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

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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.




Maybe what is needed to improve the medical system as it interacts with patients is simple empathy.    Graphic: From Google Images.


AS OF DECEMBER 10 2019, THERE WILL BE NO FURTHER COMMENTS PUBLISHED
ON THIS VOLUME. COMMENTS CAN CONTINUE ON VOLUME 107

180 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




 
At Tuesday, November 12, 2019 5:53:00 PM, Anonymous JR Issues4Thought.com said...

JF,
I have to disagree that it would have been better to have been put "under" first. It doesn't make it less a rape if you were unconscious during the rape. It just means you have no recollection of the crime but you know it happened. However, if that is the way to deal with the trauma/assault that you know will happen during the medical procedure then I understand bc we all deal differently. But you know from being here on the blog what happens so I would think being drugged would only make it worse for you bc you know the hard, cold facts of how they treat you but you would never know all the details which might always eat at you. As you know from my many postings, I am against the casual use of the drugs they use to make patient compliant & to have amnesia. It is a game of control & power which allows the abuse/assault to happen unimpeded. Not only that but some doctors are even saying the use of fentanyl doesn't actually make the pain disappear but merely traps a person from reacting to the pain which they really do experience bc it paralyzes them which then in turn makes them more apt to be reliant on painkillers after the fact. From what my husband said, he felt the pressure & such during the cath lab procedure but was unable to voice his experience or even move. He remembers the pain from the suturing too saying it was unbearable but again he was trapped. It is interesting that in Europe they use the patient's music during this type of procedure w/o the use of versed or fentanyl and have excellent results. American medicine does everything they can to keep their "secrets" hidden & to try to make Americans think they need their drugs as that adds money in the medical industry's coffers.

Banterings,

Sadly, I must agree with your description of medical providers. I have nothing but mistrust of them bc they have proven over & over again they don't say what they mean or mean what they say. They simply believe they are above the law which the law seems to support. There are no checks & balance system in place for medical providers. From having to fight for your dignity in a doctor's office to being made an irrelevant object during hospitalization, I know if most people would think about their medical office encounters or were able to remember their hospital encounters like CS & my husband, this board would blow up w/ horror stories. However, the medical industry literally has a death grip on choking down & out any bad publicity. Since this board only has a few regular posters, they don't take it seriously or they would destroy its life too like they have done to many of us on this board. Their motto has been misinterpreted--It really is Physician/nurse do all the harm you can while you have the patient under your control.

 
At Wednesday, November 13, 2019 5:15:00 AM, Blogger Unknown said...

JR, You're right of course. Just because I personally am not upset about the nudity while under, plenty of patients are.
Even if it's only one patient out of ten who is upset by it, that doesn't mean that person's feelings should be disregarded. A disposable pull-up would prevent a possible accident and some kind of bra. Treat ALL patients as though they are modest and more will seek help in a timely manner. It would even prevent some from dying.
Also, just because I wasn't concerned at the time doesn't mean I would be OK with any kind of behavior. If I learned that derogatory things were said, I would be crushed. I feel like saying derogatory things about people is abusive even if the person never learns of it because it influences how people think towards that person.
Also, if I learned that people saw me because of doors being opened up at wrong moments it would harm me. Or if a high school kid was watching the surgery.
My gallbladder surgery was supposed to be quick and easy, but they ended up doing a major surgery.

 
At Wednesday, November 13, 2019 5:46:00 AM, Blogger Biker said...

I'm going to disagree with banterings description of medical providers. Certainly there are sexual predators in their ranks, probably more men than women in that grouping. There are as well voyeurs quietly getting their thrills, probably more women than men. Then there are some women who are on a feminist power trip needlessly exposing or otherwise mistreating male patients because they get some kind of satisfaction from it.

However my guess is that the majority of healthcare staff, male and female, are simply either clueless in understanding the patient perspective, or worse they do understand and just don't care. Desensitized is a word that comes to mind. They don't understand that their being comfortable doesn't mean that the patient is comfortable too or that their convenience isn't of higher priority to the patient than is the patient's comfort.

This is why I again come back to medical, nursing, & tech training should include some degree of experience as a patient including opposite gender intimate exposure. That is the only way they can truly understand how patients feel. It is purely academic if they only hear it in a lecture during their training.

 
At Wednesday, November 13, 2019 9:49:00 AM, Anonymous JF said...

JR, You're right of course. Just because I wasn't personally concerned about modesty at that moment, doesn't mean a lot of patients wouldn't be. And protectng patient dignity wouldn't take 45 minutes. It would take however long it would take to get a disposable pull-up on and some type of small bra. The patients could put those things on before procedures ever got started. And it should be assumed all patients are modest.
If only 10 percent of patients are upset, should that mean only 10 percent should be allowed to suffer over a long period of time or possibly die?

 
At Wednesday, November 13, 2019 3:05:00 PM, Blogger A. Banterings said...

Biler,

We have to assume that is what we are dealing with until the provider (repeatedly) proves otherwise. This is what healthcare has REPEATEDLY demonstrated its character to be. The fact that intimate exams STILL OCCUR on anesthetized patients without consent is proof enough that is what the character of healthcare providers are.

Desensitized and burned out is NO EXCUSE EITHER.

Providers who turn a blind eye are just as guilty as the perpetrators.




-- Banterings




 
At Wednesday, November 13, 2019 4:44:00 PM, Anonymous JR Issues4Thought.com said...

JF,

What I am saying goes well beyond modesty. It is about treating every patient as a valued human being who unquestionably commands dignity & respect. Whether you are modest or not, you should not be subjected to being unnecessarily exposed. And when you have to be briefly exposed for the needed area to be prepped, it should be done w/ care and absolute professionalism and like Banterings has said "every patient should receive trauma informed care." For those who are in it for unpure motives, there needs to be working avenues for the patient to be able to bring the offender(s) to be held accountable. There currently are not. It is clear that personal convictions of medical workers are honored so the argument they don't have personal or sexual feelings towards patients simply doesn't hold water. As you yourself said, you may have worries they may comment about your body which is totally something that should be taboo. Also, drugs like versed may make you forgot but it is true that if you hear something like that being said about you while you are under the effects of versed, there will be a nagging thought in back of your mind of what they said. You may just be unable to pinpoint why you have that thought.
Again, there is no reason in many procedures that all of your body be exposed. And yes, there are garments made for different types of surgeries to protect patients from being unnecessarily exposed but for whatever reasons, hospitals don't feel patients are deserving to be respected especially when they are at their most vulnerable time. But mostly, JF, be careful bc it is often the drugs that allow them to mistreat you as a person. It gives them the cover of darkness on your part to do harm to your personal dignity & to demonstrate how they devalue you as a human being. It is their need & their ability to instill within potential patients they need the drugs for the procedure. The drugging of patients is what allow them to take the shortcuts that harm the patient's dignity & command of respect due to them. For male patients, it is even worse as they are subjected to the disrespect & lack of being allowed dignity during office visits. The things that male patients must put up to get healthcare is simply sickening in itself.
Biker,
Before my husband's medical & sexual assault, neither of us gave much thought as far as he having to expose certain parts of his body for treatment. As you know, prostate cancer treatments are very exposing. It was the manner in which this last episode was done and why. Neither of us ever expected what happened to happen so I understand what Banterings is saying. While I agree w/ you there may be more good medical people than bad, we seemed to have found the bad all in one night. He had been connected w/ that hospital prior to his prostate cancer so we weren't on the lookout for criminal like activities during his heart attack. We were caught totally unaware so it is in our best interest to assume all medical people are perverts/criminals until proven otherwise. Yes, it is sad but that is what they have done. We have to be defensive and also on the offensive. It is also true that too many medical procedures do not take into account they are dealing with a human being that has feelings, hopes, dreams, dignity, and a life outside of their control.

 
At Thursday, November 14, 2019 2:30:00 PM, Anonymous JF said...

JR, It's a predictable outcome when a very small ratio of the population makes the laws. The masses of us could and do get arrested for protesting PEACEFULLY.
Large numbers of letters, phone calls and emails can be ignored and are. No tracking system. No proof of them having ever existed.

 
At Thursday, November 14, 2019 3:50:00 PM, Blogger A. Banterings said...

JR,

To the profession of medicine, patients are nothing more than WARM CADAVERS.

You are either a provider that possesses human dignity OR you are a cadaver (warm or cold).

This is similar to law enforcement officers' view that people are either "cops or criminals." This is why law enforcement has such a high divorce and (to some extent) suicide rate. If they view people as cops or criminals, they view their spouse and children as criminals and treat them as such.

You will also hear law enforcement people say they can only marry other law enforcement personnel because they "understand." What they mean is that "my spouse is a cop so I treat them with respect."





-- Banterings





 
At Thursday, November 14, 2019 9:38:00 PM, Blogger Maurice Bernstein, M.D. said...

Note: I just added another graphic to the beginning of this Volume in which an expression or literal demonstration of empathy should bring the profession and the patient together. Go take a look..if you haven't already. ..Maurice.

 
At Thursday, November 14, 2019 11:30:00 PM, Blogger 58flyer said...

Banterings,

WOW! I am really surprised at your comments about cops! I recently retired after 41 years in law enforcement. I never viewed anyone as either a cop or a criminal, and have never met any fellow officer who did.

It is true that some cops believe in the sheep/dog idea. One is either a sheep, or a sheep dog. One is the protector, and the other is a protectee.

Granted, police divorce rates are high. I am personally married to my one and only, 30 years come next March. She is not a cop.

I have known 3 police officers who have committed suicide. 2 were rather unhinged to start with, one was a Vietnam vet, not that that is any issue. But there was something weird about him, and the other guy was so seriously high strung it was amazing he didn't do it any sooner. The 3rd guy was on my squad from my rookie days. He developed brain cancer and decided to go out on his terms. We were both involved in a highly publicized shooting involving a barricaded suspect. We were both shot. He would often brag that he took bullets for me. Then I reminded him that he was standing BEHIND me!

I can assure you that I do not view my wife and son as criminals. They are both treated as blessings from God!

58flyer

 
At Saturday, November 16, 2019 3:32:00 PM, Anonymous JR Issues4Thought.com said...

Unfortunately, I understand what Banterings is saying. It is better to view all as potential bad guys rather than suffering through what we went through by thinking they wouldn't do harm. It is better to prepared than not like we were especially in an "emergency" situation where the last thing on our minds were that they would actually be more inclined to do harm than good. While I also agree that most cops are not bad people the ones who act superior in their power like not having to follow basic laws or respect of others ruin the image for all. It is the same with any profession like clergy, teaching, etc. even your local mechanic can take advantage of you. I know it is a very cynical attitude but it is self-protection. We didn't have that attitude before & look what happened.
I think the medical field has done this for eternity but now w/ technology people like us have the ability to communicate to others w/ our stories. My husband is still closed mouth around here about being both medically & sexually assaulted. He is more likely to talk about being medically molested than sexually bc it still is hard for him to want to share his "shame" w/ others. I think a lot of men are like that too. Most people will not talk about what we discuss here bc they are taboo. They are afraid of being made fun of or others not understanding. It is very difficult to even get this type of treatment into a public forum as the medical community has such a death grip on the lid to silence those who disagree.
NTT,
What type of website are you looking to make? I think every patient needs to be aware that exposure can go beyond modesty issues as when they are exposed unnecessarily. At that point, it is no longer a modesty issue but an issue of sexual assault or at the very least sexually inappropriate behavior. What about writing to the AARP as senior citizens are more likely to become targets bc I have been told that older people should get use to losing control over their bodies? They have a fairly big lobbying effort.

 
At Sunday, November 17, 2019 2:23:00 PM, Blogger Biker said...

Every profession has bad people amongst their ranks. The fact that there are bad cops does not mean all cops are bad. Most are good people doing the best they can in an increasingly difficult environment.

Similarly the fact that there are bad people who work in healthcare does not mean everyone who works in healthcare is bad. It is not the individual nurse or tech or CNA etc who made the choice not to hire some males. Blame the HR dept and folks in the corporate suite for that. I only blame that staff member if their behavior is unprofessional in terms of the things we discuss here. Otherwise they are just doing the job they were hired to do.

The fundamental problem is that society as a whole does not think males are entitled to basic bodily privacy in healthcare, corrections, sports and educational settings. The old wives tales that men have no modesty and it doesn't matter for men remain deeply entrenched across society. This is why most men won't speak up. They know they will likely face ridicule in most settings, including from other men.

Healthcare would not be getting away with what it does if society didn't condone it.

 
At Sunday, November 17, 2019 3:21:00 PM, Anonymous JR Issues4Thought.com said...

While it is true that is not the fault of the worker that males aren't hired, it is the fault of that worker if she improperly or unnecessarily exposes a male patient. Even if you have same gender care, you should not be exposed improperly or unnecessarily. Most people as patients would feel better about their healthcare experience if their personal dignity was respected. Although personally, I don't like male drs. for intimate care, I can tolerate them if they are respectful of my personal dignity and that would be fully conscious & certainly if I am drugged & unable to defend myself. They should not think just bc a patient is "under" they have the right to disrespect a patient's dignity. In that case, they have a more serious obligation to protect the patient as the patient is unable to protect themselves while in their "care." I think this is part of their oath.

It does seem that society protects the right of medical providers to actually be abusive & mistreat patient. It is also for sure that no one care when a male is abused by the medical system. Some just don't want to admit they too are helpless when it comes to medical care. Some don't understand that like some women, some men want same gender care. Some also do not understand the very definite line between good touch/bad touch or in other words--necessary exposure and unnecessary exposure which is sexual assault. I think most of us understand that intimate exposure can be part of a medical procedure but it is how it is done, by whom it done, why it is done, for how long it is done, and probably where it is done. There is not even a fine line between needing & having consent for genital exposure and sexual assault. It is a very definite line but most seem to be afraid to speak up or have anything done about it.
Women feel secure they are now in control bc on the surface the medical community seems to be catering to them. But that is only on the surface. Just read the stories on Patient Modesty. Banterings is right--still doing PEs on drugged women shows that the medical community is still fully in the superiority mode they have always been in. They think we as mere humans should be honored for whatever they do to us bc they afterall, are godlike in their endeavors. Without them, we would die. Oh, I forgot, we still do die only without dignity & a big medical bill to boot. There really is no effective way to combat the stranglehold these creatures have on our rights as humans entitled to dignity.

 
At Sunday, November 17, 2019 5:22:00 PM, Anonymous JF said...

You get treated the way you teach people to treat you. Unfortunately you is plural. Men in general have okayed it. ( patients have okayed it ) Not coming back for needed care doesn't register to them because we outnumber them vastly.

 
At Sunday, November 17, 2019 6:14:00 PM, Blogger Maurice Bernstein, M.D. said...


But, JF, I have always looked at each patient as a single, unique story. It could be explained on the facts that I never found myself or ordered by others to amalgamate patients into some kind of "pool". I can understand that could happen if the duration of immediate attention is time limited.

I think the way to change the system is to provide more providers to attend to the more patients within the "pool".

Anyone here wants to chant "Join the Medical Profession" to those highschool and college students who are looking for a relatively well-paying and needed profession? Anyone here has had the experience of such a student talking to you about their upcoming life's work?

If you discourage such students, wouldn't that defeat the goal of better medical practice in the medical system? ..Maurice.

 
At Monday, November 18, 2019 6:43:00 AM, Anonymous JR Issues4Thought.com said...

Dr. B.,

Yes, some students should be discouraged. Coming from an educational background, there were many young girls who said they wanted to be nurses. I was in a unique situation as I had small student sizes as I specialized in intervention/remediation of both high/low performing students in elementary. One of my writing exercises would be to have each student write what they wanted to be when they grew up. This was when they were in 3rd to 5th grade and I was amazed that many girls wanted to be a nurse. The overwhelming response was money. I knew from working with some they couldn't/shouldn't be a nurse bc of a lack of skills (math mostly) and/or bc a lack of empathy. Once I moved to high school, I would come across many of the same kids. Luckily by that time, most of them had changed their minds. It is strange though that most of the cheerleader types wanted to be nurses and their reasoning was money & they got to tell people what to do. How is that for what is wrong with nursing? Not so pure motives so it is no wonder there are problems in patient dignity & autonomy. There were a very small group that wanted to be a nurse to help people but oftentimes those students had a lack of skills needed for college. It was the same for the doctor/pharm group that the really driven students were in but those students seem to also lack empathy and compassion. Many of those should not have become doctors bc they didn't appreciate human emotions. They often would ridicule others they thought beneath them. What fine drs. they would make! Being in primary education gave me an insight into the makeup of the students which those in higher education are usually lacking. Hardwork & being able to pay for the education through grants/loans, etc. should not be the only benchmark to make a doctor/nurse. As for the medical providers that come from other countries, we have no idea what their core values are. Many of those do not like Americans but come here bc the money is better. Maybe it is not politically correct to say but I do feel from what we have experienced it does make a difference. It is clear that a medical provider's personal feelings do come into play when treating patients as evidenced by those who refuse to perform abortions bc of religious beliefs (not saying abortion is right or wrong). If religion teaches its followers that anyone not belonging to their group are heathens or unworthy then does it not make sense that could create issues in medical treatment? I think so bc that medical provider is already conditioned to feel superior to that patient bc of religious beliefs. There absolutely needs to be a separation of church and medical care. I feel very strongly about this especially after having a clergy forced upon me who clearly made it known that he did not respect my or my husband's individual choices or decisions in a medical setting. I believe everyone is entitled to have or not have their religious beliefs but those beliefs should not interfere or harm others. I think those beliefs in a medical setting does do harm. Take for instance, a pregnant women has an emergency birth at a Catholic hospital. It had been decided beforehand due to medical reasons that she would have her tubes tied during the C-section. The catholic hospital would refuse so she must go through another procedure in order to make safeguard her health bc of their stupid refusal to honor her medical needs. All hospitals should offer the same level of service w/o interference of religious beliefs. Patients shouldn't be put in jeopardy.

 
At Monday, November 18, 2019 11:10:00 AM, Blogger A. Banterings said...

58flyer,

You do not see this behavior as much with rural LEOs. My experience that I am drawing from is primarily Philadelphia and Baltimore. It is also a simplification of the many faceted mental pathology that LEOs deal with.


Biker,

We all know that everyone who works in healthcare is not bad, but we must NOT blindly trust them. We must treat ALL of them as if we are dealing with the bad ones lest we become victimized (again). Furthermore, lack of action (apathy) does not absolve them from the sins of the profession.


Maurice,

Physicians (as students) need to taught to explain to patients what the options, then the patient chooses. NEXT, the provider needs to explain HOW and by WHO the agreed upon procedure will occur. FINALLY, the patient will modify the procedure to what the patient deems acceptable and the provider MUST respect the patient's decisions.





-- Banterings




 
At Monday, November 18, 2019 2:36:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, in support of what you wrote
"the patient will modify the procedure to what the patient deems acceptable and the provider MUST respect patient's decisions."--an anonymous writer today wrote the following on a different blog thread topic which I am reproducing below.

Medical blacklisting is outright punitive punishment. A class action lawsuit is warranted in all cases. No doctor has the right to prevent a patient from finding
a better doctor or alternative treatment. It's one thing to dismiss a patient, but quite another to permanently blacklist them for life. That's putting the patient in physical and possible emotional danger. I'm a private detective building a case against one such doctor.


p.s.-Speaking of "blacklisting", is such patient or professional attacks on the other, ethical or even legal in either direction? ..Maurice.

 
At Monday, November 18, 2019 3:16:00 PM, Anonymous JF said...

Dr B, That reminded me of Gift Bearer from all those volumes ago. Are you aware of if she was ever able to undo what that one horrible doctor did to Stonewall her getting a diagnosis?

 
At Monday, November 18, 2019 3:24:00 PM, Anonymous JF said...

Hopefully Dr B, You haven't been the kind of doctor who has female staff coming and going from the room while with a naked male patient. Also I would hope that your not examining adolescent patients in front of parents and siblings without getting that patients okay with it first. If you have, you have very possibly done long-term damage.

 
At Monday, November 18, 2019 4:05:00 PM, Blogger Maurice Bernstein, M.D. said...

JF, never. In addition we teach medical students that thee is no need for a naked male or female to be examined--by naked, I mean totally uncovered. All patients including such as those in accidents or having a dermatological screening should be sequentially uncovered. We also recognize not only that nudity is unwarranted but also nudity may lead to chilling and provide erroneous physical exam findings.

Adolescents should be treated as their mature parents with regard to observers present in the exam room. They set the scene. This is also a teaching point. ..Maurice.

 
At Monday, November 18, 2019 6:28:00 PM, Blogger Biker said...

Dr. Bernstein, educating students needs to go further than simply sequential uncovering. There needs to be an emphasis on minimizing exposure, in extent and duration, and in terms of who else is there. If scribes or MA's or nurses are required, efforts to protect the patient's privacy should be deployed in whatever form is appropriate. Dermatology scribes for example do not need to observe the patient's genitals in order to take notes, nor does an MA or nurse who is present but is not actively assisting in that examination or procedure.

Another aspect of physician training is that they need to think of themselves as being responsible for how their staff are maintaining patient privacy when they are acting independent of the physician. There is probably more intimate care provided w/o physician presence than there is with it, and it seems most of the complaints voiced here are to do with the non-physician staff.

 
At Monday, November 18, 2019 7:33:00 PM, Anonymous JF said...

I'm not talking about totally uncovered. If a person's bottom and/or genitals are visible, or a female's breasts, that's what I'm talking about. Chilling is a separate issue.

 
At Tuesday, November 19, 2019 9:10:00 AM, Blogger A. Banterings said...

Biker,

In ANY instance "self reporting" is an acceptable alternative to a physical exam. The profession of medicine has established this method. How many times has a physician asked a patient, "Does this hurt," "Show me where it hurts," or "Does this feel better?"

One of the excuses used to FORCE an exam is that the "form requires it." This is most evident with adolescents and the school physical form having a line item of "genitalia." The provider can simply write WNL (within normal limits) and ALTHOUGH NOT NECESSARY, footnote "self reported."

Furthermore, EVERY situation allows for a part of the physical exam to be omitted if refused or not tolerated by the patient. This provision is enforceable under the ADA (Americans with Disabilities Act) and by common sense. How can a provider check the legs of a double amputee?

Even Medicaid, CHIP (children's medicaid coverage) and all insurance carriers have provisions for reimbursing providers as if they completed a complete exam when they are unable to, or the patient refuses that part and the provider attempted to.

There was a case that I am familiar with where the patient refused a per rectal exam in the ED. The resident tried to explain that imaging would not do an MRI until the PR was done. The attending stated on the referral to Radiology "unable to palpate the prostate." He did not put the reason was he could not palpate the prostate was patient refusal, but the statement was TRUE.

This is also the case for patients to self collect specimens, even swabs.




-- Banterings






 
At Tuesday, November 19, 2019 10:02:00 AM, Blogger NTT said...

Good Afternoon:

One way patient exposure can be kept to a minimum which in turn will help ease patients minds is for all American hospitals, outpatient facilities & clinics to have on hand at all times a supply of medical garments given to the patient when they visit.

There are many sources out there now so there is NO GOOD REASON for facilities not to have them on hand for patients.

That's one way, you will bring more people in for testing and the like.

JR, the info I want on a website is information about what men & women might possibly be exposed to when going for medical care. I'm tired of seeing people ambushed all the time.

It's time people knew the what, where, & who's involved.

Regards,
NTT

 
At Tuesday, November 19, 2019 1:03:00 PM, Anonymous JR Issues4Thought.com said...

NTT,

Do you have content? Do you have a domain name and searched to see if it's taken? Do you have in mind what you want the website to look like? Will it have a blog like this one? My husband set up my website Issues4Thought and hosts it. I can see if he has room for the one you are working on too if you want me to.

As far as teaching goes, again there are so many doctors who have been educated in foreign countries that have vastly different ideological beliefs than what the US does. Some countries teach that women have no say & must be kept shielded from male view or in other words no one but their husband can see them naked & they are accommodated. But when those same drs. treat women here do they also respect our women's modesty or do they have the thought that our women do not matter. There are also women in this country due to MeToo that seem to believe all men are bad & should be punished. Although you may be teaching how not to leave a patient entirely naked, it is being done probably more often than any of us are aware of. Hospitals and medical providers should be setting the rules governing how treatment is delivered to a patient by ensuring it is delivered in a dignified and respectful for the patient. For those who have been forever injured by being in essence sexually molested, it is as Banterings says a side effect not divulged in all the medical literature. Most Patient Bill of Rights are worthless pieces of papers that allows them to advertise how caring & compassionate they are when behind the closed doors of actual treatment rooms, it is an entirely different story. What happened to CS, Kruschner(?), and my husband goes way beyond modesty infractions. These were vile instances of sexual molestation. CS was crying for help! Mr. Kruschner was part of a frat girl prank where they used his naked body as their prop. My husband was drugged & left naked for their entertainment. We really have no idea how often crimes like those mentioned here happens. And they are crimes but the medical community has convinced most of the world they are gods that deserve no reprimands or rules of providing compassionate care. Also, as Banterings says, even though there may only be a few that actually commit the crime, there are a host of others that are just as guilty by not doing anything to make what they witnessed stop.

 
At Saturday, November 23, 2019 8:50:00 AM, Anonymous JF said...

JR, I think you are under estimating the power of cowardice and the very real dangers of going against the flow.
If more people who don't actually need jobs would work for healthcare, then co-workers could speak up and rat out the workers who need ratted out. Trouble is most workers actually need their jobs.

 
At Saturday, November 23, 2019 5:31:00 PM, Anonymous JR Issues4Thought.com said...

JF,

I don't completely disagree w/ what you are saying but just being a coward doesn't excuse them from participating in criminal enterprise which is what sexual or medical assault is. In my school system, they had a hotline anyone could call w/o leaving their name to report wrongdoing. I don't really care if they need their jobs when they are willing to participate to participate in committing criminal activities. The medical profession doesn't need people like that who are willing to compromise the overall safety of a completely defenseless patient bc they put themselves above their duty to protect those they are sworn to protect. It wouldn't really help to have people fill those jobs who really don't need them bc I think that might care less. What we need are people with morals and ethics not just people wanting to make money or to keep their job no matter what. That is the type of atmosphere that creates this cesspool of demeaning, unsafe care. I agree it takes courage and backbone to speak up but when your clients are defenseless patients or kids that is the type of employee needed to fill those kinds of positions. It is no different even in fast food when one employee knows another employee or even employer is endangering public safety, they too must speak up. I don't feel sorry for anyone who purposely allows an innocent person to suffer bc they are a coward. I am sure if it was a RN's loved one she would view what has been to some of us the same as we view it--criminal and inhumane. JR

 
At Saturday, November 23, 2019 7:30:00 PM, Anonymous JF said...

JR, What you are saying is true but self preservation runs strong. What I'm saying is true also. We can realize a lot about what people should and shouldn't do, but it doesn't put us any closer to a solution. I have several ideas about what management should do, but if they are in denial,what can be done?
A simple hidden tape recorder in the break room and wherever staff clusters to chat would reveal a lot. Also certain questions, if you refuse to answer, instead of saying no, means the same as saying yes. Not everybody has that figured out though.
One other idea I have is for the patients to contact through Facebook and tell their guys. Some won't care or believe. Others will beat em to a pulp.

 
At Sunday, November 24, 2019 5:59:00 PM, Blogger Biker said...

I'll jump into the conversation JF & JR are having and use the example of Mr.Kirschner at Olympia Urology. I'm pretty sure the average person on the street would agree what happened to Mr. Kirschner was totally unacceptable, yet only one person who worked there saw it as wrong and alerted the Kirschners. The incident received significant media coverage embarrassing the organization and despite that all the Kirschners got out of the powers-that-be in the parent organization was a non-apology apology. Nobody got fired and my guess is nobody got more than a "don't get caught doing that again". Why would anybody that works in that organization report inappropriate behavior when its management by their actions or lack thereof has signaled they don't really see behavior like that to be a problem? The whistle blower is the one at risk of getting punished in organizations like that.

It is easy to call people cowards but nobody is going to step forward to right a wrong if they know nothing will be done and it might mean they'll be the one punished for reporting it. It comes down to hospitals and medical practices either believe all patients are entitled to dignified care and inherent privacy or they don't. Sadly many don't, and the employees that work in those places know it. The women at Olympia Urology likely had entertained themselves at their male patient's expense in the past and kept doing it because they knew they it was tacitly approved by mgt. If the culture of that organization was such that behavior of that nature would not be tolerated the staff would know it and it would never have happened.

I didn't work in healthcare but everyone that worked where I did for 40 years knew inappropriate or unethical behavior would get you fired real fast no matter how good you were at your job. The core values of that company were known by all, and they were enforced. Any healthcare organization could do the same if they chose.

 
At Monday, November 25, 2019 12:48:00 AM, Anonymous JF said...

Biker, Many people on this blog have the idea that a lawsuit is what is going to change things. I feel very sure that that is not the case. People in power band together. That's how they keep their power. To them it's amusing whatever embarrassment patients have to endure. Embarrassed people have a tendency to sneak away with their tails between their legs. Nobody law abiding is going to change things. Whatever criminal retaliation occurres will have to be done in a sneaky way. So as to gain the upper hand. Nobody gets to attack playful staff for ripping covering off a patient. I have a lot of ideas but won't share those ideas. I don't want to be accused of planting seeds in people's minds.

 
At Monday, November 25, 2019 7:47:00 AM, Anonymous JR Issues4Thought.com said...

Biker is right. Most who have a hand in the abuse/assault of patients especially male patients are aware that where they work a actually cultivates this type of behavior. Some companies have had to learn this the hard way through scandal while some are just naturally more ethical and moral. And there are others like in the medical community who still turn a blind eye. In my opinion, women are less likely to suffer through the office visit type of harassment but are subject to issues when going in for procedures when they are drugged & defenseless. Male patients on the other hand are subjected to abuse/assault during any aspect of medical care and it seems to be acceptable. There is very little way of getting public support as most new media outlets are funded by medically connected entities. We are constantly reminded how overworked and stressed the medical community members are even by a major craft store which I may now boycott as the poor, single parent nurse thing is ridiculous. The attitude of the medical provider owning your body when in their presence is truly one that needs to end. They are heroes performing feats of heroism but average people just doing the job they chose to do. It is time they appreciated us, the patient, for letting them perform their job and getting paid. It should also be that way in other aspects of life. Not only should the person performing the service be appreciated but the person needing the service should be appreciated for choosing & letting them have the opportunity. That is a novel concept. I used to tell my kids in school that as they behave and perform in school will be key in what their future would hold--a career they have chosen or a job bc of prior bad decisions they have to have. Some understood, some didn't but some understood and chose the wrong path anyhow. I think there are fewer cowards in medical care than there are those who just turn a blind eye because it is acceptable behavior in that setting. That is probably one reason they go elsewhere for their own medical care--because they know & don't want it to happen to them. To you, they really don't care as long as it doesn't get major publicity that makes them look like the slug they are. Medical care knows that how they mentally treat patients affects their overall care so that is why they use so many drugs to erase memories. They want to have their fun but they NEED the patient not to be able to remember. The traumatic nature of the procedure may indeed be how the patient is actually treated abusively or assaulted by the staff rather than seeing a scary machine. I myself like knowing what is happening as I am an adult who handle "scary" things. While I know some might want the drugs that should be a choice and not a "you're going to have them rather you need it or not."
Yes I believe it is tough to do the right time but that doesn't mean it shouldn't be done. Medical "professionals" shouldn't be able to deny who they will treat--LGBTQ or deny medical care they personally do not agree with. We, as the ones who get abused/assaulted, must speak up and teach others to do the same. Our silence gives them more fuel to continue or even worsen their treatment of us, the patient. My daughter used to say don't make the waitress mad or she'll spit in our food. But how do we know that she already didn't spit in our food? Being afraid is not a good reason. Bullies and such count on silence and not fighting back.


















 
At Monday, November 25, 2019 6:04:00 PM, Blogger Biker said...

I had long ago gotten used to the steady stream of "woe is me" victimhood female medical students and doctors posting articles about how sexist their male colleagues and male patients are but this new one here really irritates me:

https://www.kevinmd.com/blog/2019/11/why-choose-a-woman-doctor.html

She's basically advocating patients reject all male practitioners and only see females. Her distain for the male species is pretty apparent. As women slowly (over the next generation or two) take over physician ranks and hospital administrations I can see the lot of male patients only getting worse.

 
At Monday, November 25, 2019 11:44:00 PM, Anonymous JF said...

Biker, Believe it or not a lot of women prefer male doctors. Even for those gyno exams. It's been said that female gyno's are hateful and won't prescribe pain meds like their male doctors do. I don't think it's going to get worse for male patients because we're going to win this battle. We grapple with it day and night. Somebody is going to figure out how to be listened to. Be careful about glum predictions because what we say is what we get.

 
At Tuesday, November 26, 2019 7:05:00 AM, Anonymous JR Issues4Thought.com said...

Biker,

I read this article and it basically confirms what we have been saying on this blog but it should be changed to include all female staff members. In the near future, most likely all hospital staff will be female and men will have no choice for care. It is the undertow of the #MeToo movement. I believe it is exacting revenge where it can and the medical community is an easy place to exact revenge for the many years that males have dominated the scene.
No matter what side of the political field you are on, if you have really watched some of the female candidates or even the televised impeachment hearings, the strong females are only strong when they are not being challenged. Once challenged, it is the woe is me attitude. When men enter for medical treatment, the man becomes defenseless--literally exposed. How they normally interact with a female patient is different than with a male patient. They give a female a gown to change into and leave the room while she changes. They don't with a male as it is drop the pants. There would not be a male doctor and a male chaperone present during a female pelvic exam but during a prostate exam there may be a female uro and a female chaperone.
When the woman in the article says they listen and talk more she is right. She probably listens and then gossips with the girls in the office about her male patient. That is typical female behavior. Males are more unlikely to engage in water cooler conversation than a female. As for spending time, Medicare dictates how much time they will pay for so it is unlikely for female drs to spend more time bc of time and pay constraints.
Obviously the gender care difference is only recognized for female patients and that is usually only when they are not drugged otherwise they too could be stripped naked and have males working on them. But it is an added bonus for males to be subjected to the female care when they are not drugged and to be made embarrassed or like a deer in the headlights scenario. The door probably barely closes before they start laughing about what they just done to that male patient and he was totally unable to do anything about it. It is said they need humor to relieve their stress so what harm is a little humor at a patient's expense? Does it cost extra?

 
At Tuesday, November 26, 2019 8:59:00 AM, Blogger A. Banterings said...

Biker,

I saw that too. This is beautiful. As the walls are coming down from the ivory tower providers once sat in, as their paternalistic power is eroded away, there is infighting over what small parcels of power and prestige remain.

This is like the Democrat debates: The other candidates paint Biden as corrupt, Bernie as a socialist/communist, Warren as a day dreamer, Bloomberg as another billionaire, etc.

All this does at the end of the day is validate what has been asserted on this thread and on this blog, the profession of medicine has demonstrated it's failure in meeting society's expectations of competency and respect of human dignity. I have pointed to the fact that PEs on anesthetized women without consent still occur.






-- Banterings





 
At Wednesday, November 27, 2019 2:20:00 PM, Anonymous JF said...

JR, Really? The male/female medical worker ratio is going to keep getting worse? It won't if you
(we ) are successful in what we're trying to accomplish on this blog.
I have never worked at a doctors office or hospital. Just Nursing Homes and Assisted Living Homes.
But from my experience, your evaluation of the female personality isn't fair. Some females are &$#@ holes and abuse other staff and patients.
But more often than not, we will have at least surface friendship with each other. No one certain worker that is slandered and bullied. And even with me being white, working with an almost completely black and Hispanic staff, most everybody gets along good. A small amount of clashing with first shift. But just a few workers

 
At Wednesday, November 27, 2019 4:17:00 PM, Anonymous JR Issues4Thought.com said...

JF,
I am confused on the "really" but I will amend my what I said to that it is a female trait but some choose not to participate in the backstabbing and gossiping. Some males are also guilty of this. But coming from a mostly all female workforce (elementary) I can tell you during lunch it was gossip time. If they knew someone who worked at the hospital or in a medical office, then their attention would turn to the gossip they knew about patients because the patient information was bantered about freely. Luckily, since I had specialized classes I was able to adjust my lunch time to miss the gossip crowd. But I will stand behind my theory that too many female workers in a medical setting gossip that is why sometimes male patients are used for entertainment. I had what I called a working relationship with most of them but I saw them tear their "friends" apart and others who were strangers to me. People like those are ones I am polite to in a working relationship way but more than that I avoid. I will also stand behind my assessment of some the better known women in politics wanting to be in the same as the boys but cry foul when the play gets too rough. You can't have it both ways either you receive the same treatment or you want to be treated differently. Also, there have been numerous studies done confirming that women as a whole tend to gossip more than males. And yes, I do believe that the medical field will become more female during the coming years because they have long resented the physician field being mostly male. Also, more and more administrators are female so male complaints will fall on deaf ears because really they don't care because they know they have how healthcare is delivered locked down.
And yes, my opinion of the female medical worker especially of the nursing variety is harsh because of what they did. We can't afford to not to have that attitude because we can't allow my husband, myself, my kids, etc. to be abused/assaulted so all are view with mistrust, contempt, evil-doing, etc. until proven otherwise. PS I think of male providers the same way especially doctors and paramedics. Have not had a bad experience with a male nurse but rather better experiences with male nurses.
JF, I hope what I said did not personally offend you as it was never my intention but rather the way I now see things. These things were learned the hard way. It was asked for but it is what it is nonetheless. The experiences we have suffered have made both my husband and I change and it cannot be undone. From what you have said, I gather you are a person who cares about those you are caring for in the nursing home. JR

 
At Wednesday, November 27, 2019 6:26:00 PM, Blogger Maurice Bernstein, M.D. said...

It's System $$$ intake vs the best in patient care:

15 Docs Fired From Illinois Health System to be Replaced with NPs"

..Maurice.

 
At Wednesday, November 27, 2019 6:35:00 PM, Blogger Maurice Bernstein, M.D. said...

And read the over 100 comments by professionals at the end of the article.
Yes, there is a need for the medical system to have some guidance by the views of the public (patients and patients-to-be). I think that is the view displayed by participants in our blog thread. ..Maurice.

 
At Wednesday, November 27, 2019 10:23:00 PM, Anonymous JF said...

JR, The really was about the female/male ratio thing. We have to believe we can make a difference somehow, or why are we hashing it out on this blog.
As far as women slandering other women, I agree we're probably worse than guys are generally speaking.
And I wasn't upset with you. I get upset about the accounts given on here but not usually at the people posting.

 
At Thursday, November 28, 2019 5:56:00 AM, Blogger Biker said...

Dr. Bernstein, I read the article and enough of the comments to get the flavor. That urgent care system did this because they can get away with it. It will not lower costs for patients but rather increase profits for the owners and salary for the CEO.

What that urgent care system did symbolizes that what is best for the patient is not the highest priority in the new world of corporate medicine. Coming back to what we discuss here, patient dignity or at least that of their male patients, is not going to be much of a priority for them either. What are the odds 100% of the NP's being hired to replace physicians there will be females given how lightly staffed most urgent care centers are and the unstated societal norm that deference must be given to female patients?

 
At Thursday, November 28, 2019 6:46:00 AM, Blogger Biker said...

JR & JF, on the gossip issue, in my experience the sometimes very personal nature of female gossip tends to be tempered when there are guys present. In a medical setting where the subject of gossip might be the patients, it is all the more reason for greater balancing of male-female staffing.

Here is just one example. A couple years ago there were 3 women working at the town hall one day,and me. The ladies got immersed in their conversation and forgot I was there. Somehow the conversation evolved to one of the other women sharing that her daughter's friend had started working in a medical setting where she had access to exposed male patients. That 20 something young woman then shared what she was seeing with her friend and her friend's mother who in turn shared with the other ladies at the town hall. I will note that no specific patients were named. When they realized they had forgotten I was there they were a tad embarrassed that I had heard them and that conversation was at an end.

In a 100% female medical setting, to the extent such discussions might occur, specific patients are going to be identified. That the men being talked about will never know they were discussed is irrelevant, especially in small settings where it is very difficult for anyone to be anonymous.

Note that I am not suggesting that all female dominated medical settings gossip in this manner. I highly doubt that all do, but it is problematic that some do and that it is tacitly condoned by the powers-that-be. If nobody got fired at Olympia Urology after what happened to Mr. Kirschner, for sure nobody gets in trouble there for gossiping about the male patients.

 
At Friday, November 29, 2019 5:57:00 AM, Blogger Biker said...

Here is an interesting article that speaks to better patient outcomes having been achieved by not catheterizing patients having afib ablation surgery. It would be nice to have other procedures tested in this manner.

https://www.medpagetoday.com/cardiology/arrhythmias/83599?xid=nl_mpt_DHE_2019-11-29&eun=g1032431d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%20Top%20Cat%20HeC%20%202019-11-29&utm_term=NL_Daily_DHE_dual-gmail-definition

 
At Friday, November 29, 2019 2:22:00 PM, Anonymous JR Issues4Thought.com said...

Biker,
I read that article several days ago & thought it was very interesting. There are many procedures that do not need cathed but are done so for staff convenience like heart catheterizations (my husband somehow escaped this being done). For staff, there is less mess and less having to wait on the patients if they are cathed so that is why it is done bc like in heart caths the dye can injure the kidneys so the must measure urine output so they would rather cath than have to give extra care. It seems to be standard treatment to put staff convenience above patient safety.

JF,
What I meant by saying I see more females in all aspects of medical care was not something I support but what I see happening. It is a perfect area for them to dominate males and an area that typically had more male doctors, administrators than female so it an area that the militant females want to take down. The added bonus for them is to exact revenge on male patients. It seems to be a pattern in this country. Having said this, when I was younger I was a liberal and a feminist. Not anymore for life has a way of making some grow up and I was one. I now appreciate the differences between men and women. My view of too many women now are they want to be equal only as long as it is not inconvenient or messy.

Also from MedPage this week was an article about the nurse suicide rate being high. Well here's to hoping all those nurses involved in abusing my husband are part of the stats. I don't know if nurses like those are the ones (probably not bc they have no soul or conscience) or it is the nurses who have compassionate, etc. that are increasing the suicide rate. The article made me smile bc it is clear there is no recourse to remedy abuse/assaults by nurses so this piece of info is just a small piece of comfort bc of what happened, I have absolutely no compassion for them unless they prove they are a good, compassionate human being. The burden of proof is solely on them.

I had also read earlier about the drs. at immediate cares being replace by NPs and thought 1. it good that even the demi-gods aren't exempt from being made obsolete but on the other hand 2. what we don't need are more female nurses to assault male patients. Furthermore, it was a NP who misdiagnosed my husband's heart condition a couple months before he had the heart attack so I wonder about how skilled they really are.

Stopped today at a truck stop and heard a bleached blonde younger woman talking to an older man about her job. Guess what--she's a nurse at the closest branch of the hospital from hell. She was talking about patients & using names of some she thought he might know. So much for HIPAA and her oath. She was talking about pranks and such and how annoying patients are or they are too needy (obviously the hospital from hell doesn't believe in patients first). She was also talking about how much money she made and how she volunteers for better paying time shifts like holidays. She than went on to say how much time off she has and how much she travels bc of how much money she makes. What I didn't hear her say was she was a nurse because she truly wanted to help people.

 
At Friday, November 29, 2019 2:41:00 PM, Anonymous JR Issues4Thought.com said...

Also, MedPage did another articles about violence towards medical staff. Again, I don't condone violence but I do understand why it happens. When they are dealing w/ someone who is high, they should know by their education that person is unpredictable. I am not medically trained and know that. They made my husband high but did not note in their records how much he was given nor did they note in their observations that he was indeed high as a kite but rather said he was normal. It was not normal for him to be high and unable to function. Any of them would have deserved to have been slugged by him for what they did. However, what MedPage has not covered is the abuse/assaults committed by medical staff upon patients. MedPage and others like them make it sound like there is no underlying reason but oftentimes there are. Sometimes it is pure stupidity on their part. Fentanyl and versed especially when combined can make patients very aggressive but they keep on giving it bc they want their patients to be submissive and with no memory so they are willing to take the chance. As far as someone who uses street drugs, they need to act more aware of what could happen. Even drunks can be violent. They know this. MedPage and all want to make us feel sorry for them but what about those of us who have been abused by them? Why don't they cover that too? Why because they don't want to admit there is a problem and they don't want the problem fixed bc it would cause them to loose power and control. So feeling sorry for them is not something I have until they can admit to the issues they have.

 
At Friday, November 29, 2019 9:53:00 PM, Blogger Maurice Bernstein, M.D. said...

I do look forward to views by visitors to this blog thread who have contrary views to what has been written here. Please feel free to write and defend your point of view. I will defend those visitors to express their opinions.

I make this statement based on my opinion that not every single patient has the general views expressed on this blog thread and I want those who meet my opinion not to feel rejected from posting.

As long as the discussions remain productive of expression of views pertinent to the topic and there is no ad hominmen statements, they will be published here. ..Maurice.

 
At Saturday, November 30, 2019 11:51:00 AM, Blogger Biker said...

I too would love to hear from those who work in healthcare about the issues we discuss here. Part of my ongoing interest in this forum is because I hope to someday understand the "why" to a couple key questions.

One such question is how those women who work in healthcare can say there is absolutely nothing sexual about healthcare and healthcare is gender neutral when it is safe to say the overwhelming majority of women who work in healthcare themselves would object to a male mammographer or a male CNA showering them, or a male nurse giving them a catheter, or male MA's & scribes observing their GYN exam and so forth. Why would they care if there is nothing sexual about it and healthcare is gender neutral?

The other key question is given female healthcare workers do care when they are the patient, why do some of them resort to mocking & bullying behavior when a male patient expresses a similar concern (you don't have anything I haven't seen, we have no modesty here, are you afraid of women etc).

I think these are fair questions.

 
At Saturday, November 30, 2019 10:36:00 PM, Anonymous JF said...

Ok Dr B, I'll bite. I think that plenty of medical staff actually don't get any sexual gratification out of veiwing exposed patients,
whether the patient is the same gender or opposite. That still doesn't mean there aren't problems though. Once when I was reading back over earlier volumes, when Marjorie Star used to post, she told of a 15 year old girl who had been in an accident. The nurse or doctor cut her clothes off while the cops and paramedics hung around to watch. The girl was franic because of humiliation.
It could possibly be that the nurse was working too many hours and just really wasn't realizing what she was doing. PT then chimed in and said he had witnessed the same thing on more than one occasion but that the victim/patient were oftener male patients.
Busy staff entering and exiting exam rooms trying to get as much done as possible, are walking time bombs also. Eventually they are going to provide a free show for whoever happens to be walking past the exam room. And any doctor who intimately examines a teenager in front of an opposite sex parent
(a same gender parent is bad to ) without that teenager's consent, is a piece of $#@t!

 
At Sunday, December 01, 2019 6:26:00 AM, Blogger NTT said...

Good Morning Everyone:

Biker, they'll never publicly answer your questions because then they'd have to change the way they deliver their services to patients.

On another front, the Brits are busy working on a way to better detect prostate cancer without putting the patient through a biopsy.

https://www.menshealthforum.org.uk/news/new-prostate-test-wee-bit-easier

Regards,
NTT

 
At Sunday, December 01, 2019 11:49:00 AM, Anonymous JR Issues4Thought.com said...

Although I agree w/ JF that not sexual gratification is not always the motive, I can think of a motive as to why more males may be exposed. That is bc of power and control. How many other settings do females get to totally dominate a male and make him totally helpless, defenseless, and more to the point comply w/ whatever they are directed to do?

The story about the 15yr old girl was before my time but I consider that to be sexual abuse and even more grave bc she was under the age of 18. Those police & paramedics had no reason to be in there when she was exposed. That is sexual gratification behavior and she is probably mentally scarred for life. (The helicopter stayed around to watch my husband being exposed so they were also perverts & to my husband it doesn't make it less traumatic they were male. They had no business seeing his private parts except they are sick & perverted S%Bs) They and the medical staff were complicit in sexually assaulting a minor. No one who should have comforted her did--they let her be eye raped by the male audience. There is no excuse for that as being too tired, overworked, etc. an excuse for exposing any adult. They are there for the patient's benefit--to serve and protect them when they are at their most vulnerable time. Medical staff is used to dealing with sick and injured so therefore they do know better and they do how they are supposed to protect every and any patient. I don't care whatever their reason is for negligence or maliciousness--PERIOD!!! Failing to safeguard a patient's dignity/modesty should result in consequences as a patient's mental well-being is every bit as important as their physical well-being. I do believe many female nurses enjoy the thrill or rush they get in dominating male patients. They don't seem to understand they have no right in abusing or assaulting any patient especially male patients. To make it even worse, society as a whole allows them to do this bc there is no avenue in place for a male patient to complain & actually get something done. There is nothing out there to help male patients that have been sexually assaulted or abused by female medical staff and they know it and take full advantage of society's gold stamp of approval for their behavior.

I have absolutely no compassion for those who have exposed patients, humiliated patients, assaulted patients, etc. There are no valid excuses or reasons why they should be able to do these types of things to any patient. ABSOLUTELY none! May what comes around go around.

 
At Sunday, December 01, 2019 1:11:00 PM, Anonymous JF said...

Biker, I think for many female patients it's the patient's husbands or boyfriend's who don't want their ladies exposed in front of male staff. I've heard too many friends and co-workers talk of getting thrills from this certain male doctor doing a gyno exam on them. Females don't generally say something like that unless it's true.

 
At Sunday, December 01, 2019 2:48:00 PM, Blogger BJTNT said...

JR,
Ditto. Amen.
With males, probably sexual perversion. With females, probably control, control, control.
BJTNT

 
At Sunday, December 01, 2019 2:49:00 PM, Blogger Maurice Bernstein, M.D. said...

I just arrived home from being hospitalized for 24 hours. I had an interesting problem. My Foley catheter which had been functioning well but was time for a change could not be removed from my body because the balloon holding it in place in my bladder could not be decompressed of its water and size for removal due to encrustation of its interior with crystalline material. This required an unexpected hospital admission to consider an approach to solution. Fortunately, besides frank surgery, an alternative was available with an intervention radiologist who performing simply on a local anesthetic drove a needle, under CAT scan monitoring through my abdomen into the bladder and opening and collapsing the balloon, thus allowing the Foley to be pulled out. I became his first such case with a non-malignancy biopsy intention.

My main reason for posting my experience was not what I wrote above but something administrative which my readers here will say "we told you".
Shortly after admission, I was asked by a staff member whether I wanted "VIP" service. (I never heard the same on my July admission or in prior admission for West Nile Virus.) I said "NO". And then today shortly before I was finally discharged, I was asked essentially the same question and I said "NO". So what this confirms is the view of some writing here that based on my degree and what else? VIP category is still in the books. I personally think that this is unfair to all patients and will write this opinion when I receive the routine follow up mail from the hospital regarding my view of my hospital experience. Unfortunately, VIP concept is not deceased but currently actively considered and presumably utilized.
..Maurice.

 
At Sunday, December 01, 2019 4:40:00 PM, Anonymous JR Issues4Thought.com said...

Dr. B.,
Glad to hear you are doing better. However, in reading your post, it leaves me w/ the question of what exactly does VIP treatment get you? Does it enable you to take part in choosing your treatment from options? Does it exempt you from being sexually abused or assaulted? Does it mean your family can visit you and you won't be isolated? What exactly do VIPs get that average male patients would not?

NTT,

There have been a few articles recently that have in essence said that PSAs are worthless and too many men are being forced into prostate treatment when a wait and see approach may better. Most prostate cancer treatments have lasting side effects that do affect the quality of life for many men. One such side effect for men who have had their prostates removed in their 50s like my husband is it makes them more prone to have heart attacks. That side effect was not disclosed to us and we found out the hard way. Too many treatment procedures and the ensuing medicines have hidden side effects that won't be recognized until it is too late. It is like the calcium rage which they later found out was clogging arteries but then the rx treatment-statins-and the resulting rx from heart cath-plavix or brilanta-may cause bones to become brittle or fracture just as warfarin does too. There do not seem to be any clear or easy choice to make if you are allowed the option of choosing. Some aren't afforded the option.
Something else to consider is if you are an emergency patient they do not have to have your permission to include you in experimental research. That is really scary! So you could get something done to you so far from what you would have wanted done just to be an experiment in treatment.
JF,
So that just proved our point that something that should not be sexual can be turned into something sexual. For some female staff they can get a power and control rush by committing an act upon a male patient they know is sexual in nature. There is no doubt there is a certain amount of sexual domination satisfaction on their part to make a man completely naked and defenseless when they know the exam does not require complete exposure. For some it is even more of a thrill if they have a co-worker witness their dominance and how blindly even the most masculine of males will obey their command to strip and lay there without cover while they do whatever they please. And no, I don't believe a lot husbands have that problem. I think a lot more women are just more vocal about who is allowed to see their bodies bc I think women have had more education in good touch/bad touch types of situations. Also, some husbands know what their wives will or won't allow and are standing up for them when their wife may not be able to do it for herself. Do these same co-workers get a thrill when they come across a male patient in their care that needs intimate care?

 
At Sunday, December 01, 2019 6:42:00 PM, Blogger Biker said...

Sorry to hear you had another hospital stay Dr. Bernstein, but kudos to that radiologist for being willing to try an innovative and less intrusive solution.

My only surprise with the VIP matter is that they openly asked you vs just doing it.

The scenario you described offered opportunity for respectful or disrespectful treatment as to your exposure. I know you are not especially modest but were you satisfied that all the appropriate protocols were deployed to protect your privacy as best could be done under the circumstances?

 
At Sunday, December 01, 2019 6:50:00 PM, Blogger Unknown said...

Or maybe ALL patients should receive VIP service.

 
At Sunday, December 01, 2019 7:12:00 PM, Blogger Maurice Bernstein, M.D. said...

JR, I would say VIP patient's potential is regarding administrative, personal issues regarding the standardized non-VIP patient nursing procedures and finally a more "communicative" and decision-making experience between the VIP patient and his or her physicians.
Administrative, for example, may involve simply not informing a phone call from someone who wants to know if a specific patient is within the hospital if the patient is VIP.

Biker, in my past experiences previously noted and that of the current episode, I was satisfied with the bodily privacy matters. With regard to photography, yes they did want to again film record my back and buttocks but it was emphasized to me that it would only be with my permission. Now, whether I was considered VIP in the "with my permission" statement I really don't know. I agreed again since I understand the hospital's legal rationale regarding this action.

..Maurice.

 
At Sunday, December 01, 2019 7:17:00 PM, Anonymous JF said...

We care for the elderly. I'm not saying that nobody could or would be be sexually attracted to the elderly. But if they are they are keeping that info to themselves. I will tell you I'M not.

 
At Monday, December 02, 2019 5:45:00 AM, Blogger Biker said...

JF, of course most who work in healthcare are not sexually attracted to most of the patients they interact with. In our every day lives we all come in contact with many people without being sexually attracted to them. I absolutely would not want to see most of those I come in contact without their being fully dressed. In a healthcare setting the fact that the staff person isn't attracted to a patient doesn't mean it is OK to inappropriately expose the patient or that the patient should be OK with being inappropriately exposed. It still comes down to respecting the patient's privacy and dignity (as opposed to doing what is most convenient for the staff person).

NTT, on my questions, as much as I would like an honest answer from female healthcare workers, I don't expect any are brave enough to speak to the disconnect I point out (sexual when they are the patient/not sexual when they are the caregiver). I suppose this not being willing to see it from the patient's perspective speaks to the underlying us vs them system both in terms of staff vs patient and female vs male in which patients in general and males in particular are the losers.

 
At Monday, December 02, 2019 9:03:00 AM, Blogger Maurice Bernstein, M.D. said...

"Unknown" written yesterday, please if you continue to participate here end you further commentaries with a unique permanent pseudonym for identification by others.


With regard to your possible suggestion that "all patients should receive VIP service", I think should bring chaos to effective medical treatment and doctor-institutional-patient relationship in certain circumstances and that is why I reject that institutional intensification or permission. ..Maurice.

 
At Monday, December 02, 2019 9:55:00 AM, Anonymous JR Issues4Thought.com said...

My real point was that some can make something sexual out something that is not sexual. As we know, many sexual crimes are not about the beauty or attractiveness of an individual but rather if they can commit the sexual crime upon that person. For the record, I don't think most sexual assault against men is sexual attraction crimes but rather sexual dominance crimes. However, I do believe that as humans when we see a naked body our natural instincts take the forefront and I believe that all medical staff have that moment in them before some of them shift into their professional demeanor while some of them while not ever shift into professional mode. That is why when a patient has an unusual genital characteristic they call others to observe, converse about it, or take pics. That is a sexual crime bc they are viewing that body part as a sexual part. Hopefully that type of medical staff is in the minority. I also think that no patient's body part should be needlessly exposed for whatever the reason is. All patients should be guaranteed their right to dignity/respect. It would seem that is only granted for chosen patients. Unnecessary exposure should be considered a sexual crime and be dealt with accordingly. I don't care why they did it but rather the fact it was done. I don't care for excuses or reasons because it doesn't make the pain of having been violated diminish any for the victim. It just adds to their anguish of not being important enough to be treated humanely.

Dr. B.,

I was not "unknown" but now I am curious. How would what you described in your answer to my questions from a previous post bring "chaos to effective medical treatment...." if all patients received VIP treatment? Shouldn't all patients be the deciding factor in how treatment care is delivered, what treatment they opt for ("more communicative and decision-making....", how private info. is given out or not? Aren't patients supposed to be the ones that make their healthcare decisions based upon advice given by the professionals or is what a doctor thinks needs done the last, absolute word and the patient's consent is only window dressing? It goes back to you will, the doctor ordered, no, etc. tones which is a very paternalistic approach to the patient/doctor relationship. In fact, that is not a relationship but rather a superior talking to someone in their command. It is also the attitude that most patients are stupid to understand and to make their own life decisions like loosing weight. The real kicker is being ordered on a diet by a 300lb chain smoking doctor & you're having your hospital approved lunch checked over by a 300lb nurse who clearly thinks eating healthy applies to her but you're forced while hospitalized to eat cr_p. Who would it create chaos for if all patients would be treated as VIPs--the medical staff bc they would have to treat each patient with more thought and consideration. That would create the chaos in the world of medical workers who prefer to pick and choose which patients they will abuse and assault either medically or sexually.

 
At Monday, December 02, 2019 1:12:00 PM, Anonymous JF said...

JR, Here is an example of not respecting a patients dignity in an absent minded moment. Once at a nursing home I worked at ( two women shared a room ) The one woman's son was visiting. My coworker went in and started undressing the other woman. Just like she always did. I had to tell her Don't strip her in front of him. The co-worker wasn't deliberately doing something wrong. It wasn't sexual to her. But it was a very wrong ( almost ) action. Another time, construction workers were outside and my nurse starting stripping an elderly woman. I told her to wait,then I shut the drapes. She said O, I don't think they'd be turned on. Then me, being my obnoxious self said, They wouldn't be turned on by seeing either of us either, but we'd still have to poke their eyes out.
It was me that commented that all patients should be treated VIP. All that I even meant by it was regarding bodily privacy.
Realistically, healthcare IS about workers AND patients. Both are important. Nobody can or should work for free. Our issue comes up when staff makes our dignity less important than it should be.

 
At Monday, December 02, 2019 2:40:00 PM, Blogger A. Banterings said...

Rape and sexual assault are crimes of POWER.

Sex is the weapon used to commit the crime.





-- Banterings




 
At Monday, December 02, 2019 4:07:00 PM, Anonymous JR Issues4Thought.com said...

JF,
If only more were like you there wouldn't be such a problem. It isn't about being turned on by seeing a naked elderly person but it is about the elderly person's dignity and the respect they are entitled too. What you described happened years ago when I was visiting my grandmother. I had to pull the curtain & remind the worker that everyone is entitled to personal privacy. People are not objects. Being forgetful or in too much of a hurry is no excuse. All of those dignity infractions erode away at elderly person's mental well being until the point they may believe they are less than human & it will affect their physical well being. Certainly there needs to be more training on dignity & respect aspects of care. And there also needs to be more pay because what you do is hard work & often under appreciated because some only appreciate the professionals like RNs but CNAs do more actual patient care especially in a nursing home. Certainly nursing homes make money but they are not willing to give the pay the CNAs deserve to have. I believe only females should care for females & males for males as far as any type of intimate care is involved. And JF, what you said to that worker was certainly less obnoxious than what I would have said especially nowadays. Kudos to you for standing up for patient dignity! But JF you can't be everywhere & not everyone is you. There have been numerous studies of late about how the suicide rate among the elderly is rising. I have concluded that nursing homes are just places to put old folks to wait for them to die. I have seen too many bad things from the times I have visited nursing homes. On the flipside, I have known some who have worked at nursing homes and they are wonderful, caring people but unfortunately not all who work there are. And sadly, there have been a number of articles about nursing home abuse/sexual assault being on the rise. The ones I saw last winter working at the nursing home my sister was briefly at to for recovery purposes, many of the young women were clearly drug or alcohol addicts. The 2 male workers I saw were taking old women into the restroom. The young women were openly hugging & kissing the old men & taking money to "buy" things. You're right--all patients are VIPs to at least somebody and all patients deserve the best of care and not graduated degrees of care while hospitalized.

Banterings,

Agreed that is why the female healthcare worker will expose a male patient--power, control, and dominance. They use their position of authority on a defenseless male patient to expose his sexual organs to humiliate and gain control. The method is different but similar as if a male patient was tied and gagged especially if they are drugged and are unable to mentally and physically function in a normal manner. They are helpless to defend themselves but just as a hostage must suffer what is done to them against their will so does the male patient. I can't imagine how it feels to be completely helpless and having no way to make someone who is assaulting to stop. It is beyond my imagination so this why I am so adamant about what happened to my husband bc he is one of those who remembers like CS is. Ask a male patient who has suffered from sexual assault and to them it feels like a rape but people who haven't been assaulted as such may think labeling it as a rape is overkill. But rape is meant to injure and destroy the very core of your personal being which is what the medical sexual assault does. I believe most exposure of male patients done in a hospital is done purely on purpose. Certainly, for all patients it is done on purpose during OR procedures bc they don't think you will be able to remember so therefore they are free to act however they desire which is in a sexually abusive manner.

 
At Monday, December 02, 2019 4:28:00 PM, Blogger Biker said...

Good examples JF. The 1st speaks to her just not thinking about the fact that the room mates's son was in the room. The 2nd speaks to someone thinking it didn't matter that the patient would be exposed to the construction workers on account of the patient's age. Both examples speak to a casualness which is perhaps the single largest problem patients face; the staff just not thinking first and foremost about patient privacy and dignity.

 
At Monday, December 02, 2019 9:34:00 PM, Blogger 58flyer said...

"Agreed that is why the female healthcare worker will expose a male patient--power, control, and dominance. They use their position of authority on a defenseless male patient to expose his sexual organs to humiliate and gain control. The method is different but similar as if a male patient was tied and gagged especially if they are drugged and are unable to mentally and physically function in a normal manner. They are helpless to defend themselves but just as a hostage must suffer what is done to them against their will so does the male patient. I can't imagine how it feels to be completely helpless and having no way to make someone who is assaulting to stop. It is beyond my imagination so this why I am so adamant about what happened to my husband bc he is one of those who remembers like CS is. Ask a male patient who has suffered from sexual assault and to them it feels like a rape but people who haven't been assaulted as such may think labeling it as a rape is overkill. But rape is meant to injure and destroy the very core of your personal being which is what the medical sexual assault does. I believe most exposure of male patients done in a hospital is done purely on purpose."

Wow JR! You nailed it! I have been in this position and this is exactly how I felt.

58flyer

 
At Monday, December 02, 2019 9:57:00 PM, Blogger Maurice Bernstein, M.D. said...

JR, I have read your questions directed to me above and they provide the issues which I have regarding VIP classification and treatment. I don't think one patient should have some priority over decision-making or care management simply for pre-illness occupation or some other status such as employee of the particular medical institution. Clinical pathology and clinical course is not altered by being some one "important". The germs and pathology doesn't know the patient's "VIP status" and that is why even President Trump entering a hospital (as he did recently) for any reason should be looked upon as a patient for medical or surgical investigation or monitoring and not anything other than a patient who should have appropriate clinical attention as with any other patient.

VIP does not change any underlying patho-physiology or anatomy and such segregation of patient care and attention should not be of clinical importance compared to any or all other patients. If VIP is to continue to exist, it should be applied to ALL patients...period! ..Maurice.

 
At Tuesday, December 03, 2019 11:20:00 AM, Blogger A. Banterings said...

I post these comments in regards to the current discussion on "shared decision making." Note that the links are to my Twitter page where I have links to academic research supporting the statements. In fact, most statements that I make are either taken from the research or an editorial on the research.



Our doctors should not be our bosses, but should be our consultants and technicians. They make recommendations and perform procedures - we listen and make choices.
(Source: Twitter Archie Banterings)



Physicians do NOT use #SharedDecisionMaking for #ProstateCancer. Even after educating the physicians, there was no significant increase in #SharedDecisionMaking
(Source: Twitter Archie Banterings)



...concluded that the best way to facilitate the appropriate care would be with efforts to educate
physicians about the shared decision-making process that should include countering the beliefs that perpetuate routine screening.

(Source: Twitter Archie Banterings)



after receiving education on shared decision making, physicians still performed poorly in shared decision making...

...90% of physicians self-reported that they took patients’ perspectives into account although objective data showed the opposite

(Source: Twitter Archie Banterings)



Most physicians (64%) lectured the patient about prostate cancer screening, rather than engaging in a two-way discussion (28%)
(Source: Twitter Archie Banterings)



Hoffman et al. noted that shared decision making has failed in other diseases as well. This list of disappointments includes breast cancer and colorectal cancer in both men and women
(Source: Twitter Archie Banterings)



Unfortunately, I have heard many health care providers judge our patients for their promiscuity, when we need to educate them – not be their judge and jury.
(Source: Twitter Archie Banterings)


Here is a really big issue that I have, lack of support for people who choose NOT to screen for cancer. In fact, some doctors FORCE patients to undergo cancer screening by holding other med hostage (Reference: Holding Birth Control Hostage – Mother Jones)

There is a lack of support for men who choose NOT to screen for #ProstateCancer
(Source: Twitter Archie Banterings)



The truth is the truth. As much as providers want to deny it, they cannot. As the truth comes out and we see providers for what they really are, society will slap more sanctions on them and they will cry the blues more and more.








-- Banterings




 
At Tuesday, December 03, 2019 12:55:00 PM, Blogger Biker said...

While the definition of what constitutes VIP treatment may be elusive, it is inevitable in a world where some hold greater power or privilege than others. This is no different than the deference or VIP treatment that the powerful and privileged receive in every aspect of their lives. It is the way all societies across the ages have worked. It is human nature and healthcare is no exception.

All I want, and I think all most people want, is to be treated as if my privacy and my dignity matters. I will generally defer to the professionals as to the best course of action but if there are options talk me through those too and let the choice be mine. If the recommended procedure is a 1st for me, and it is going to be potentially uncomfortable or embarrassing, tell me what it entails rather than allow me to be taken by surprise.

For those doing the actual procedure, if it requires I be intimately exposed, assume that I am modest without me having to tell you and minimize that exposure in the way you'd want your own exposure minimized.

If I express a modesty concern, acknowledge it. Respond with a "yes I know this can be embarrassing but please know...." and you have a chance of winning my trust because you will have acknowledged my feelings. If you ignore my concern or dismiss it however politely you may do so, I will assume you don't care about my privacy or dignity and I'm not going to trust you. Sadly, I think most nursing education teaches students to just go in there with a confident demeanor and "get 'er done" rather than teaching empathy and acknowledgment.

All I'm really talking here is basic human decency in seeing patients as people that matter rather than as objects.

 
At Wednesday, December 04, 2019 11:30:00 AM, Blogger A. Banterings said...

JR and 58flier,

Read about the Stanford Prison Experiment (official website). WATCH THE VIDEOS!

Note on the "arrival page" nakedness, uniforms (gowns), and humiliation were used as a form of power and control.

Each prisoner was systematically searched and stripped naked He was then deloused with a spray, to convey our belief that he may have germs or lice.... A degradation procedure was designed in part to humiliate prisoners and in part to be sure they weren't bringing in any germs to contaminate our jail. This procedure was similar to the scenes captured by Danny Lyons in these Texas prison photos.

It is interesting to note that the "guards" were NOT instructed to use nakedness as a means of control. This is just human nature

The guards were given no specific training on how to be guards. Instead they were free, within limits, to do whatever they thought was necessary to maintain law and order in the prison and to command the respect of the prisoners. The guards made up their own set of rules, which they then carried into effect under the supervision of Warden David Jaffe, an undergraduate from Stanford University. They were warned, however, of the potential seriousness of their mission and of the possible dangers in the situation they were about to enter, as, of course, are real guards who voluntarily take such a dangerous job.

As with real prisoners, our prisoners expected some harassment, to have their privacy and some of their other civil rights violated while they were in prison, and to get a minimally adequate diet – all part of their informed consent agreement when they volunteered.
Source: "guards page"

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

Yet, these inhumane traditions endure in the profession in the guise of healthcare justified by the fallacy of "we need to..."






Biker,

We should be treated as VIPs.

Our doctors should not be our bosses, but should be our consultants and technicians. They make recommendations and perform procedures - we listen and make choices.

Patients MUST be offered choices in exams, treatments, and procedures (including the patient's making alternative recommendations), choose the components of each they wish to accept, the MANNER they wish to receive them, by whom it is delivered, AND these decisions MUST be RESPECTED by all providers.







-- Banterings








 
At Thursday, December 05, 2019 6:12:00 AM, Blogger Biker said...

Banterings, I don't disagree with you on what the goal should be but rather am focusing on what is generally feasible today. I am free to make requests or demands for that matter, but doctors and hospitals are equally free to say no. There is no likelihood in any timeframe that matters today that doctors and hospitals will be mandated to do things in the manner patients want it done. There as well is no possibility in any timeframe that matters today that non-physician staffing could achieve gender parity. Were nursing schools to suddenly be 50/50 in their student mix it would still take 30+ years for parity to be achieved. I thus maneuver through the system with these realities in mind; choosing my battles carefully and making compromises that offer a greater chance of success on those few things I focus on.

I cannot demand the sole urologist in my county have male staff, nor the sole urologist at the even smaller hospitals an hour to the south or an hour to the north have male staff. They have all the business they can handle and don't need to do anything to attract me as a patient. Instead I drive an hour and a half (or more depending upon winter weather or if there is a truck in front of me as I wind through the mountains) to NH where there is a larger hospital where I can say I want a male nurse to do my prep, and where to date they have complied w/o any hassle.

I similarly can't demand the local hospital replace their sole dermatologist (a female) but I can drive as I do to NH to get a male doctor. Again, the local dermatologist has all the business she can handle and doesn't need me as a patient. In NH I can say the female LPN's cannot come in during my exam and the female scribes must either exit or turn around for the genital/rectal part of the exam, and thus far my request/demand has been honored.

That particular hospital seems to be more progressive on privacy/dignity matters than most, which is luck of the draw for me, because any alternatives would entail much longer distance travel.

On the actual care to be received, many doctors aren't going to spell out all of the alternatives as we here discuss they should. My current batch of doctors in NH seem pretty good at discussing my options with me and explaining things, but I don't lose sight of the fact that if they didn't the onus falls on me to ask questions I need answered in order to make an informed decision.

Of course living as I do in sparsely populated Northern New England my reality is different than most people who live in more urbanized areas. When there is effectively little to no competition such as I describe, it is the patient that must yield in some manner. In my case it is driving 75 miles each way. Even there I had to go with a PA for primary care given the extent of primary care physician shortages in rural America. PA's & NP's are more common now in primary care than physicians, and they are creeping into all of the specialties too. The sole local urologist now has two female NP's, one with urology certification and the newest one just hired with no urology experience at all. In fairness that hospital has been trying for several years to hire a 2nd urologist to no avail.

So, I agree with the goal but at the same time must navigate within the reality that exists where my ability to just demand things be done my way is very limited.

 
At Thursday, December 05, 2019 7:19:00 AM, Anonymous JR Issues4Thought.com said...

Banterings,

I have read on your site about the experiment. My husband and I tried to watch the video but had to stop as he was too upset. The stripping naked part and delousing reminded him too much of him being stripped naked and scrubbed without his permission or being capable of understanding why it was happening as 150 mcg of fentanyl combined w/ versed was overkill and then being left exposed. The experiment confirmed what we have said here before that medical people are first humans who can and will act on their basic human instincts despite whatever training they have had. Some have vile and cruel instincts while some may have compassion. However, as a patient you will never know until it is too late which you have.

As it has been said before, most everything the medical system does is to de-individualized each patient it comes in contact with by taking around their individual rights and identity. The systematic stripping of patients & then issuing them the revealing gowns is a prime example of how they do this. Also, their language is another key in how they control. Rarely are you asked for permission but rather told, when observers are brought into a room it generally is not a question but rather a statement of so and so is here to observe, etc are all key components of how they control. I have said that a patient is treated like a prisoner but however most prisoners have rights and groups like the ACLU to defend them. Patients have no one. The Patient Bill of Rights are only lip service at most facilities. They are to give the patient a false sense of safety but rather mask all the suffering that will or could happen.

I am in agreement that if it takes being a VIP to have all the consideration being a VIP comes with then every patient automatically should be a VIP. All patients should be treated w/ respect, dignity, consideration, and be in charge of their decision-making process regarding their healthcare. Medical staff only are paid advisors who have the ability to carryout our desired course of treatment. They should never be so smug as to think they are in charge of deciding what treatment course we will get but yet they and too patients allow them to treat them worse than an uneducated child. This is especially true if you are older.

On an interesting note I read a post by a male nurse who works in ob-gyn. He said he always asks and explains what he procedures are proposed. In other words, he doesn't tell them but asks their permission. He says this established trust. However, the issue that bothers me is that he has a chaperone present and that person is basically just someone who stands only to look at the patient's private parts. Isn't it ironic that most male nurses have to have a chaperone to perform intimate but female nurses do not. However, I read that a female prepper likes to have a couple of others in the room to talk with as she is exposing a male patient. Their attitude to the male patient was just get over it. She in her description said she was chesty and she like to see the reaction of the male patient as she bent over him. How's that for no sexual intent?

 
At Thursday, December 05, 2019 10:18:00 PM, Blogger 58flyer said...

Biker,

I see where you are coming from. I may have posted this before, I can't remember if I have, but my good friend has a brother who was a urologist in the Atlanta area. I say was because he is now retired. He and I had a conversation and he told me they had no problem in having a certain number of male medical assistants on staff for the male patients as they just told the local medical assistant schools to send the male students to them for their first job. So it wasn't a problem in having male assistants available for those men who wanted them. He also said there was a lower rate of cancellations as long as male assistants were available. He said the problem in most areas is the preponderance of females in most urology practices and that left male patients with little or no choice. What is really hurting men is that there is a need for female urology. The prevailing opinion is that male medical assistants can only work with male patients whereas female medical assistants can work with either sex. Discrimination at it's best. Therefore the reason for the all female assistive teams. So, with female patients filling up the schedule, that schedule is largely filled. As long as the schedule is filled and there is no gaps in the schedule, there is no incentive to meet the modesty needs of male patients. It's all about money and right now there is no need to change anything as the schedule will still be full even if some men will not present for treatment due to the lack of male personnel.

Back to my position that legislation will be the only relief.

58flyer

 
At Friday, December 06, 2019 2:23:00 AM, Blogger NTT said...

Good Morning:

Banterings, I read that the Stanford Prison Experiment was debunked as being fraudulent.

One of Psychology's Most Famous Experiments Was Deeply Flawed
https://www.livescience.com/62832-stanford-prison-experiment-flawed.html

Famed Stanford Prison Experiment was a fraud, scientist says
https://nypost.com/2018/06/14/famed-stanford-prison-experiment-was-a-fraud-scientist-says/

I agree with you 58Flyer about legislation being the only way to bring about change.

JR, do you have links to these articles?

"On an interesting note I read a post by a male nurse who works in ob-gyn. He said he always asks and explains what he procedures are proposed. In other words, he doesn't tell them but asks their permission. He says this established trust. However, the issue that bothers me is that he has a chaperone present and that person is basically just someone who stands only to look at the patient's private parts. Isn't it ironic that most male nurses have to have a chaperone to perform intimate but female nurses do not. However, I read that a female prepper likes to have a couple of others in the room to talk with as she is exposing a male patient. Their attitude to the male patient was just get over it. She in her description said she was chesty and she like to see the reaction of the male patient as she bent over him. How's that for no sexual intent?"

Maybe if the stories hit twitter they get noticed more. Every chance I get I give my brother articles to expose the way men are mistreated by the system & he gets out out on twitter so people notice.

That's it for now.

Regards,
NTT

 
At Friday, December 06, 2019 5:05:00 AM, Blogger Biker said...

58Flyer, yes if they have patients enough to use all of their capacity there is no incentive to be more accommodating of patients. In rural areas such as I live in it is amplified when there literally might only be one doctor in a given specialty. The local hospital is offering a $450,000 base for a 2nd urologist (who will subsequently become the only one given the current urologist is at retirement age) plus incentives. That much money would put you amongst the upper tiers of the 1% in this State. I would add that this is not some desolate area but rather it is Vermont where the entirety of the State is a tourist zone. We even have World Cup ski competitions at the local ski area and can offer quite a nice lifestyle, but newly minted physicians all seemingly head for urban areas.

The hospital an hour to the south of where I live went a couple years w/o a dermatologist until they were able to recruit a young woman, and that is in a historic town with an elite college, so not a bad place to live.

Though we may not have much bargaining power in such no-competition settings, we can vote with our feet such as I do and we can insist upon proper protocols being followed that protect privacy and respect dignity. Dealing with complaints sucks up resources and so even in no-competition settings, patients can yield some influence. I did as much with the local hospital writing a letter to the CEO and also to the local college's nursing program and the local tech school's LNA program.

 
At Friday, December 06, 2019 9:30:00 AM, Blogger Biker said...

This is a followup to my comment earlier about the ability of complaints to have some value even in no-competition settings. The local tech school's LNA training program that had no males on their website when I contacted them has since updated their site. They currently feature 4 students, 2 of them males. The local college's nursing program that previously featured no males on their website has also updated their site. Now out of 6 students featured, 2 are males. In both cases my complaint was that the absence of males being shown on their websites is sending a message that male students aren't welcome.

My letter to the CEO of the hospital included a complaint of no male staff other than the doctor in urology and there being only female sonographers. My guess is urology is still all-female but they have since hired a male sonographer. I also noted the unprofessional responses on the part of their female staff in urology and ultrasound when I inquired as to whether they had any male staff. Whether that has changed anything I don't know but my guess is that at a minimum there was some coaching of the staff in how to respond to such inquiries.

 
At Friday, December 06, 2019 12:21:00 PM, Blogger A. Banterings said...

NTT,

Rather, scientists "have been arguing for years that conformity often emerges when leaders cultivate a sense of shared identity. This is an active, engaged process — very different from automatic and mindless conformity," Van Bavel tweeted.

This still backs my assertion; the shared identity is created in med school.

The controls of the experiment of the Stanford Prison Experiment were not properly identified. The conclusion that this occurs spontaneously but rather occurs in a shared identity. This is valid to the Holocaust.

The methods and conclusions just need to be tweaked.




-- Banterings


 
At Friday, December 06, 2019 2:47:00 PM, Blogger Maurice Bernstein, M.D. said...

The Other View: "Gender This or Gender That"
but one (the medical system) may argue, it is not about patient gender but it is all about "Disease and Disorder: Diagnosis and Treatment". It's all about skill by physicians and nursing staff. Shouldn't that be what patients are looking for? ..Maurice.

 
At Friday, December 06, 2019 3:40:00 PM, Blogger BJTNT said...

These are not mutually exclusive:
The Other View: "Gender This or Gender That"but one (the medical system) may argue, it is not about patient gender but it is all about "Disease and Disorder: Diagnosis and Treatment". It's all about skill by physicians and nursing staff. Shouldn't that be what patients are looking for? ..Maurice.

Yesterday I had an eight o'clock doctor's appointment. The outer office door opened at 3 minutes before 8 AM. Three of the four of us waiting had 8 AM appointments with the same doctor. Tell me again that patients are not simply objects to be processed at the convenience of the caregivers.

Last week, I had laser eye treatment. After instilling eye drops in one eye from four bottles, the medical assistant washed her hands [the only time]. Why then? It was also the first time that the chin rest and forehead strap were not wiped, at least cosmetically.

Question for the medical community apologists: Is the excuse for perfunctory sanitation in the delivery of medicine that the germ theory is only a theory and not a law as in the taxonomy of field, discipline, hypothesis, theory, and scientific law? What is the opposing hypothesis/theory/whatever that allows token sanitation?
BJTNT

 
At Friday, December 06, 2019 3:54:00 PM, Anonymous JR Issues4Thought.com said...


Dr. B.,
While what you said may be justified in a medical setting but medicine needs to recognize there are other components that make up how to successfully treat a patient. Mental needs have to be met or else the physical treatment will not be successful or will fail. Cured the ailment but killed the patient because they neglected the mental health of a patient. No patient should come out of hospitalization with PTSD. The physical treatment of the patient by staff should not be so abusive and horrific that the patient is forever mentally injured. Is that not a failed treatment and a side effect that is not mentioned? Even RXs mention some potential side effects. Procedures mention some possible side effects. However, they do not mention that because they may treat you less than humanely you may suffer from PTSD.
For some it is not that some female nurse sees their penis or a male nurse sees the breast(s) of a female patient. It is the manner in which it is done-with permission, for a valid medical purpose, & done with the patient's dignity & respect in mind. It is the ambushing of male patients of having an audience during an intimate exam of 2 or more females (some chose a female dr. & are fine with her but not with the nurse, MA, etc.), it is not having the same choice as female patients do in ultrasounds or even ward care, it is about how callously the exposure of a male patient is done & oftentimes done excessively or unnecessarily, it is being told it doesn't matter if we see you naked but society and religion teaches it does matter, it is made to feel you have no choice, etc. Although I myself prefer women doctors, I have seen male doctors in the past. Even 20 years ago with a female doctor, I told the nurse she didn't need to stand & look bc that wasn't necessary to my exam.

Would you feel comfortable in using a restroom urinal with both females and males present? Probably not but why not? I as a female know your body parts are different from mine and I have seen penises before so if their theory is valid then it would make no difference. All after it is a restroom and that is what happens in a restroom. I have read time and time stories where nurses won't go to their employer hospital because they said they would be uncomfortable with their co-workers seeing them naked. WHOA--are they allowed to have different thoughts than us the mere mortal patient? What about locker rooms? Would you shower with females after a workout? Probably not. Because you would want your personal privacy just as patients want theirs or to be able to choose who they let into such a personal matter.

As far as looking for skill, is it a skillful nurse who intentionally exposes her patients to her co-workers? Isn't it part of her oath to protect the dignity of her patient? If she is willing to forego this part of her job, then what other aspects of skillful patient care is she willing to forego? Why is it okay to act like a patient's nudity is not a big deal when it is to the patient? Having a female chit chat in the patient's room while they are naked or being prepped is not skillful or even professional. It is a violation of everything a nurse should be.

And lastly, it is the right of the consumer if they do not feel comfortable with the provider of a service to shop around or to ask for another service provider. It is done all the time in other ventures so why would it not be the same in medical care industry. Is medical care not a service industry? Are medical providers not paid for their services? In most other industries, the customer is always right and should be able to get the type of service that meets their needs. It really is a no brainer but for an industry that is supposed to be the brightest, their bulbs are flickering & dim.

 
At Friday, December 06, 2019 5:47:00 PM, Blogger Biker said...

Dr. Bernstein, they can say "it is not about patient gender but it is all about "Disease and Disorder: Diagnosis and Treatment". It's all about skill by physicians and nursing staff." but you wouldn't have Mr. Kirschner style incidents if that were true. Or the Denver 5. Or Twana Sparks. Or the various experiences of people who have posted here. And on and on.

That statement may be true for some but it certainly is not true for all. Given hospitals and medical practices don't post which of those camps their individual staff members fall into, I find it easier to simply practice avoidance of female staff for intimate matters. I will also posit that hospitals and medical practices know which camp their individual staff members fall into. They know who is careless with patient exposure and who talks about enjoying the view and so forth but they mostly choose to look the other way. The mere fact that nobody got fired for something as egregious as what was done to Mr. Kirschner says it all. Or none of the Denver 5 got fired. Or Twana Sparks neither got fired nor lost her license. And on and on.

If the healthcare system wants us to trust them on these matters, then they need to take these obvious breaches of patient trust seriously.

 
At Friday, December 06, 2019 7:02:00 PM, Blogger Dany said...

Doctor Bernstein,

For any patient to consent to a medical procedure (be it "simple" assessment or an actual medical intervention), there must be trust. Trust is, at the core, a very instinctive reaction that doesn't always follow a logical thought process. That gut feeling is often derived by the level of comfort of the patient. It is much more about human nature than it is about degrees and diplomas.

Clinical skills, while important, may not always be at the top of a patient's priority list when deciding which clinician to chose (assuming they have that choice) or if they will give their consent.

This becomes particularly important if exposure of the genital area, or any perianal care, is going to happen. That level of comfort is going to manifest itself in very clear ways. Patients are going to feel embarrassed, humiliated, perhaps even horrified by the experience. I am not at all confident that "skills" alone can offset or compensate for this.

On a personal level, my own level of comfort is driving my choices in health care settings. And while I am fine with my current doctor (a woman), there is only so much I will let her do for/to me. She has not assessed my GU system and never will. She will not perform a DRE no matter how important she thinks it is. Don't get me wrong, I have no doubt she is more than qualified to do her job and I bet she's good at it too, otherwise she wouldn't have it.

But...

There's that level of comfort that kicks in and impact the amount of trust I am willing to give her.

Maybe I am just weird. Or maybe I simply dare say out loud (okay, write) what many people are thinking but won't say.

Dany

 
At Friday, December 06, 2019 7:35:00 PM, Blogger Maurice Bernstein, M.D. said...

Well written responses to my challenging statement. And now.. who is it except "us" who are participating in this challenge of patient dignity? I await others coming to this blog thread to "speak up". I know there are others.. so feel free to discussion-wise present your views. ..Maurice.

 
At Saturday, December 07, 2019 11:13:00 AM, Blogger Maurice Bernstein, M.D. said...

On the other hand, if you believe in the aphorism "actions speak louder than words", perhaps "actions" should be the approach to change the medical system to one which is wanted and also appreciated by everyone, regardless of gender. ..Maurice.

 
At Saturday, December 07, 2019 5:01:00 PM, Blogger Maurice Bernstein, M.D. said...

Here is the link to the "Medscape Nurse Career Satisfaction Report 2019". Zip through it and tell us what you think about some of the statistics of both RN nurses and others in the nursing profession and how it may apply to stuff being discussed here. JF, as a participant in this occupational area of the medical system, I would be particularly most interested in your evaluation of some of the statistics, perhaps as it applies to your specific area. ..Maurice.

 
At Saturday, December 07, 2019 7:17:00 PM, Blogger Maurice Bernstein, M.D. said...

And with regard to the VIP concept and its practice in medical care read the following:


"https://www.wbur.org/commonhealth/2017/03/20/study-looks-at-the-special-pressure-of-treating-a-vip-very-important-patient


https://www.journalofhospitalmedicine.com/jhospmed/article/132083/hospital-medicine/perceived-safety-and-value-inpatient-very-important-person

..Maurice.

 
At Saturday, December 07, 2019 9:16:00 PM, Anonymous JF said...

What is bad is when it's unsafe to tell when we are in over our head and can't get all of our assignment done. The last job I had, our nurses were our best friends. They pitched in and worked right along our side.
Oftener however nurses will just scold the CNA's and think that is their contribution towards getting things done. Our patients become part of us, because we get to know them long term. That wouldn't probably be the case in a hospital or clinic though. Another negative is my body feels like it's falling apart after doing the CNA thing for so many years. ( at nursing homes and Assisted Living Homes )

 
At Sunday, December 08, 2019 9:07:00 AM, Blogger Biker said...

At the end of the 1st of the two articles Dr. Bernstein posted are two comments. Here is a portion of the 2nd comment that I found interesting:

"Totally apart from issues of "unnecessary" or "low-value" things the VIP patients may demand, most of the front-line staff I know who have experience working on VIP floors believe that the care provided there is LESS reliably good than the care provided on other floors, perhaps most commonly when staff feel hesitant to pursue things as carefully and thoroughly as the best medical and nursing care sometimes would involve (a thorough physical examination of parts of the body that the patient may experience as intrusive; tests that the patient may experience as inconvenient or burdensome; procedures or other interventions that may involve some discomfort; mobilization of a patient post-operatively when the patient is tired or in pain and in the moment would rather be left alone)."

Amongst other things it seems to say that they are more accommodating of patient modesty if you are a VIP. The writer poses that as a negative for the patient which is not unexpected coming from a doctor but interesting nonetheless. I wonder to what extent VIP's get a say in the gender of their caregivers for intimate matters.

 
At Sunday, December 08, 2019 9:52:00 AM, Blogger Maurice Bernstein, M.D. said...

Yesterday at 10:11pm Joe Testa wrote his personal story but unfortunately to the closed Volume 78. I will publish the story here and I hope he finds this active Volume 106 to further contribute. ..Maurice.


I had a cystoscopy last month. At that time, I was told I needed a Urolift to correct my BPH. One was scheduled. On surgery day, in pre-op, I was told there would be six medical personnel for my procedure. Two Rn's, a nurse anesthesiologist, a scrub tech, my Urologist/Surgeon and a medical assistant - all female. (I had previously viewed many videos of this procedure and never saw more than 4 people being used for such a procedure). When I questioned the Circ. as to why so many, I was told that it was because the Urologist always brings her RN and her medical assistant for such procedures??? After pre-op I was rolled into the OR, and the scrub tech and the Circ shifted me onto the or table and strapped my arms straight out perpendicular to my body. While doing so the tech said, "Make sure his gown in not tied in the back so we can get it off without any problem." I had not anticipated I would lose my gown completely. I thought it would just be raided up over my groin, and then I would be draped appropriately. I was told then, by the NA, that I was being given sedation through my IV. In the second or so before I felt my self drifting off I felt a tug on my gown. My last thought was that I was now TOTALLY naked in front of five strange woman - at this time the Urologist had not entered the OR. I imagine I was prepped and, hopefully, draped afterwards. This would have never happened with a woman patient. I felt somewhat embarrassed yes, but much more than that I felt I was treated in a most inconsiderate manner. I was only introduced to the Circ and the NA. The other three never even said hello.

 
At Sunday, December 08, 2019 1:39:00 PM, Blogger Biker said...

Mr. Testa's story is another reminder why I won't have female doctors for anything that might involve intimate exposure. Not all perhaps but too many have little regard for male patient privacy and don't think twice about how many other women they bring into the room. They don't understand that while a man might be comfortable with her, it doesn't mean he is comfortable with her bringing the rest of the female staff into the room to watch.

 
At Sunday, December 08, 2019 2:27:00 PM, Anonymous JF said...

I don't know who the respondents are and don't work at a hospital anyway. At nursing homes however VIP's receive considerbly better care. So do the squeeky wheels. If our NURSES were to say otherwise, it's because we don't tell them. We CAN'T tell them because then we would be in trouble for something we can't help any way.
VIP's generally get care 2 or 3 times before our fall through the crack patients get care once. Things get even bleaker than that if there are lazy staff present.

 
At Sunday, December 08, 2019 2:49:00 PM, Blogger Maurice Bernstein, M.D. said...

JF, in nursing homes, specifically who meets the criteria for VIP? Are they former medical care providers, are they politicians, are they the "rich", are they individuals who have in immediate attendance forceful relatives? Do they enter with the "diagnosis" of "VIP" or is it a title created by the nursing home administration?

I understand there is communicative interaction between some patients in nursing homes, is there conflicts between "non-VIPs" and "VIPs" with regard to any differences in their attention and management? It would be of interest JF reading what your experience and understanding can tell us. ..Maurice.

 
At Sunday, December 08, 2019 3:36:00 PM, Anonymous JF said...

They were private pay patients. We were told point blank to answer their lights first. If we were attending one patient and one of these people's call light would come on, often a nurse would come into the patient's room and tell us to go attend to Mr VIP. If it was time to go to lunch break and the VIP's call light came on, we were told to attend to him first, then go to lunch. One time when that happened I told my nurse No, and for her to answer his light.
As far as the squeeky wheels, it was usually women ( like 85 of patients are ) They were alert and appeared to be upper class. We just instinctively knew we'd be turned in if we didn't drop everything and run to please these ladies. Meanwhile the patients unable to talk, wait and wait until we can get to them. And like I said, if your hall partner was lazy...

 
At Sunday, December 08, 2019 4:35:00 PM, Anonymous JF said...

Joe, I don't think it's so much that females are more accommodated than males. It's just male staff has accountability and female staff doesn't. Do you imagine that there is never animosity from female staff towards female patients? How do you feel modesty would be attended to when that happens? And after a patient ( male or female ) is put under, that patient will be attended by whoever is available.

 
At Monday, December 09, 2019 9:20:00 AM, Anonymous Anonymous said...

Hello,

I believe that JR accused medical staff of writing inaccurate medical records. Please read the following re falsification of Medicare records. Question: If healthcare personnel are bold enough to attempt to defraud the government, is there any reason to fear altering the records of lowly patients? My hope is that record altering is not pervasive in the industry.

Reginald

https://www.justice.gov/usao-edla/pr/mandeville-nurse-pleads-guilty-conspiracy-alter-or-falsify-records-federal

 
At Monday, December 09, 2019 12:48:00 PM, Blogger JR Issues4Thought.com said...

Reginald.

It is funny you mentioned this because q u Ora just had an article about this very same topic this morning. It was written by Maureen Boehm who is a former Internal Medicine physician. She Wrote an answer entitled what does no one tell you about hospitals. She calls hospitals medical profit centers. She said changing patients medical records is a standard procedure especially if they think they might be involved in a lawsuit. I've also read other articles which I have failed to bookmark which also say the same. It is cited that because electronic health records it is easier and more convenient for them to falsify medical records and putting down what really happened. It has been said that the ehrs allow them to falsify information. I believe it. The information in medical records today is in there for the hospital and Physicians convenience rather than for a true story of what happened to a patient.

 
At Monday, December 09, 2019 1:21:00 PM, Blogger A. Banterings said...

Read about The Stigma of Men in Nursing (on AllNurses).

The comments and research (O’Lynn, C. E. 2004) show that females are actively keeping men out of the profession.




-- Banterings





 
At Monday, December 09, 2019 4:07:00 PM, Blogger Dany said...

... And it looks like KevinMD is also jumping on the band wagon. The website just published an article titled "The gender imbalance in nursing."

They not quite touching on the elephant in the room issue of gender concurrent care as a preference from patients but I suppose it is a start.

Dany

 
At Monday, December 09, 2019 9:37:00 PM, Blogger Maurice Bernstein, M.D. said...

And..on the other hand.. the emotional and physical treatment of the healthcare provider by the patient. Although I have never been physically assaulted by a patient, I empathize with those in healthcare who have or who have always to be "on guard". I think we have to admit that bad behavior due to various reasons can occur on both sides of the medical profession-patient relationship.

This observation takes nothing away from the malpractice behavior by the medical profession as described by patients on this blog thread.. but it is important to remember that emotional and physical trauma can be occurring in both directions.
============================
Oh my! We are now in the 170 response figure and it is getting time to move on to Volume 107. Any suggestions from my visitors here regarding an appropriate new graphic to start out the Volume? Please send me the link for one which is not copyrighted and can be used for our thread: doktormo@aol.com. ..Maurice.

 
At Monday, December 09, 2019 11:40:00 PM, Blogger 58flyer said...

Dr. Maurice,

In response to your last post I don't have a graphic to post but I have a graphic in mind. Find a picture of a female nurse looking at herself in the mirror before she begins her work day. Is she thinking "I will go to work today to help my fellow human being?" or is she thinking "Today I will go to work to do harm to my fellow human being?"

Of course she thinks that she is there to help and to do no harm, but, she knows her own thoughts and preferences about her own concerns about who will be involved in her personal care. She knows that she will not ever allow a male nurse to be involved in her intimate care, but how does she think that her own involvement in the intimate care of men will be considered appropriate and professional?

In the end does she think that all is well in nursing, or that as she begins her workday the thought creeps in that "today, I will go to work to do harm to my fellow human beings because I would never consent to allow my male counterparts to do to me what I do to men?"

I see a picture of a female nurse looking in the mirror and asking, "Am I the reason that men don't go to the doctor?"

58flyer

 
At Tuesday, December 10, 2019 9:00:00 AM, Blogger Biker said...

58flyer wrote: "I see a picture of a female nurse looking in the mirror and asking, "Am I the reason that men don't go to the doctor?"

I like it! It may just be wishful thinking that introspection of that nature occurs, but I like it nonetheless.

Dr. Bernstein, on your violence against healthcare staff article, violence against healthcare staff is wrong, no different than violence against anyone else is wrong. Certainly the incidence of violence in healthcare settings may be higher than elsewhere given people are arriving in ER's under the influence of alcohol or drugs or violence that sent them there, and given mental health issues that healthcare staff must contend with.

This is perhaps an odd thought but I wonder if all those medical dramas on TV where the staff take extraordinary interest in and care of their patients has led some in the general public to have unrealistic expectations of what they will encounter when they are a patient. In some instances maybe that contributes to misbehavior on the part of frustrated patients.

 
At Tuesday, December 10, 2019 9:26:00 AM, Blogger A. Banterings said...

Maurice,

I like 58flyer's idea, but I would change it a bit. I would use a Jekyll and Hyde graphic with the good doctor looking in the mirror and the monster is reflected back ( like this:)

The doctor (nurse, or other provider) think themselves angels for their "saving of lives" but are really demons because of the manner in which they do it. As JR said in her Friday, December 06, 2019 3:54:00 PM post:

"...Cured the ailment but killed the patient because they neglected the mental health of a patient. No patient should come out of hospitalization with PTSD. The physical treatment of the patient by staff should not be so abusive and horrific that the patient is forever mentally injured. "





-- Banterings




 
At Tuesday, December 10, 2019 3:41:00 PM, Anonymous JF said...

Biker and Banterings, The idea that THEY might be at fault for men avoiding care would be resisted. Like when male doctors started delivering babies instead of midwives doing it. When somebody came up with the possibility that mothers were dying because doctors weren't washing their hands between patients... When I first heard about it I wondered, Why didn't they just start washing their hands to find out? But it would be devestating to realize such harm and damage came from something YOU caused. Me? I believe every word of it. But the resistance? That's my theory!

 
At Tuesday, December 10, 2019 5:55:00 PM, Anonymous JR Issues4Thought.com said...

NTT,

Unfortunately, I have not been able to find those articles again but I will keep looking. I didn't bookmark them bc my mind is so one-tracked and I was looking for something else when but now I could kick myself. I have been doing a lot of research on patient informed consent and what constitutes real consent. But in hindsight, those articles would have also provided me with needed information. I read a lot on Quora, MedPage, etc. They are good sources. That internal med. doctor I mentioned in a previous post has a lot of interesting things to say.

I saw that Trish whoever is up to BS again. She had her article on modesty be dam- re-posted on Very Well Health on 11.13.19. So this time I responded that she didn't seem to know the difference between patient modesty and patient dignity which are different but similar. Patient dignity is an inherent right to every human being and every patient should be treated with dignity and that is to say if they have modesty concerns than those concerns must be respected. I also reminded her that some do not have what she dismissed as needing help for modesty concerns but rather they have been victims of sexual abuse and have even suffered sexual abuse at the hands and eyes of medical providers. I told her that sexual assault happens when a patient is unnecessarily and without permission exposed. She is really rather arrogant and should not profess herself as a patient advocate when clearly she is dismissive and doesn't understand a patient's mental state of being is as important as their physical. Also, how they are treated physically (nudity) will affect their overall well-being.

I think a good concept is to demonstrate the Patient Bill of Rights mean nothing and to show a patient being surrounded by a group of female nurses just standing around looking at him. That is basically what happens. One does the stripping and the prepping while the other just look and talk.

 
At Tuesday, December 10, 2019 6:48:00 PM, Blogger Maurice Bernstein, M.D. said...

AS OF DECEMBER 10 2019 THERE WILL BE NO FURTHER COMMENTS PUBLISHED ON VOLUME 106. YOU CAN CONTINUE THE COMMENTS ON
VOLUME 107
. ..Maurice.

 

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