll onto my side facing away from her and she pulled down the blankets, seeing for the first time that I was not completely undressed. I was ready for some comment about why I as not nude under my gown but since my condition had been confirmed by a lab test, I saw no need for any kind of genital or rectal exam and was determined not to submit to one. To my surprise, the RN just listened to my lungs and then said, “Well, I guess we’ll skip the rest then” She said someone would be in to start an IV and left.
I think the reason she did not insist on a further exam is that by refusing to obey her directions to undress completely, she realized that I was not going to follow the script and play the role of the child-like, obedient patient and she did not want to get into a power struggle she knew she was going to lose. I was in the hospital for six days and no practitioner made any comment about my choice to wear sweatpants.
Many doctors, nurses, and CNA's assume that once you are a hospital patient you have given up all right to bodily privacy. This is not the case. You do not have to submit to intimate exposure and you should not be asked to do so unless absolutely medically necessary. You have the right to wear your own clothing as long as it does not interfere with your medical treatment. RESIST.
Finally, I want to say how thankful I am for this blog. Without the knowledge I have acquired here, I probably would not have had the conviction to insist on respectful treatment.
MG









 
At Thursday, November 07, 2019 10:48:00 AM, Blogger Biker said...

Having been taken by surprise enough times to have learned my lesson I now make an attempt to understand the basics of what a scheduled procedure is all about beforehand. I am then better prepared to speak up and/or ask questions.

One lesson learned the hard way is to know what the appt. is for. That may seem a no-brainer but the day I had my very first cystoscopy I thought I was just having an office visit to talk to the doctor. They failed to tell me I was scheduled for a cystoscopy and I failed to confirm my assumption that it was just a talk to the doctor office visit.

Perhaps the most important lessons learned are knowing I can speak up and knowing that the staff's convenience and comfort is of higher priority to them than is my modesty and privacy; that if I don't advocate for myself nobody will.



 
At Thursday, November 07, 2019 12:36:00 PM, Blogger A. Banterings said...

Maurice,

Dr. Miles compares medical procedures to sexual assaults (acknowledging the sexual component). I have always said take the procedure out of the hospital and put it in a motel room and see how one would view it. This just further proves my assertion that despite how desensitized the provider is, how sterile and clinical the scene is, there is a sexual component.

It is a failing of the profession of medicine to pretend that sexual components do not exist in the procedures and the attempt to gas light patients into "drinking the Kool Aid" and believing this too. All this does is erode whatever little trust, credibility, and good will the profession has left with society.

As to Dr. Miles questioning why healthcare providers did nothing, it is the same reasons (as he alludes to) that physicians participated in the death camps and other aspects of the Holocaust. My research shows that the basis of this is the destruction of empathy and replacing it with sociopathic behaviors in med school.



JR,

Dr. Miles writes about torture in the "war on terror" prisons and the participation and complicity of the profession of medicine in his book Oath Betrayed: Military Medicine and the War on Terror.



For those of you discussing catheters,

Patients can REFUSE catheter checks, cleanings, etc. by hospital staff AMA (against medical advice). I highly recommend that in place of hospital staff, the patients clean, check, self report, etc. to the nursing staff the catheter care and condition so at least they can document the self care.

I have no problem making it known to staff that I have the final say in my care. I am in charge and the attending answers to ME!




-- Banterings




 
At Thursday, November 07, 2019 12:49:00 PM, Blogger A. Banterings said...

Biker,

That is the problem with providers, they just do what they want. I had to tell my doctor that before he orders ANY blood tests, that he goes over with me what he is ordering and why. Too often he would just order my legally required chem-14 test (for liver tests), he likes to throw in CBC and lipid profile because it makes my doctor feel like he is taking care of me. I noticed that there were other (unrequested) tests appearing.

Patients need to train doctors they they need to ask our permission.




-- Banterings




 
At Thursday, November 07, 2019 1:00:00 PM, Blogger Maurice Bernstein, M.D. said...

In The Defense of "Good Words" is the title of my posting here.

First read this brief article in the "Harvard Medical School "Lean Forward" ("A Place for Medical Proviiders to Converse on Health Care Topics" )titled "Setting the Stage: Why Health Care Needs a Culture of Respoect" written by Ted A James, MD. But then read at the very end of the physician's text the following written by the medical school:
*OPINIONS EXPRESSED BY OUR GUEST AUTHORS ARE VALUABLE TO US AT LEAN FORWARD, BUT DO NOT REPRESENT OFFICIAL POSITIONS OR STATEMENTS FROM HARVARD MEDICAL SCHOOL.

Come on Harvard, what is wrong with the 10 ways to show respect?


Listen to understand
Keep your promises
Be encouraging
Connect with others
Express gratitude
Share information
Speak up
Walk in their shoes
Grow and develop
Be a team player


This is an example of even a thoughtful physician speaking up to the system gets knocked back by the medical system. ..Maurice.


 
At Thursday, November 07, 2019 2:06:00 PM, Blogger Biker said...

Dr. Bernstein, my guess is that the disclaimer at the end of the article is a standard lawyer-mandated item added to every article rather it being specifically targeted at the content of that article.

It was an excellent article. Though not based on anything specific he said but rather as a general comment on healthcare staff in general, I do wonder if the author understands the difference between staff being polite and following standard protocols and staff respecting the patient's dignity. I say this because what the patient thinks seems to never be part of "we respect patient dignity" and "patient modesty is preserved" kinds of statements healthcare organizations and staff members routinely make. It is always what the staff person thinks is respectful and what the staff person thinks constitutes preserving the patient's modesty.

By way of example using Dany's example, no doubt those two women would affirm that Dany's dignity was respected and his privacy preserved because they shut the door, were polite, and used that organization's standard protocol to prep him. Were he to get a Press-Ganey survey about that experience he wouldn't find a single question dealing with his privacy or dignity. Why not? The hospital organizations aren't interested in knowing because those aren't issues they want to acknowledge.

 
At Thursday, November 07, 2019 2:47:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, such a disclaimer while appropriate for some professionally controversial articles or statements, it still provides the reader with a benchmark for evaluating the philosophy and goals of the institution or, broader, the medical system itself. Articles like this one should be institutionally accepted or should be rejected and not published. It is demonstrating "weakness" in the underlying behaviors and goals of an institution to find merit in what should be generalized professional behavior and allow publishing and yet provide a non-specific, non-descriptive disclaimer.

Again, if what is written regarding the philosophy or ethics of the institutional behavior is not acceptable then don't publish. If acceptable or rejectable, in parts, then the institution should write a specific analytic statement as a response. Legal fears should never trump an accepted ethical good. Anyway that is my philosophy though I look upon myself as an ethicist and not a lawyer. ..Maurice.

 
At Friday, November 08, 2019 11:33:00 AM, Blogger NTT said...

Good Afternoon:

58flyer is correct. Its going to take legislation, not the good intentions of female professionals, to fix the problem. Problem is finding someone in congress not already bought off by the healthcare system willing to listen to us & help.

I understand that when one is dealing with illness, all they want to do is get better. But what MANY people don't understand is one doesn't have to sacrifice their dignity & privacy to do so.

I'm finding many men telling newbies (patients that haven't had intimate exposure in the presence of opposite sex), to get used to it when male intimate related exams, tests, & procedures are in play because it is what it is. I HATE that statement.

It hurts me to see guys who just refuse to stand up for themselves & say no. It takes some research & maybe a bit of traveling but one can keep their dignity & privacy intact if they choose to while getting medical care.

Newbies need guidance BEFORE they go to the lion's den for help so they don't come out of the visit shell shocked. There should be an online "clearinghouse" where patients can go to get detailed information about exams, tests, and procedures. Google is a source but they don't really tell ya who's involved & who does what to you and when.

We know we can't count on the PCP for that info. They just say "I don't know how they do it".

If people know the who, what, when, where, & how then & only then can they make a true "informed" decision.

Take MG's C-Diff episode where he went into the hospital. "After being shown to my room, an RN came in, handed me a gown and told me to take everything off including my underwear and that she would return to do a new patient evaluation." A newbie, would have done exactly as she told him to do & take off all their clothes because they don't know any better or what's involved in a "new patient evaluation".

The more men & women we can educate before the visit, the more voices for change we will have on our side.

So until there is a place where info about tests, exams, & procedures can be uploaded for people to read before they go, I will continue to talk on websites to guys who believe it is what it is even though that's NOT how it has to be.

Regards to all,
NTT

 
At Friday, November 08, 2019 12:59:00 PM, Anonymous Anonymous said...

Hello,

Please read with great pleasure a doctor with GUTS!

"Doctor who challenged double-booked surgeries at Mass. General reaches settlement

A former Massachusetts General Hospital orthopedic surgeon who publicly criticized the hospital’s policy of allowing physicians to perform more than one surgery at a time has reached a $13 million wrongful termination settlement with the hospital. Dr. Dennis Burke, who was at the center of a Boston Globe Spotlight series exposing double-booking surgeries, was fired in 2015 after allegedly clashing with the hospital administration for calling out the practice, which allowed surgeons to book concurrent surgeries — overlaps that could last hours — without letting patients know that they were sharing a surgeon. MGH, which says Burke was fired over violations of patient confidentiality, has since changed its surgery policy. Burke has now been offered his old job back and will be honored with a new hospital safety initiative bearing his name. Burke told the Globe, however, that he doesn’t plan to resume working at MGH."

Reginald 

 
At Friday, November 08, 2019 3:35:00 PM, Blogger Biker said...

NTT, even if men purposely search for it online they are not going to easily find out exactly how they are prepped for things like cardiac caths or how procedures like urodynamics testing are actually done. The patient's pages for most hospital websites rarely tell the patient anything about how things are actually done. Videos for things like dermatology full skin exams and head to toe nurse assessments always skip over the genital areas. That there will be a female scribe and possibly a MA or LPN there at derm appts is never included in the videos. The result is men are taken by surprise and the system continues on as is.

Reginald, at the barber shop one day I asked an anesthesiologist who was there about why there will be an anesthesiologist and a CRNA for surgeries, and maybe also a Resident. He told me anesthesiologists do more than one surgery simultaneously. They oversee putting the patient under and then leave for another surgery, leaving the CRNA (and resident if there is one) to manage it from there, calling him if he is needed. Of course the patient is never told this.

 
At Saturday, November 09, 2019 3:58:00 AM, Blogger NTT said...

Good Morning:

You are right Biker there isn't a lot of info out there on the how & who does it.

My brother is looking into maybe getting his own website thru godaddy. If he does, info on who's involved & what happens during male intimate exams, tests, & procedures will be posted there so guys have a heads up ahead of time.

Have a great weekend all.

Regards,
NTT

 
At Saturday, November 09, 2019 6:27:00 AM, Anonymous JR Issues4Thought.com said...

NTT brought up a good point. Reading the consent to the cardiac cath. that wasn't signed but in his file, it gives the dr. the ability to have whoever he wants to actually do the procedure even though you might think you are signing for that dr. only. The only way you "might" know who actually did your procedure is to get a copy of the MRs if they are truthful but usually they are not. What you agree to verbally doesn't mean anything especially if no note is made. That is what happened in my husband's case. He depended upon them being honest & they were not. Unlike other service providers, they think their opinions are so superior that you must adhere to them. That is why I recommend that every patient has the USB recording device to make a memo of what is said. If you make changes to a form, note there are changes where you sign or otherwise they can insert in a clean page thus deleting your changes in the body of the form. It is a real shame that you have to protect yourself but we have learned the hard way what can happen. Biker is also correct when he says sites don't show you what really happens. The hellholes my husband went to have videos online showing how humanely that treat heart attack & heart cath patients but in real life it was nothing like that. There are also videos that show how patient dignity during heart caths will be protected but again it merely shows how it should be done & not actually how it will happen. Do the research & put it on the consent form how you want your dignity to be preserved before, during, & after the procedure. Have your Advance Directive enhanced to include all these things. Have multiple copies & check to make sure your chosen hospital has it on file. Banterings is correct in saying you should have it noted you have been a victim of sexual trauma. We have told my husband's cardiologist he is a victim of hospital sexual & medical assault. They reluctantly put it in his file. They said it is in the past so I countered that is telling a woman or a child who has been a victim of sexual assault that it is no big deal as it is in their past? That shut them up as they knew it would be pc incorrect. It is crystal clear that 1 they don't believe men can be victims and 2 that female medical workers can also be guilty.

I am going to work on some items that should be explicative defined in a true Patient Bill of Rights for both in-hospital & office care. I will put them on my website bc of space limitations. I'll advise so all can take a look & add or comment. In the meantime, feel free to give suggestions. I would like to see that document sent to all lawmakers to make them aware. I have been sending the male modesty brochure by Misty but I would like it clarified it is not only an issue of modesty but an issue of owing to every human being the right we already possess of being treated w/ dignity & respect.

 
At Sunday, November 10, 2019 7:57:00 AM, Anonymous Anonymous said...

For my lung cancer robotic surgery I was stripped naked as soon as I entered the O.R. for prep. I pleaded for help. I was ignored by all the personnel inserting IVs etc. They glanced up and then continued their jobs. I had no gown on, no sheet, no blanket covering me. I lay there freezing, mortified. I was woken up naked from the procedure. No gown, no sheet, no blanket. Throughout, no one talked to me, explained the procedure or what they were doing. No personnel told me who or what they did. I succumbed to hypothermia and other blood pressure complications in PACU. When I questioned the hospital, surgeon, and staffs I was told "We don't treat patients like that." Yet the one PA said,"Yes you have no clothes on." I was prepped with male techs in and out of my O.R. (I am female). My urinary catheter was done by males. None of this is against my civil rights or patient rights they told me because it is done AFTER I am under anesthesia. (Yet I was awake for some of it and saw what they were doing and pleaded for help.) I think this is akin to "date rape." I said I didn't want males present for my procedure. They said that was discrimination AGAINST THEM not to see me naked and work on me. The gowns are a joke. Every doctor I've interviewed on talk radio shows agrees. A patient who is calm, educated, and under no duress is a more effective patient as well as wearing their own underpants and NOT being catheterized. (That is another tactic to make it easier for them AND get more $$$$). Yes, the doctors' hospital records are falsified. Mine are. I've ordered them all. Joint Commission, facility admin., patient advocates, cancer center admin., Press-Ganey, state legislature all do nothing to help me. Today I suffer PTSD and medical trauma from the heinous care, surgeon bullying me, staff neglect and disrespect. One RN who treated me told me my surgeon had a LOT of patients, a real lot of them. That's the answer---too many patients, treat them like an assembly line, strip them naked to make it faster and easier for docs and staff. 'Cut and Run'--'Deny and Defend'. Six US states have realized this mindset doesn't work. They are helping patients get help. IN FL surgery techs aren't certified, licensed or regulated. These are the guys who inserted my urinary catheter and witnessed me totally naked. Many are bartenders or servers as second jobs. And I am discriminating against them asking for a gown, to be treated with dignity and respect. As far as verced and fentynl AND propofol yes they subdue the patient. A dermatology surgery RN told me, "Yes, we don't want to bother with these patients, we want to see that big bag of milky liquid hanging from the pole (propofol) and do what we want." My own surgeon told me he had other patients and it would take him 45 more minutes to do what I was asking to be done. He didn't care about my dignity and respect. It was all what's easier for him and them. And this "care" is for LUNG CANCER! I am onboard for any and all protesting, letter writing campaign, contacting legislature, etc. I produce 10 min talk radio segments talking about all of this to try and help people and get the word out there. I pray someday patients get respect and dignity. It used to be forefront, but in this day and age of big pharma and big $$$$$ we are schlepped aside for convenience. And over diagnosed. Thank you for listening. And if I can help anyone I will. CS

 
At Sunday, November 10, 2019 9:29:00 AM, Anonymous Anonymous said...

I want to add: hospitals, surgery facilities send the surgery patient a "Patient Booklet". Are these to suffice for that patient's "education." Legal box checked. Leaves more time for the surgeon to "interview" another patient. Going into my lung cancer surgery I talked with the surgeon for barely 10 minutes (at the initial consultation). No other appointment was routinely scheduled for me--the patient--to discuss this operation, side effects, prepping, anything. HOW is this "medical care"? "We give you our office phone #," the surgeon's PA told me when I was hood-winked by this heinous care; yet their own booklet stated I'd have a "team" in place to answer any and all questions. A team I NEVER MET.....till after surgery. And then all they did was explain my follow up X-rays as "looks okay." This medical care is absolutely beyond comprehension. This was at a "teaching" hospital. What in the world are they teaching!?

 
At Sunday, November 10, 2019 2:46:00 PM, Blogger Maurice Bernstein, M.D. said...

CS, I think it is important that "teaching hospitals" who call themselves by that expression should be applied to patients and their families as well as medical students, interns and residents and other hospital staff.
In fact all hospitals should consider "teaching" as one of their requirements of appropriate function. And the teaching should be related to appropriate medical practice and patient health. And I agree, teaching a patient and family should be considered part of the disease therapy and not a waste of hospital time or money. ..Maurice.

 
At Sunday, November 10, 2019 3:39:00 PM, Blogger NTT said...

Good Evening:

CS it sounds like your hospital, like most these days are modeled after factories.

Get'em in get'em out & bring in the next one. Keep the production line going.

The only way we as patients will end this nightmare is by forcing our elected officials to LISTEN to us and make sorely needed changes to this broken system.

The way we make them listen is by the power of our vote. You don't listen, you lose my vote.

Congress has gotten fat & lazy by taking healthcare lobby dollars for decades instead of listening to the voters. It's time to send them home if they won't or can't listen to those that elected them to their cushy positions.

Use your vote & start a wave of change. WE deserve better.

Regards,
NTT

 
At Monday, November 11, 2019 4:53:00 AM, Blogger Biker said...

After years or reading personal accounts I wouldn't think anything would floor me anymore but I am astounded at how callous the OR and PACU staff were in their treatment of CS. Where was their basic humanity?

Legislation can address many aspects of what we discuss here but it would be pretty tough to legislate basic human compassion and empathy, and even harder to define it. Bear in mind most legal processes rely upon the letter of the law rather than the spirit.

Legislatively addressing standards of care would defer the setting of those standards to the appropriate governance agencies who in turn will most assuredly defer to the interests of the hospitals and "professionals" over that of the patients.

The question then is how does one legislate respecting patient dignity and privacy when the people who would be tasked with writing those definitions are the offenders themselves.

 
At Monday, November 11, 2019 5:15:00 AM, Anonymous JF said...

CS, I'm sorry you were treated so horribly. It seems to me that the more groups get involved, the more disfuntional health care gets. It should cost what it costs, regardless of whether health insurance pays or patients pay out of pocket. Set prices.
It seems like they were trying to rush you through as quickly as possible and didn't even have enough empathy to put you under first, all for the purpose of getting on to their next assignment to get a better wage.
The way I believe they should get their better wage ( without disregarding patient dignity ) is to reduce the cost of medical school. Somebody is being overpaid and possibly several somebodies.
I know a lot of posters disagree with me but I don't know how else it can be achieved, video procedures WITHOUT staff's knowledge. ( possibly with a patient who agrees before hand. Let staff try to get their stories straight amongst themselves THEN prove them to be lying.
Dr B often talks about speaking up and in certain circumstances maybe it can be done. But you spoke up and we're ignored. Often the moment for speaking up doesn't happen until after the fact.
ONE root of the problem is not enough doctors and surgeons. That's because med school is too expensive. I have ideas that MIGHT work ( and might not ) about how we could have enough doctors and surgeons.

 
At Monday, November 11, 2019 7:48:00 AM, Anonymous JR Issues4Thought.com said...

CS,
My husband's experience was much the same except they forced a procedure on him. He laid there freezing, naked, and high from the drugs they had w/o his knowledge injected into his IVs (he had 4 lines). Although versed is supposed to make you forgot and disinhibited, it doesn't always work that way. It is also supposed to be an anti-anxiety but on some it has the opposite effect. Fentanyl is used not only for pain but also as a paralytic but also you make you high enough you don't care. His being left naked and exposed continued another 5 hours after the procedure when he was isolated into a patient room. You are right--you are left w/ the feeling of being raped. Bc of this, he will no longer have more procedures done. Medicine does not care how what they do affects your mental well being if they are doing a physically procedure. The techs & rns only care about getting the job done fast being neither compassionate or really worried if the job is even done correctly. He too said they neither spoke to him but he was aware of them talking to one another & having a good time probably at his expense. Since you verbally told them to cover you, what they did constitutes assault as they must listen to what a patient says. The issue is there is no proof & that is how they get away w/ assaulting so many patients. They know this too & that is why it will continue.

As far as being a teaching hospital, they only teach what is convenient for them to learn. They make a show of saying the right things such as in the "Patient Bill of Rights" but those rights died long before the tree did that they are printed on. Their goal is to give lip service they care when they know otherwise. They only care as far as their stats & rankings go. Every once in a while, you might find a medical provider who is human but most are not. In my husband's case, aside from them not having his consent, they also did not need to expose his genitals for the procedures as there was no foley catheter but for their own perverse pleasure and/or convenience, they usually choose to make each patient as much as an object as they can. There is no compassion in hospital medical care. Bc this is how they treat patients is the big reason they do not allow patients to have an advocate present. Having someone present in the procedure is entirely possible as look at having a C-section. Fathers are present all the time & nothing bad happens but what is different is how they treat the mother during this time--they generally use care & most staff is of the same sex except maybe her chosen male dr.
Pls read my website at Issues4Thought.com to see my husband's full story & some of our feelings. Although it happened last year, the feelings never go away. We have tried to get his story out there but most avenues are so well funded by medical that it is impossible. We need a voice to be heard & make changes.

 
At Monday, November 11, 2019 10:08:00 PM, Blogger 58flyer said...

On Monday I was back at my Urologist Practice for a 3 month follow up. A new medical assistant attended to me. I asked about her past and she said she spent 14 years in primary care. I asked why she chose urology and she said it was a new challenge and something different. After a blood pressure check, which was surprisingly low for me, she had me lay back for the bladder scan. Without saying a word, she started unbuckling my belt intending to get my pants down for the bladder scan. I stopped her by pushing her hands away and saying that I would do it. I asked at that point if she was aware of my abuse history. She said she was not. I started to explain and she said there was no need as she understood. When finished she took me to another room to await the doctor.

After a frontal exam and DRE, we began discussing wuth my doctor my cancer treatment and Resume procedure. My PSA continues to fall and while that is good, we still have to keep vigilant. For the Resume procedure, I asked if the male nurse practitioner would be attending me. He said that the gentleman they had hired had decided to take employment elsewhere, so he had no male nurse for my procedure, but he was attempting to hire another male nurse practitioner.

During the discussion he asked why I objected to female exposure. I was taken aback as I thought we had that well established. I asked him why the new medical assistant was unaware of my abuse history. He said that it's not something that's flagged on my EMR. I told him it should be and he asked why. I told him of the encounter with the medical assistant and explained that maybe she would have been more careful if she had known. I explained to the doctor that I have had at least 5 bladder scans at this clinic by 3 different nurses and none attempted to open my pants but allowed me to do it. He asked if I thought she was unprofessional and I responded that at the very least it was a boundary violation. He agreed but then added that after 37 years in his urology practice that I was the only male that objected to female involvement in my care. Much discussion followed which is too much to go into here. I did ask him why he was intent on hiring a male nurse practitioner. He said that men are much more comfortable in discussing ED issues with another man than with a woman. So I advised him that he did understand the issue of too many females involved in male care. He agreed and looked embarrassed that I basically caught him on it.

So now I have to keep checking back to see if a male nurse practitioner gets hired so I can proceed with the Resume procedure. My doctor did not offer to call me.

58flyer

 
At Tuesday, November 12, 2019 8:43:00 AM, Blogger JR Issues4Thought.com said...

I read several interesting articles on Med page lately. One dealt with patients being bias towards medical providers and the medical providers King that is wrong. The article I read yesterday was about nursing students who have bias against certain types of patients such as transgender patients. It was noted in the article that if a nurse has highest about providing care for certain types of patients it is noted in their file so that they don't have to deal with that type of patient. The nursing students who objected to dealing with Transit gender patients objected to their Anatomy that they would not do any type of intimate exam. So my question is why is it acceptable that medical providers can have bias that patients cannot? Should I not be allowed to pick what type of medical provider I want? It is clear that bias does exist in medical providers. If medical providers are allowed not to provide treatment based on their religious background then does it not also make sense that I as a patient should be able to choose what medical provider I want based on religious background? For male medical providers that believe that women are inferior to men I would not want that man attending to me. Having read both post from CS and 58 flyer, I see that both of them were accused of discrimination against medical providers. That is their argument if you refuse care. However to them they are able to refuse care based on their personal or religious beliefs and that is okay. Such a double standard! Also it is clear that when you want something noted in your medical record, they decide if they want to put it in the file. This is help types of abuse happens. It is what happened to my husband. Medical providers need to understand that they are our temporary employee they are not in charge of us. I would imagine that in the private medical file that is not released upon patient request, or probably is now a notation in 58 Flyers medical records that he is a difficult patient.

 
At Tuesday, November 12, 2019 10:10:00 AM, Blogger A. Banterings said...

JR,

When dealing with medical providers one must realize that you are not dealing with a human being. You are dealing with a sociopath, sexual predator, Dr. Frankenstein, Dr. Mengele, assembly line robot, teeny bopper, etc.

Their tools of control are drugs, gas lighting, "professionalism," bullying, threats of death/promises of eternal life, withholding treatment, dismissal as a patient, pain, etc.

You must assume guilty until proven innocent.

This is the atmosphere that medicine has created. Providers fail to realize that unless they are part of the solution, they are part of the problem. Too many are silent and say that it does not involve them or what can they do. They are part of the problem and will pay the price just as if they were perpetrators.

How people who claim to be so intelligent can act so STUPID (not knowing common sense human dignity) is beyond most (although I understand through my research).




-- Banterings




 

Post a Comment

<< Home