Preserving Patient Dignity (Formerly Patient Modesty) Volume 119
As can been seen and read on the previous Volumes, defining and establishing recognition and preserving the inherent dignity of each and every patient is a challenge for all those who attend them. It is a challenge which is not removable nor to be discarded but must be part of each and every interaction with a patient or even the patient's family.
And even a pet cat as a ill cat and patient deserves dignified professional care. Such an example was published on Volume 118 but reproduced here as presented by JR. She contrasts the pet's attention and care with her current and prior description of the care provided for her ill husband. ..Maurice.
As some of you might have noticed, I took some time off bc my one cat, Jimmy, was very ill and I wanted to devote as much of my time possible to him. He didn't make it so I needed more time but now I am ready to start working again.
I wrote to Dr. B. and he suggested I might share my experience w/ Jimmy's care as I am the wife of a medically/sexually abused patient. Jimmy's experience was totally different. Even though the family vet left Jimmy's illness go on for way too long without knowing what he had, I know he was doing his best. He and his staff were nothing but kind, compassionate, and caring towards Jimmy. Everything done to Jimmy was explained and permission asked. Completely different from my husband's experience.
The specialty vet center where Jimmy went for chemo was wonderful beyond words. Chemo and specialty treatments for animals is very, very expensive. They made sure before they did anything to check with us listing alternatives, risks, expectations, etc. before doing anything. We rec'd detailed summaries of every aspect of the medical encounter along with detailed billing even receiving a refund on an overcharge which truthfully we wouldn't have recognized if they had decided not to be honest.
During the visits, they would talk to us. They would talk and interact with Jimmy in our presence before taking him for testing to make sure he was comfortable with them. I remember once while we were waiting the tv was playing a show that was on tv the night I had to wait for hours & hours at the hosp from hell having no word for hours abt my husband (this happened while he was being sexually abused by Leather Hench & co.). I was distressed & so was my husband. I asked them to pls turn off the tv asap bc of the traumatic events associated with it. They did it asap and from then on there never was a tv on in our patient room. This clinic is actually just a few miles from the hosp from hell but to this day, we have never seen it again bc it represents hell.
On Jimmy's last day, I knew he wasn't doing well. He was supposed to get his 2nd dose of chemo as they gave it to him over 2 days each treatment time. His lymph nodes had swollen bigger than ever just basically overnight. He wasn't moving around much as it was getting difficult for him to breathe. I could tell Izzy the nurse knew he had issues as she took him back. Dr. W. came in a short time later to say he was in distress and needed to put a catheter in his arm while she still could. We agreed. She left and came back and we had the talk abt what was best for Jimmy for the final time as from the beginning Dr. W. had laid out all the scenarios and it was clear the chemo had failed and had in fact, caused the cancer to become more aggressive. Our son didn't like hearing that it was time for Jimmy to die before he suffocated to death. He said he needed to see the proof--the science. W/o any hesitation, she provided the medical evidence. She knew I didn't believe in killing them bc the shot can have bad consequences but she explained she doesn't merely give a shot but goes in through the catheter with a pre-med. Once it works, she goes in again through the catheter & administers the drug that actually kills so there are no horrific side effects of being killed. She said she would arrange for it to be as peaceful as possible. She did.
She had us taken to another room that is not an exam room but rather a private family space. She came back with Jimmy all wrapped up in these think furry blankets. She told us to spend time with him as he was stable for the moment. We all held Jimmy. He got up and moved around. She and Izzy came back and arranged us on the floor around Jimmy including her and Izzy. We sat there and held Jimmy's hands while she administered the drugs. All of us were crying including her and Izzy. She said would continue to cry later at home (she had told us one of her cats had brain cancer so she knew what we were going through). Jimmy left us very peacefully. Dr. W. had asked us what we wanted done w/ Jimmy & we wanted to take him home so she said she would take him back when we were ready & clean him up, clip some of his hair for me, and make prints of his paws. She also said she would take off his bell for his sister Danny to wear. I gave them Jimmy's blankets and later they came back with a packet of Jimmy's things and Jimmy in a little cardboard casket. She said we could leave by the side door and we could settle the billing later.
posted by Maurice Bernstein, M.D. @ 9:50:00 AM
175 comments
175 Comments:
Jr.
My condolences on your lose . I can tell from your posting how much he meant to you . I have been there several times myself . Here is what I did with there remains . For several years we put their remains in a back closet not knowing what to do with them . Then my wife passed away . While planning her funeral it came to me . Bury them with mom . In life they were her 4 footed babies . Now they will be together forever . Hope things work out well for you . Al
From JR (a followup from above thread introcuctory text) which was written by her but not published on the closed Vol. 118. ..Maurice.
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JR @rights4patients
Since that time I have rec'd from Dr. W and staff (everyone who interacted w/ Jimmy) a handwritten card w/ paragraphs from each of them abt Jimmy expressing their sympathy. Dr. W. also arranged for Jack to see their kidney specialist. Unknown to them I had adopted 2 kittens just prior to Jack's appt and they were ill so they took them in too seeing a different dr. Dr. W. said she would supervise Jack's visit which she did. Jack had some extensive kidney tests and he is doing okay w/ even the possibility of improving his kidney numbers. They have went above and beyond in all the questions & concerns I have had abt Jack & the kittens. I will be taking Danny, Jimmy's sister, to see them as she had lung damage as a feral kitten. I have written to Dr. W. and staff abt how grateful we are for their compassionate and excellent medical and family care. If only care given to human patients resembled the care given to Jimmy there wouldn't be the need for boards like this. Jimmy's life was short but he taught us a lot abt life. He lived everyday to the fullest and wasn't afraid to push the limits. He was overflowing with personality. My one little kitten, Timmy, has the same look in eyes like Jimmy. When adopted Timmy was a long-haired black cat. Jimmy was a long-haired gray but now Timmy is turning gray. Huey is a long-haired buff and he retains his feral characteristics like Jimmy's sister Danny has to this day. Huey needs extra love and assurances whereas Timmy like Jimmy was, is ready to take on the world. We are honoring Jimmy by helping at least 2 other throwaway kitten lives to be able to live instead of being sentenced to die.
Al,
Thanks for the kind words. We have a place we bury all of our babies. When we moved, some moved here with us as this supposed to be our forever home. Due to the medical assaults, that is no longer true so once we find another state to build a house in, we'll move them with us.
My husband and I have talked many times abt how different the medical care was for Jimmy and how different it was delivered to Jimmy and to us. We always go back to one point and that is why cannot human care be delivered in the same manner? Why must some providers seek total control and power over the patient often to the point of excluding family? And again, why are some providers allowed to cause intentional medical harm by their actions?
I have just read 58flyer's story. It is sickening the way he was treated. There is no way that facility would have 2 men watching a lone female showering so why is it acceptable for 2 women to watch a male patient showering? And yes, Dr. B., it does bring back the very real, intentional harm that was inflicted upon my husband. Those crimes committed against him do not fade or heal even with time. It is always in back of his mind and mine that if he were to have medical care ever again, it could happen again as nothing has changed. There will always be bad sociopaths in medical care just like in any other field but for the medical field to harbor such sickos does make their crimes more heinous as their victims are generally defenseless much like a ped raping a 2 yr old. Whether the offense as in 58flyer's case was not malicious or was malicious like in my husband's case, the damage done to the victim is lasting and cannot be undone. For as brilliant as they like us to believe they are, many in the medical field cannot comprehend how they deliver the medical care can be more important than the actual medical treatment itself. In my husband's case, his medical treatment was a failure bc of the assaults (sexual & medical) he will not do any active follow-up or other care. There is no trust in the medical "profession" and without trust a relationship cannot exist or be sustained. Apparently, they do not teach this in medical training for any of them or perhaps the sociopaths are asleep during this believing this doesn't apply to them.
I had an email feud with a retired urologist saying I was irresponsible in what I said but when I pinned him down abt his exam method (the strip as you go w/ the female present) he calmed down bc he couldn't deny this was a personal dignity offense and that men are treated differently than most females are (different=worse). When I told him I personally knew of men who avoided medical care bc of this, he again went silent. He struggled to separate what he had been taught as modesty is a fault of the patient rather than each patient is always entitled to personal bodily dignity. I imagine it was quite an experience for him to realize that all those years he had been sexually abusing his patients and probably had contributed to some not seeking needed care bc of how the exam was done. I had to remind him several times it is not about the necessary exam of the genitals but rather how that exam is conducted that is the issue. Many struggle with that concept.
JR. I'm sorry about your Jimmy getting sick and dying. I'm a cat lover myself.
( and a dog lover ) They are FAMILY! I think one main difference is the vast majority of people aren't sexually attracted to animals. Animals also don't have a lot of modesty. Their hair are their clothes. I know that probably Dr B doesn't agree with me but I feel that certain of the exams are sexually gratifying to some of the staff. Some of it is also repelling to the staff. That isn't good either and is humiliating to the patient if they pick up on it.
Also I want to apologize for calling you a Trump worshiper. We have different opinions about what his influence has been. But that's what Facebook is for. Not this blog.
I agree with JF that the goal of this blog thread is not to spread "political speech" as such but to present points of discussion which will lead to the understanding and preservation of patient dignity.
What I want you all to know is that when I was in active medical practice, every time I performed a male or female genital, rectal (or even female breast exam) I had in my mind, on an ongoing question beyond the physical observations, findings and conclusions was "how is this patient feeling about what I am doing?" and that is what I taught my first and second year medical students regarding this and other anatomic areas of the physical examination.
Laying on eyes, laying on hands or hands with instruments on patients needs attention of the physician or nurse beyond the purely clinical basis for the action.
And I wouldn't be upset with any patient who would speak up to me or my students.
Unless strongly sedated or under anesthesia when an effective communication would be difficult or impossible, there is an ethical (termed autonomy) and patient dignity power for the patient to "speak up". There should be no contrary argument for this statement. ..Maurice.
I had an appointment 3 weeks ago bout a concern of mild bleeding during urination, extreme pain in the flanks radiating to the bladder along with acute stomach and transverse colon pain. Dr. is a nice young man, never dealt with him before as I am a between client because the NPA decided to go on extended leave with the upcoming birth of their second child. He did a simple check of eyes, heart, lungs and glands. As I commented that I had gone thru this in 2018 which was worst. He suggested a abdominal cscan, which is no big deal as this would be my 4th in 14 years. Then ever so casually and smoothly "happen to mention". I responded, No, no, hell no under no way. He thought he could breach this answer with some smoozing. I informed him that I was a survivor of gross sexual attack bt 2 female medical staff as a female doctor looked on and did nothing. I asked him why he was afraid to use the proper term CYSTOSCOPY. He sat there a little glazed, and I again said no way because he could not guarantee male medical staff and even then the answer was no. I also brought up that after what today would amount to $750,000 of therapy no one was going to put me into PTS under and circumstance. I informed him that when I said no the answer was no. Period. This past Monday, 7/26 I had another appointment to go over the ct scan with very pointed questions about the radiologist's comments. Agian he brought up a "bladder scan" as he pyt it. I corrected him told him not to talk down to me and the fact my education likely out stripped his and my connections to ome of the top people in the country wold leave him dizzy. I mentioned an world a well know expert in his field who is still associated with Cornell, his alma mater. I knew by his face he was taken aback and fumbled a answer that he may have had him for a few courses. I responded, oh, really. Well the doctor and had gone thru preschool and competed in the same college prep classes thru high school. I figured he would cool his gets, but know. He stared to ask in my wife's presence if I had ED. She laughed as well as me. I responded what would you expect if someone was on blood pressure meds for 35 years. He still didn't develop a clue. He next asked I I still had sexual desire. At first I laughed, which set off my wife laughing. I clearly stated," I do not discuss my private life with strangers, and I will no live long enough to develop a close friendship with him. Then finally I said, "This is on a need to know and he will never need to know" My wife was floored and has never really the crap I have put up with doctors. When we go home we discussed this and she asked do other men go thru this crap with doctors; I had to explain to her that what I have experienced is the tip of the ice berg---she was appaled saying I have never been so disrespected by a doctor. I cautioned the doctor at the first appointment that the ct scan would show nothing that could point what was going on, and the new scan was nothing new.
In conclusion matters have settled down. This all started 8 months ago with a sever reaction to the flue shot which put me into bed for 3 weeks UT problems. That all settled until the first Phiser shot which wiped me out and a week in bed with a 102.5 temp. Still days I am exhausted, have no strength and no interest unless I really push. I find I must have 10-12 hours of sleep. In the past episode I quickly removed myself from tramadol and relafen, which is very damaging to the stomach. Doctor could not understand that I could just stop 1000 mg tramadol and 2000 mg relafen without a problem. Sorry not addict material-to much in control!!!
JF,
Thank you for your kind words! No worries abt calling me a "Trump worshipper" bc I knew I was not but we do have different views which is what makes this country free. I also agree that some staff do find exams involving nudity sexually gratifying as some do get sexual pleasure at exhibiting their power and control over a patient especially when they are able to make the patient comply with unnecessary nudity requirements. It follows the same MO as rape as rape is not a crime of sex pleasure but the power and control the rapist has over the victim is what gives them the pleasure. One nurse made that clear to me when I talked w/ her abt her past behavior towards male patients. She wasn't personally interested in the their genitals but it did give her a "thrill" to expose/humiliate them. Part of the issue is that the majority of medical providers will not admit within their profession there are those are sick and commit intentional acts of harm which will influence others to commit those same acts of harm ie. for us--unnecessary exposure. We need to figure out why the exposure/disregard for patient dignity is being done in order to fix it. Is it because they can and who falls into this category? Is it to save mere seconds and figure who is doing it for this? Is it because long ago this is how it was done and fix that? I realize the criminal element is probably smaller but its influence can be like a malignant tumor.
Dr. B., I disagree as more and more politics is coming into play into healthcare. Healthcare providers are more and more allowing politics to become part of their medical processes. However, this is a multi-fault area meaning both and all parties are equally guilty. It is also my experience that none of them in either major party are willing to help. I currently have an underdog candidate from Indiana on Twitter who is understanding more and more abt medical harm. He and I have different political beliefs but this is a common thread for us. He was espousing Medicare for All which being very familiar with Medicare, I don't want. He hadn't thought about using the name Medicare would conjure up negative responses. Also, the govt (either party) has done a horrendous job with VA hospitals so do we really want them in charge while concurrently they (CMS included) has done an equally horrendous job of making sure how private healthcare is delivered is safe. It gave him food for thought. He realized I wasn't merely opposing his political view but had valid issues. That is what discussion is all about. Different views communicating. Congress should try it sometime.
CS and I have had some gut-wrenching interviews which are available on Spreaker. There are a lot of spouses like me upset abt the care their husbands are getting (making me not an outlier after all). One wife was a victim of sexual abuse and the assault her husband suffered brought back her trauma. We have knowledge of several men who have been sexually abused by VA hospitals. One woman was stripped naked for lower leg surgery after she tried to make sure she wasn't. That surgery was goofed up so when she had it redone, in the same town, the other surgery center was floored that stripping a patient naked for that type of surgery would be needed. Clearly, there are widespread issues and these must be addressed. We need consistency. We need patients educated and in charge. The patient needs to be the captain of their care team. Everyone else is just a player that can be replaced if they are not playing by the rules of the game.
JR, I am so sorry about your loss. Reading your account I found myself thinking if only we all could be cared for in the manner your Jimmy was. In your last message you also made an excellent comment:
"it is not about the necessary exam of the genitals but rather how that exam is conducted that is the issue. Many struggle with that concept"
True, so very true.
58flyer, how did your clinicals go for your CNA training? I am glad to hear that older adults are pursuing CNA training. There are exceptions to every rule but I just can't see the average teenager having the maturity to handle opposite gender intimate care in a fully empathetic and respectful manner. In my State you can become a licensed CNA within a couple months of turning 16. If I had no choice but to accept intimate care from a female CNA, I would much prefer it be an older person.
my apology for the numerous grammatical errors and inconsistent thoughts. I was tired and typing this after midnight was unwise. My wife now goes with me and sits in on appointments as I want a witness after dealing with the abusive crap from doctors and staff at univesity of utah health. My wife is still stunned by this young doctor's coldly distant arrogance. Fortunately I am better at the game he was trying to play. I ,not the doctor stipulated what was to be covered in blood and urine tests-he seem to have no clue and had never looked at my chart and never looked into down loaded files I had supplied about ct cans 3 years ago. Somewhat impressed with the young doctor at the first appointment but after the second appointment I had no respect for him or trust. I was amazed he could not remember prior conversation. Sorry, not interested in hearing how busy a doctor is. BS. I ran a very upscale 'carriage trade" business for 31 years and had a steel trap memory of conversations for years and generally saw between 50-75 people per day. Quite clear he did not pay attention. I have requested copies of his 2 post appointment summaries to see how he has skewed these summaries and/or if I will simply had an attorney deal with COO and/or chief of staff. Frankly after the second appointment I walked out feeling raped again. An experience I had gone thru and had made him aware of during the first appointment and during the second. As he was trying to push this "bladder scan" I posed the fact that was he going to guarantee a male only stall and frankly I was not than capable of injecting a numbing agent in my own penis myself. No responce. I firmly stated that now on 2 occasions regarding his "bladder scan" he hand been told 'NO,NO,HELL No", and he better pay attention. Would I pass up medical care in the future if it involved any form of intimate exposure to female staff or some numb nut pushing surgery and is too lazy to read my record which states that I have sever reactions to any for of sedation--damn right I will!!! And damn right most people who are survivors 0f gross sexual assault by medical staff will not get involved again and willingly accept the responsibility of their decision.
An aside. I have had a number of clients who were either COO or CEOs of hospitals. I am very aware of the rampant immoral sexual crap that goes on among doctors, nurses, male interns and male residents and with other doctors' wives and even including building staff. Not an admirable above board group of people. No one in their right mind would ever trust the lot of them. My other observation of doctors and their wives that one of then if not both were drunks and their children were self centered asses. I did high end interior design on the East Coast and had a client list that read as a who's who. Working with clients I lived with then 2-3 weeks a year to prevent them from conning me with so delusion of importance as they stood over the kitchen sink stuffing themselves on take-out food. So I watched alot and after they plied themselves with booze, the crap flew and the details came out. What a good 'ole boys club!! Altruism is a rare quality. Either you are born with seeped in your soul; but you can not learn or buy it.
Ventilation has had a potential therapeutic value from posting on this blog thread ever since the topic started in 2005. As a physician, "potential therapeutic value" has clinical value to me. This blog thread then not only discloses facts but also discloses feelings which are then open to further disclosure and but also support by others who may have been similarly affected. Couldn't be better! ..Maurice.
I had spoken in the last volume what happened to Mel's friend. (Mel is my transgender friend's moniker.) Her friend finally asked Mel to help her go after the surgeon and the facility. Mel has enlisted me to assist. We are drafting a letter that is a work of art comparable to the work of Michelangelo.
The letter is footnoted in the APA style since the allegations are so damning. Doing the research, I stumbled across this: A position paper from the New Jersey Coalition Against Sexual Assault, February 2020 on Invasive Exams without Prior Consent.
Advocacy organizations that focus on sexual assault are taking the position that these exams amount to medical rape.
58flyer,
Has your wife ever asked prosecutors at her job how they view such issues?
I would argue that existing laws of sexual assault should be enough to bring charges in such cases.
-- Banterings
JR,
Please accept my condolences on the loss of your Jimmy. You are in my thoughts and prayers. Reading your post made me go and give our Dixie an extra hug.
Biker,
We had no clinicals in the CNA class. My state does regulate CNAs to the extent of scope of practice and specifying the educational requirements. However, there is no licensing of CNAs in my state.
Banterings,
My wife has extensive experience working with plaintiff firms and defense firms but has only about 2 years with the state prosecutors office. She hasn't worked with them long enough to really get to know them. One thing I was astonished about is the turnover in prosecutors. And the pay. I made way more as a law enforcement pilot than most of the attorneys employed by the state in any capacity. To answer your question, no, she has not discussed such issues of assault or sexual assault. Maybe she will get the opportunity in the future. I did discuss my most recent situation with a sex crimes detective with the local sheriff's office. He said that it didn't fit the elements of a sex crime and the best I could hope for would be battery or maybe false imprisonment. The legal issues would be that with my mental state, encephalopathy caused by extended sedation, and my inability to remember some of the event and the exact wording of my statements to the occupational therapists, the state would likely nol pros the case. My best hope for some correction would be with the state board of professional regulation. I may not prevail, but I will certainly get their attention.
58flyer
Biker and 58flyer,
Thank you for your condolences.
I read and posted the an article from MedPage abt a dr blackmailing a NP for sexual favors. He was arrested. They can investigate and arrest a medical provider for a crime against a medical provider but are not willing to arrest a medical provider committing sexual crimes against a patient unless 500 patients are affected. Why is wrong with this?
I also read an article sent to me by Misty abt for a online women's magazine about unconsented for pelvic/rectal. Some issues I had with this article was it did not mention males were also victims of this practice. I also believe males may be subjected to more unnecessary genital abuse than female patients bc the majority of careworkers are female. In this article, a female doctor talked abt when she was a med student and was required to examine an unconscious as part of the gang rape ritual. She said she felt guilty & later went to the women to explain her part in the woman's care. Care? She wasn't a part of the woman's care but rather she used the woman to further her educational needs. The way she looked at this told me this doctor still does not understand what she did. When someone doesn't consent, it is assault. That's really simple and I would think someone as educated as a dr should be able to grasp this. No consent--no true emergency = assault.
I read another article in MedPage abt a group of naked female drs. in a hot tub. Author was a ob-gyn. She was uncomfortable and mentioned she saw 20 or more naked women a day. The more she drank, the less inhibited she became until she wasn't uncomfortable. You can see where I am going with this as this is the purpose of such drugs as versed. Versed is used to make pts uninhibited. What this dr. failed to understand is she CHOSE to be naked in the hot tub w/ strangers of her same genders---patients DON"T have that choice.
All 3 of these articles relate the disconnect medical providers have towards the concerns of their patients. They don't see patients as humans who have the same concerns they may have or have experienced. How do we fix this? Why happened to 58flyers is a prime example of that disconnect. They used his drugged state to dismiss his concerns. It is typical of any abusive relationship which is how many patient/medical providers can be described as being. Now he must live with the side effects of what they to him.
As for the 1st article I mentioned, it shows how little they care about intentional (criminal) harm that is done to patients (ie. what happened to my husband) but they do take it seriously if it is being done to them. How little regard they have for us mere patients is totally sickening but don't seek medical care for it as it will likely make your harm worse.
Here is another study via Medscape which surveying 2000 physicians
which supports the views of physician misbehavior or worse which
has been written and rewritten here on this thread. ..Maurice.
So Maurice has spoken about complaining vs doing something. Mel's friend was treated by a plastic surgeon who has all types of "certifications," recommendations, rankings, etc. These organizations are LGBTIA, human rights, etc.
The patient has experienced events that have been described by those organizations and other organizations as cruel, inhumane, degrading, torture, and even sexual assault. Our plan is to bring this to the attention of all the organizations that the surgeon and his facility work with. After a news conference, these organizations will have to distance themselves from both.
The nextstep is taking advantage of the current cancel culture. All involved will feel the social pressures brought on those who harm minority and vulnerable populations.
You tell 'em I'm coming... and hell's coming with me, you hear?... Hell's coming with me! Kurt Russell as Wyatt Earp in the movie Tombstone (1993)
Mel is hellbent on destroying the surgeon and the facility for hurting her friend in such a way. She has studied what the new cancel culture is doing. This is a way that social change of big institutions is being made.
-- Banterings
From that survey you posted Dr. Bernstein, it is fairly clear how common misbehavior involving patients in some manner is. That is understandable given doctors are human with all the accompanying frailties of being human. The problem is the extent to which their co-workers and the system itself protects bad behavior from consequences. They all see it, and most of them look the other way.
What makes it worse than what the survey indicated is that basic violations of patient privacy and dignity likely don't even register with many of the survey respondents as being misbehavior. It is the rare doctor indeed that sees female chaperones as an assault on male patient privacy and dignity. How many hospitals would ever think there might be something wrong with sending female CNA's, especially young ones, to bath & shower male patients? None is my guess.
Banterings, let us know how Mel's effort pans out. It sounds like her transgender friend was treated like a zoo specimen rather than being afforded some basic human decency.
58flyer, let us know any further developments with that rehab hospital. If nothing else those two women need to understand that what they did was wrong.
Do you plan to work as a CNA? Up here in VT & NH they are LNA's (Licensed Nursing Assistants) and there are more hours in clinicals than in the classroom, though the entire program is just 2 or 3 months. My biggest beef is they can start an LNA training program on their 16th birthday. Not old enough to buy cigarettes or alcohol, nor vote or join the military, nor rent a car, check into a hotel, or enter in to a contract of any kind, but they are old enough to bath & shower & intimately observe opposite gender patients.
This is kinda for JR. I don't know if anyone else is interested. The female patient that Hospice tried to kill in such an inhumane kinda way. She outlived her Hospice and left for a nursing home Friday. Thursday she looked at me and was very clearly getting ready to cry. I've never seen her cry before though.
What I'm HOPING is now that she didn't die and Hospice is no longer involved the nursing home she's now at will give her meal portions like everybody else. I never stopped sneak feeling her. So far as I know only one coworker knew I was doing it. Although I suspect other staff MAYBE knew of it. I think that possibly I could have more than just gotten fired over it. Maybe I could have been blamed for interventing with a Hospice medical plan.
Biker,
To answer your question I do have some interest in working in the healthcare field which is why I took the CNA course. The pay isn't great but I have 2 pensions plus soon will add Social Security. I just turned 65. So pay is not a an issue. I just want to see the true nuts and bolts of working in healthcare on a daily basis. There is the attraction of working in an air conditioned environment. I spent most of my working life outdoors. It's hot in Florida.
I'm thinking of a response to the letter the CEO of the rehab hospital sent me. I think he had a real good grasp of the reason for my objection of the female staff during the shower assessment. But the one of his statements was "It was certainly not the intention to cause you discomfort and moving forward staff will be sure to more thoroughly explain what to expect during sessions, which will help to ensure the patient is comfortable with the process." In my case, I was very aware of what to expect which is why I objected to the female staff. A more thorough explanation is not what is needed. Respecting the patients concerns is. They did not respect my dignity by disregarding my concerns. That is the whole point. In the same letter he said "I understand that our Director of Therapy also reached out to you following your discharge to discuss your experience and share the actions we will be taking to prevent a future occurrence." I wish! Yes, she did contact me, but she did not discuss any specific actions they will be taking. She only offered sympathy, saying she knows what I went through since she has been a patient herself. I don't want sympathy, I want correction. I don't want other men to have to go through what I did. There are so many men working in that facility that they could easily institute a policy of women shower the women and men shower the men. Problem solved.
In addition to a response to the CEO, I was thinking about writing a letter to each of the female therapists. No doubt they have been confronted with my complaint. I want them to know on a personal level how their actions made me feel.
I am open to suggestions as to how to word my thoughts to the CEO and the 2 therapists.
58flyer
JF,
I am so glad to hear that lady made it. You did the right thing and I wish there were more people like you. Hospice can be a cruel road as it was for my dad. Being starved to death is not pleasant. I remember that even the drugs they gave him did not mask his hunger and how he would cry. I don't know if you can end up in trouble with Medicare/Medicaid/hospice but I know you did the right and humane thing. The people at the top make these rules which are not sustainable at the bottom of the totem pole. They don't have to see the actual results. I know bc of the rules, some workers become harden hence why so many patients are abused and mistreated but every once in a while there is someone like you who knows the difference between right and wrong and does the right thing. Thank you from all of us who may be harmed or have been harmed by a system that does not care.
Hello 58flyer,
I'm sure that others will advise you re the wording of your letter to all concerned. Please, please do not let this drop. Everyone in healthcare needs to become aware of male intimate care concerns. We will, no doubt, be termed weirdos, fanatics, etc.; however, we will not be heard unless (as Dr. Bernstein has said repeatedly) we SPEAK UP (I would also add, "CLEARLY AND LOUDLY"). Please keep us informed and, know that we will all be helped by your efforts. Take care.
Reginald
58flyer, I can't give you the words but I will offer suggestions on nature and tone.
The letter should not be angry or rambling as you will quickly lose their attention that way. It should be concise and relevant to your specific experience without extraneous topics that aren't anything they can do something about. The focus should be on what is within their purview. Make specific suggestions for how they can do things differently. Include a follow-up action element that necessitates a response. Without an action element your letter simply becomes comments offered. Include the emotional aspect of how their actions made you feel and of the lingering effects it has on you as a medical setting sexual assault survivor. The emotional aspect are perhaps the most important points to be made. Be polite but be clear. Don't offer them excuses. Don't rant.
Said another way using the "I'm OK, you're OK but we have a problem that needs to be addressed" approach that I learned in grad school which served me well in the corporate world: The manner in which those two women treated me was unacceptable and caused me significant emotional harm; lets talk about how it can be prevented for other patients going forward. What that does is keep the focus on the problem itself in an action oriented manner. It keeps the focus on the actions of those two women rather than on the two women as individuals. That gives more leeway for solutions. It invites the other party to join you in resolving an issue that you share, albeit from opposite sides. It seeks a win-win solution by making the other party a partner rather than being a test of wills that seeks only win-lose by making the other party an enemy. This is how I did things with great success; be it for contract negotiations, personnel issues, performance issues, and any manner of problem resolution.
Good luck. Keep us informed as we all learn from the experiences of others in this regard.
Hello Biker,
Your suggestions for 58flyer's letter are stellar!
Reginald
I found this wording by a contributor to a clinical ethics listserv:
I would view the privilege of working in health care much like the privilege of operating a motor vehicle. It must be earned by demonstrating a basic respect for the safety of our fellow humans.
And I look at "safety" fully from a physical but also emotional, psychological or psychiatric point of view. Health care workers must demonstrate the are attentive to the activity and "can stay in their lane and on the road". ..Maurice.
Biker,
Your tips and advice are very much appreciated. I was thinking along the lines of making something good come out of this. I have to confess that I never heard of the term action element. I have been researching the meaning of it and I think I understand what you mean. Great advice.
In addition to writing the CEO I am thinking about writing a letter direct to each of the 2 therapists to let them know how they made me feel after I clearly indicated my opposition to their involvement. I was very angry at first but now that has subsided and I just want to let them know how I felt and provide strategies on how to prevent harming patients in the future.
As an aside I was going through the records of the hospital and was reading the 2 therapists account of the shower session. I was dismayed when I read that one of them wrote that "the patient tolerated the session well." What a lie! She has no idea! She should have known that I would not have tolerated well since I articulated my concern about the gender issue. In another line she wrote that I was unable to dry the buttocks and lower extremities. I take that to mean they jumped in and dried me off. She also wrote that she had to help me "thread his feet into the briefs." I'm just glad I don't remember any of that. Then I had to go to the activity room for the following week and see those 2 women every day feeling really uncomfortable knowing they had seen all of me. That which is seen cannot be unseen.
I was thinking of CC'ing a copy of the letter to the CEO and the letters to the therapists to the nurse in charge of quality control. Should I or shouldn't I?
58flyer
Dr. Bernstein,
That was a great point you made in your last post about basic respect. Clearly, the basic respect was missing in my encounter with the therapists with my recent hospitalization. They said they respected my dignity, yet disregarded my concerns. They did not "stay in their lane."
58flyer
58flyer brought up another point which is a very common happening--medical records with false statements/observations. Not only are numerous entries in my husband's records intentionally falsified but I know of so many other people who have found false statements/observations in their records. This begs the question of are these really true/accurate narrations of the medical encounter or are they purposely manipulated to ward off legal consequences of their actions? According to CMS, medical records are the only source of material allowed or believed to tell the story of the medical encounter. I was told by a CMS supervisor the medical records are accurate and patients are not believed bc they lie. However, she held that line until I brought up not one but multiple glaring examples of false entries. She then changed her tune to say I should realize sometimes they make mistakes. So in other words medical records are true until they are not and then it is still okay and nothing is done.
What this narrow-minded woman failed to admit or maybe she is so brainwashed by CMS's endeavor to not protect patients from inaccurate/damaging MRs, is how dangerous their practice of not making sure MRs are truly accurate. If a patient has an allergy to a medicine but the provider for whatever reason fails to record that for whatever personal reason they have, a patient could be seriously injured or even die. My husband was put on meds resulting from the medical assault that initially caused him severe reactions. Once we got copies of those MRs, the negligent wrote "patient tolerated meds well' which was an outright lie. He told my husband to stick with them. However, my husband didn't and switched doctors once the invisible waiting period was over. Because of those lies and the attitude of some medical providers is why to this day my husband is RX free but his MRs have in them he is on certain meds. If MRs are not a true representation than 2 can play that game. It messes with the data too.
Because MRs are inaccurate and give a false narrative like in 58flyer's and my husband's circumstance, anyone viewing those MRs in the future will think everything was fine. No, 58flyer is not fine with opposite gender intimate care. My husband was not fine with multiple medical and sexual assaults. Because MRs are so full of lies, there is no way to discern the truths from the lies. Therefore, we do not use the MRs. We do not authorize access to them. They are a work of fiction. As far as the stenting, we have taken the stent card and marked off all info but the serial number and added onto the card that under no circumstance are they to make contact with the hospital from hell or the doctor from hell. Their actions has caused my husband to take on risks he should not have had to come to terms with. Inaccurate/false medical records do have consequences.
And how do you all evaluate the physician, nurse or others in the medical profession by their bodily attire? Be sure to read this current article regarding a current formal survey on this subject. I would like to read whether their professional dressed appearance has anything to do with what you as a patient expect them to behave and accomplish. ..Maurice.
I hope you write us your opinion of what difference it makes how a medical professional dresses. Isn't their dress a reflection of healthcare provider dignity? ..Maurice.
58flyer, I wouldn't send letters to the two women. I totally understand wanting them to understand how it made you feel but it could detract from the letter to the CEO as it could come across as harassment. The larger goal is for the CEO to make changes in how such things are handled so I'd keep my focus on him.
Sorry for the confusing term "action element". It was a common phrase in the corporate environment I lived in. Meetings didn't end w/o it being clear what the next steps were, same with written communications. Otherwise it wouldn't be more than a discussion.
I think the "tolerated well" must be a stock phrase hospital systems use. It is on every one of my cystoscopy and dermatology skin exam summaries.
JR is right about the incorrect medical records. My last skin exam summary said I refused a full skin exam. I did not. The one before that said I had a full exam. I did not. I may just discontinue getting skin exams altogether. This last time he barely looked at any of me. I never even got out of the chair. At a minimum I need a new doctor, though the one I have is the dept head. I suspect not wanting him will get me labeled as a problem patient so it might be best to seek a different practice, which is easier said than done given the rural nature of where I live.
Dr. Bernstein, I am probably not a good one to comment on how doctors dress given the casual nature of dress in Northern New England. If you recall the media reaction to how Bernie Sanders was dressed at the inauguration this past January, up here no one would have given it a second thought or even noticed had the media not drawn attention to it. When the media drew attention to it, people thought he was the one who dressed appropriately for the weather and it was everyone else who looked silly dressing as they did for a prolonged outdoor event in the winter. It wasn't all that cold (42F - I looked it up) but sitting still and with a breeze will get chilly after a while, so Bernie was the smart one.
My expectations are that my doctors will be dressed neatly and cleanly but there is no need for a lot of formality.
Biker and 58flyer,
Thanks for providing examples of false MRs. It is more common than anyone can imagine. The advent of EHRs has made the falsification of MRs more easily done rather done by error or intentionally. Also, I agree that 58flyer should not write to the 2 women involved as it will be perceived as harassing and maybe even threatening. Many of us would like to write to the ones who have harmed us but it is not a good idea. Keep it simple and to the point. Lead them into thinking they have discovered both the issue and how to fix it. They really should be directed to Misty's site--MedicalPatientModesty.org because she has all the information and it is delivered in an non threatening manner.
Dr. B.,
Patients are evaluated on how they appear by the medical staff so it is only fair we also evaluate them. I don't care if the dr. wears a white coat. In fact, I prefer if they don't. A clearly visible nametag is all they need. Back in the day, I remember drs. just wearing a shirt, tie and of course, slacks. The white coat is more for them to set themselves apart from and above us. I do judge when I see staff wearing scrubs in public as they are germy and should be left at the hospital. However, I too dress in my uniform for visiting health providers in basic black. That is how I now feel about them. No jewelry or other personally identifying articles so I can just imagine their observation. Their shoes are my best judging of them. Tells me a lot about them. Shoes are the souls for personal observations.
How about my blog thread title
"Is Being A Modest Doctor a Virtue and a Benefit for Their Patients?" from February 22,2008. This thread and the responses fit with the current discussion here about the physical appearance and dress of the healthcare provider.
..Maurice.
Concerned Patient
As far as a female dermatologist requiring a chaperone during the full body exam of a male patient… Why can’t the dermatologist require the chaperone to turn her head during the genital exam of the male patient thereby not embarrassing him with an unnecessary set of eyes viewing his genitals.
Dr. Bernstein, I read that modest doctor thread and found the very last post from TS quite interesting. I think it would be a good thing if doctors were personally modest in that it would likely increase the chance of their being sympathetic to modest patients. Of course none of us have any way of knowing of our doctors are modest or practicing nudists.
Concerned Patient, I don't think most dermatologists care whether their patients are embarrassed or not, at least the male patients. They wouldn't turn it into a spectator sport if they did care.
Concerned Patient
I would love to see a dermatologist comment on the above blog and explain why this does not happen at the office visit. Most men, even though they won’t admit it, have enough modesty that they don’t want another female watching an exam of their genitals, when it is totally unnecessary!! A lot of men are so humiliated by their experience during a full body exam, that they will forgo any future visits to the dermatologist which could cost them their life if a melanoma is not found early enough!! Please consider this in the future.
Concerned Patient, I concur with Biker that most dermatologists don't care about what their male patients think about the female observers. My few experiences with dermatologists shows that they will respond if you SPEAK UP. My last full skin assessment was conducted by only the doctor, but only after I told the medical assistant that I wanted no-one in the room with the doctor. Since then, the male dermatologist has been replaced by a female doctor. At least they were thoughtful enough to call me in advance of my visit to ask if I was OK with the female replacement. I was not and the appt was cancelled. Going forward I will have to ask if they will recommend a male dermatologist for my next skin assessment. We will see. I have been real busy with my primary over this Covid thing and my orthopedic doctor with my hip replacement acting up. I am trying to get more done this fiscal year since I have reached my out of pocket limits for the year.
Dr. Bernstein, I have not yet read the modest doctor thread but I think my orthopedic doctor is modest himself. He went out of his way to accommodate my modesty requests and would not allow unrinary catheters for the hip replacement patients. He terminated the female medical assistant who walked into the exam room while my hip incision was being examined by the PA. When he needed his own hip replacement, he opted to go out of town so he would not be treated by the local medical community. I think he is personally modest.
Biker, is there a way I can send you my letter to the rehab hospital CEO for critique, like maybe email? I was to send it before the weekend but I had a problem with the word program so it won't go until Monday, which gives me time for a critique.
58flyer
Concerned Patient, I agree with you about dermatologists and have had my own issues to the point I am contemplating simply not having skin exams anymore. For me personally I can much more readily tolerate a female staff member actually performing a procedure such as cystoscopy prep being she is doing something that is necessary even if I'd of preferred a male staff member. It is observers such as occurs with skin exams that cross the line into the intolerable. Their presence makes it feel like I've been put on display.
The two privacy issues at the top of my personal no-go list are observers and showering/bathing. 58flyer, this is why your recent rehab experience and your prior inpatient experience with the high school girl resonated with me as much as they did. You encountered my two hot buttons.
58flyer, yes of course. I have asked Dr. Bernstein to give you my personal email address.
On your last post, I'm not remembering the account of the MA walking in during your exam, but good for the doctor taking it seriously.
Dr. Bernstein, thanks for passing along Bikers email info.
Biker, Hopefully I have worked out the Word program deficiencies and can get a copy to you for critique. I value and appreciate your input.
58flyer
A small victory for the modest!!
It was a small victory during my last full body exam at the dermatologist when I asked the scribe to turn her back when the dermatologist was about to examine my genital area. She complied because I asked! Sometimes that is all men need to do, is ask! My real complaint is that the scribe didn’t automatically turn her back when she knew I was getting ready to lower my boxer shorts. I don’t want a spectator sitting there viewing my genitals! How would she feel at her OB/GYN appointment if the doctor brought in a male assistant to view her uncovered genitals? A good chance she would file a lawsuit.
58flyer,
I would attach a copy of the medical record with "tolerated well" highlighted. If you are contacting the CEO, it was NOT tolerated well.
"It was certainly not the intention to cause you discomfort..." Many crimes such as DUI, battery, etc. do NOT require intent.
Unless someone makes a prior statement of intent, only actions are measurable. Furthermore intent does not cause harm, but actions do cause harm. (I wold argue that lack of intent only adds insult to injury.)
-- Banterings
Hello,
Please read the Medscape article re hospitalists.
https://www.medscape.com/viewarticle/956103?src=wnl_edit_tpal&uac=256761AY&impID=3552431&faf=1#vp_3
Some posters have advocated (sometimes very vocally) that legal proceedings are a solution to patient maltreatment/ dignity violations (however these may be defined). Apparently, the medical profession is finally taking note that respecting the patient may be a better option. The following is an excerpt from the conclusion of the article:
"An analysis of plaintiffs’ depositions found that the key reasons that patients decided to file a malpractice claim include a poor relationship with the physician – specifically, a lack of empathy from the physician, feeling deserted by the physician, and feeling devalued by the physician. These findings support the use of programs that assist physicians in compassionately disclosing adverse events to patients. Among inpatient physicians, patient satisfaction survey questions about the time the physician spent with the patient and the physician’s concern for the patient are better predictors of the physicians’ risk management performance than is the question about the skill of the physician. In the aftermath of an adverse event, focusing on maintaining a strong patient-physician relationship is not only the right the thing to do, the data tell us that it is also a sensible approach to reducing medicolegal risk."
Interesting! Well! What happens next?
Reginald
Banterings, nice idea, I will consider it. I also found another place in the records where the second female therapist was being evaluated as a student. I feel that played into the primary therapist's determination to get me to cooperate with the shower plan. That will be addressed.
Biker, thanks for the input, it is very much appreciated.
58flyer
58flyer,
Did you know that one was a student? Florida has a pending law that prohibits intimate exams on anesthetized or unconscious patients without explicit consent.
I am assuming that you are in Florida.
Although you were not anesthetized, the issues that damage the PATIENT-provider relationship still exist here. I would pose this to the CEO:
Why not ask? Why ambush?
They knew what they were going do.
This violated the standard of care. Today trauma informed care is the standard of care.
The primary ethical justification for obtaining informed consent from patients is to respect their right to determine what happens to their bodies (ie, respect for autonomy).
I would include this info in your letter.
Speaking of letters, Mel is sending her friend's surgeon a letter outlining the human rights violations. I will keep everyone posted.
-- Banterings
Banterings,
At the time I did not know that one was a student. It was only by reading through the volumous EMR that I found an entry that read: "I provided supervision of this student." I believe that is what motivated the 2 women to push back when I stated I was concerned about the opposite sex issue. I was the subject of a training session that they needed to get done. I will provide a copy of the page in my EMR that shows the student supervision entry when I send in my letter. Also I will send a copy of the entry about tolerating the session well.
58flyer
All students participating in the medical profession in the presence of a patient must indicate or be indicated by others as a "student" and their presence and/or participation in the history taking, physical or procedure must be approved by the patient.
Every patient to which I assigned my first or second year medical student over the years was made aware at the onset that the history and physical would be performed by a student and they were given the opportunity to reject the student's presence. This rejection by the patient was always accepted and followed.
Before I entered a patient's room with a group of 6 students to demonstrate a physical finding, I entered the patient's room alone and explained to the patient about the student visit and then followed the acceptance or rejection by the patient. ..Maurice.
Well, I took in my response to the CEO's letter. I say took it in because I didn't mail it but preferred to take it to the rehab hospital in person. I was going that way anyway. Now awaiting their response.
58flyer
Dr. B, You appear to be a decent and somewhat caring person. However, get a grip. What you describe is not the norm that we as clients find happening to us. You can preach all you want about what you say to students but perhaps you are an exception to the rule. After all the years of running this blog one is clearly snacked in the face that your lovely details regarding your truth is not what the rest of us experience in reality. One has to realize that medical care is an industry/profit making corporation whose only concern is to keep the revolving door of cash flow going. What is to the client's best welfare and interests is not that of the industry. Sorry, wake up and smell the sink of reality.
mitripopulos, what I wrote here is what I have been teaching and monitoring my students for 30 years. It is also based on my personal experience but also, on the other hand, what is written here on my blog and what I read published in the national and international news. Fortunately what has been experienced by others writing here has not been, as yet, my own personal experience as a patient. And, yes, I know that others here can argue that I am being treated in the medical community as a VIP, perhaps even contrary to my objection to the VIP painting, by some, of professional physicians or nurses.
I have given up calling what has been written here as "statistical outliers" and accepting that there is much I don't know and experienced and I also admit that it is certainly possible that all my teaching in the first two years of medical school "goes out the window" as those students move on to physician-hood.
Mitri, as long as there are no "made-up stories" published here, the personal experiences and views are certainly welcome. ..Maurice.
I can't imagine someone going to the trouble of making a "made-up" story of harm as experiencing a real story of harm is pure hell that never goes away or even gets better. Experienced harm is always at the surface and always ready to totally overwhelm the harmed patient and/or family. Every faucet of life known previous to harm is affected. Existing after the harm is realizing how easily medical harm happened to you previously and because nothing has really changed, it can easily happen again. I don't imagine those who might make-up stories recognize the trauma medical harm inflicts. It is the ultimate betrayal for the average person as you allow them to be make you entirely defenseless only to be cruelly betrayed by those you trusted not to harm you. To my husband, this feels worse than if he would have experience a similar harm from a stranger. Whether this harm is the callous and dismissive manner in which medical personnel abuse your personal dignity to the more criminal behaviors of lack of consent, sexual assault, etc. the emotional toll is very similar. However the harm is inflicted, the outcome for the harmed is a lifetime sentence while those who harm continue as if nothing ever happened which does make the trauma even worse.
I don't know if you, Dr. B., as a medical provider and as one who espouses they have never suffered harm, can understand what I saying. I do know without any doubt, the inflicted harm has changed both my husband and me forever. I can tell from others who regularly write on this blog, it has changed them forever too. My question to you, Dr. B. and all other medical providers, why is it so difficult to comprehend that actions do have consequences and changing the way in which health care is delivered to patients can be a positive action for all those involved. If medical staff were truly humane and compassionate in the manner in which they delivered their services, patients would be less likely to complain and even to file malpractice lawsuits. I wrote the article for future medical providers to review on how to more respectfully interact with patients. It is a start in the education of them along with the wealth of information on MedicalPatientModesty.org Info of this type should be part of their educational process and not just a passing remark but making it a truly important part of their education.
I presented the following to a clinical ethics listserv when there was discussion about the classic Hippocratic Oath potentially covering our current professional life and requirements.
https://www.pitt.edu/pittwire/features-articles/modern-day-hippocrates-incoming-school-medicine-students-write-their-own-oath
University of Pittsburgh School of Medicine Class of 2024 Oath
As the entering class of 2020, we start our medical journey amidst the COVID-19 pandemic and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery. We honor the 700,000+ lives lost to COVID-19, despite the sacrifices of health care workers.
We recognize the fundamental failings of our health care and political systems in serving vulnerable communities. This oath is the first step in our enduring commitment to repairing the injustices against those historically ignored and abused in medicine: Black patients, Indigenous patients, Patients of Color and all marginalized populations who have received substandard care as a result of their identity and limited resources.
Acknowledging the privilege and responsibility that come with being a physician, I take this oath as a call to action to fulfill my duty to patients, to the medical profession and to society.
Thereby, I pledge as a physician and lifelong student of medicine:
I will support and collaborate with my colleagues across disciplines and professions, while respecting the patient’s vital role on the health care team.
I will honor my physical, mental and emotional health so as to not lessen the quality of care I provide.
I will carry on the legacy of my predecessors by mentoring the next generation of diverse physicians.
I will recognize the pivotal role of ethical research in the advancement of medicine and commit myself to endless scholarship with the ultimate goal of improving patient care.
I will care for my patients’ holistic well-being, not solely their pathology. With empathy, compassion and humility, I will prioritize understanding each patient’s narrative, background and experiences while protecting privacy and autonomy.
I will champion diversity in both medicine and society, and promote an inclusive environment by respecting the perspectives of others and relentlessly seeking to identify and eliminate my personal biases.
I will be an ally to those of low socioeconomic status, the BIPOC community, the LGBTQIA+ community, womxn/women, differently-abled individuals and other underserved groups in order to dismantle the systemic racism and prejudice that medical professionals and society have perpetuated.
I will educate myself on social determinants of health in order to use my voice as a physician to advocate for a more equitable health care system from the local to the global level.
I will restore trust between the health care community and the population in which I serve by holding myself and others accountable, and by combating misinformation in order to improve health literacy.
In making this oath, I embrace the ever-changing responsibilities of being a physician and pledge to uphold the integrity of the profession in the clinic and beyond.
Are you all happy with this Oath all these students starting medical school will speak out to their teachers and family gathered for the "White Coat Ceremony"? ..Maurice.
Dr. Bernstein, I'd prefer a simpler statement myself. The author certainly means well in their own mind but it does have an elitist savior ring to it. To me the statement reads that the care they give will be shaded by the boxes the patient checks off on the "woke checklist" rather than seeing each patient as a unique individual to be treated equally regardless of which boxes they check off. The author is somewhat demeaning in that they seem to see all non-white, non-male, non-disabled, not-gay patients as victims in need of their protection. Paternalism anyone?
One good aspect is it mentions socioeconomic status. I think that is a larger determinant of how people are treated than are most of the other defining variables.
Biker, the authors were medical students about to start 2020 first year in medical school and prepared this Oath themselves for their entire class to "take". Of course, there was a representative from the medical school administration to help but as I understand it from that representative, the Oath was basically written by the students.
Can you present to us the full Oath statements, as presented, which upset you the most and the Oath statements which specific statements which pleases you? ..Maurice.
Dr. Bernstein, none of the statement upsets me as it is all so par for the course of what saturates the national dialog these days from anyone looking to virtue signal, but here are a couple statements worth commenting on:
"...and a national civil rights movement reinvigorated by the killings of Breonna Taylor, George Floyd and Ahmaud Arbery." Their deaths had nothing to do with healthcare and there is nothing anything anyone can do as a doctor which could have prevented those deaths. If the author wants to convey healthcare as being racist, then use examples of racism in the delivery of healthcare.
"This oath is the first step in our enduring commitment to repairing the injustices against those historically ignored and abused in medicine: Black patients, Indigenous patients, Patients of Color and all marginalized populations who have received substandard care as a result of their identity and limited resources." Note it says "identity and limited resources" rather than "identity or limited resources". There is a huge difference between identity and limited resources, and here the author gives us a classic stereotype inferring that non-white people are poor and white people are not poor. There are millions of poor white people out there too as well as millions of middle and upper class blacks and Hispanics. That blacks and Hispanics may have a higher rate of poverty than whites & Asians is not an excuse for stereotyping in this manner. As I said in my first post, socioeconomic status is likely a greater factor than identity.
"I will be an ally to those of low socioeconomic status, the BIPOC community, the LGBTQIA+ community, womxn/women, differently-abled individuals and other underserved groups in order to dismantle the systemic racism and prejudice that medical professionals and society have perpetuated." Again, this is the kind of pandering statement required of anyone looking to virtue signal. There seems to be a compulsion to do so these days from people who want to be seen as the savior of their chosen profession. Rather than aspiring to be social justice warriors, I'd like to think future doctors were seeking to be expert in their craft while committing to treat all patients equally and with dignity.
The other thing is that when the author includes maybe 75 - 80% of the population (women, non-white men, and white men that check any of the other boxes) in their list of victims, it really would be easier to say the population is diverse and they'll treat everyone equally no matter what boxes they check.
I agree w/ Biker that the deaths of Floyd and other blacks have nothing to do w/ racism in healthcare. It does point to possible dangers of those who authored or signed on to this "oath" are as they are creating hate and false statements against others. There is no proof that Floyd's death was a racist event. We can argue that when an unarmed white person is killed by a black cop or a white person is killed by a black person that racism is involved bc the media/govt. is signaling all white ppl are inherently racist. So my big concern is the false racism beliefs of this med student & others like him/her will lead to them maybe harming a patient representative of their hate beliefs.
Hate crimes in the medical setting can and do happen. You have the doctor from CNN saying inflammatory remarks against the unvaxxed. You have drs. saying whites are racist. You have female drs. saying men are pigs. Does this affect patients? Of course it does. My husband was sexually violated by a pack of nurses who believed (per their social media) that older white men sexually harass/violate women so they set about to inflict on an innocent, sedated man sexual violations all the while laughing as they were doing it. I, as an unvaxxed person, would fear even more for my life if by no choice of my own I was taken to a hospital where someone like the CNN doctor practices. Given her statements, I object even more to any medical treatment by her than I would of the average doctor. Of course, to receive any medical treatment I would have to be unconscious because I have been forced by the actions of the medical community to refuse medical treatment as there has been no effort to stop their criminal activity. i don't this author would recognize my older white husband was a victim of a hate crime. They could even choose what the hate crime was: was it because he is an older white guy from an area thought of as being Republican or was it because he was labeled as being a gay, married man at a catholic hospital involved in a lawsuit to deny medical care to the LGBTQ community?
I agree with Biker a doctor or any anyone in the medical industry should worry about the patient and not so much if they are black, white, purple, male, female or somewhere in-between. A patient is a human and by given labels they are creating an atmosphere of inequality thus lack of fair and impartial care. It worries me even more knowing there are medical providers out there like the ones this "oath" exposes. Doctors who do not deal in facts are future patient harmers. Doctors must deal in facts and must not like their personal biases interfere in their delivery of medical care.
Questionnaires that limit the answers that can be given aren't questionnaires at all. There needs to be blank spots for other concerns.
I think that patients should write the oath.
I bet it would look very different...
-- Banterings
I hope we can get back to the discussion concerning patient dignity and patient modesty to which this blog addresses and take the other discussions to Facebook and Twitter. There are many who read this blog that would like to hear others’ experiences with dignity and modesty concerns and what can be done to improve the situation. Concerned Patient
Concerned Patient,
While on the surface, some of the discussions look like they have nothing to do with bodily dignity, it does. Not only do the attitudes and guidance coming down from corporate level control but how these medical providers personally feel such as their biases. If you have a medical provider willing to inflict say for instance a procedure without consent, do you think that same medical provider would have any hesitation in committing dignity offenses? All their life's influences help to shape them into the medical provider you experience. The oaths they take also shape their attitudes or else there would be no oaths.
The fact that medical student was willing to call what was done to a man with a rap sheet a mile long who was in the midst of committing a criminal act racism instead of what it was and that was a cop who believed he had ultimate power and control to harm at will, is concerning. To me, this same medical student is a danger bc facts are not something that student is big on. I also feel from reading the oath that med student would have no issue using their power and control over a patient by inflicting upon a patient unnecessary exposure. Discussions even on what appears to be different, unrelated issues gives a glimpse into why there are so many dignity crimes being committed. Talking abt the CNN doctor also told me someone like her would be one who also would have no issue in unnecessarily exposing a patient bc she seems to feel superior and has the attitude "because I say so is why it must be done". Again, ones like her are the ones who seem not to care abt dignity and therefore influence others who personalities are not as strong to aid in committing the dignity offenses.
By talking abt other issues, we see their mindset and their mindset is not really patient-friendly. Far too many of them believe a patient must give up their right to dignity and even autonomy to receive treatment. I have said they believe patients are their property to do with as they please which would explain why dignity is not something they believe needs to be safeguarded and protected although some oaths do cover the preservation of patient dignity. If you want to read a very short summary of my husband's medical assault and rape, please go to https://medicalerrorinterviews.podbean.com/e/larry-jane-part-1-profit-and-punishment-profiteering-hospitals-intersect-with-religious-bigotry/ for part 1 and for part 2 https://medicalerrorinterviews.podbean.com/e/larry-jane-part-2-profit-and-punishment-profiteering-hospitals-intersect-with-religious-bigotry/ The crowd here is tired of hearing it. Yes, I do Twitter and FB some bc we need to get the word out there. I also do a weekly show with CS on Spreaker mainly addressing dignity concerns. We also have different guests on to talk abt their experience. This past Monday we had on a therapist talking about medical PTSD. We also cover other medical issues as really in the big picture, all are related.
Concerned Patient, wouldn't patients re-writing the Hippocratic Oath to be followed by medical students moving into the profession, as suggested by Banterings, be an act which could and would "improve the situation"? To me, that suggestion would certainly represent an act reflecting attention to an element of patient dignity.
What element? Patient autonomy (the patient to set the rules for the patient's care). ..Maurice.
Dr. B.,
In the article I wrote for you, I pointed out the med community always talks abt a patient care team working together but usually only includes the patient as a team member and not as the captain of the team. IMO, the patient is the captain and all others work for the good of the patient. The patient receives all the info. and advice but is the one who makes the final decision. However, this is not really how it works as many in the medical field patients are not the decision-makers but rather just the victim (oops--patient) who signs off on the medical team's recommendation.
Autonomy and dignity are 2 of the biggest issues for patients as both are pretty much ignored or abused. There is much talk abt informed consent but much consent is not really well informed as far too many med. providers only give the info they want the patient to have. Consent is usually given by the patient based on the little info they have rather than putting it all out there so the patient may make a truly informed decision.
In all this, we have the issue that within the informed consent process, many patients if not most are not told what the procedure entails like how much nudity, how it is done and by who. Anesthesiologists are assigned rather than the patient's choice so many times you also get a different gender anesthesiologist. The drugs they use are explained in a very condescending manner as "something to help you relax" for drugs like versed that do much, much more than that. Many pts are unaware they experience the nudity in real time in real misery but the drugs erase the vivid memory from their brain. Many patients also do not realize much of the complete nudity is not necessary but rather is done for the convenience of the staff. Many patients don't know they do have options and are coerced by how the info is presented to them. Also, some are intentionally lied to like one woman was told she could leave her underwear on for foot surgery but was told after she was sedated it had to come off. Bc of the sedation, she complied which is a side effect of sedation. A couple of vets were shaven and had no idea this would happen and now they feel sexually violated. The list could go on and on.
Yes, it is extremely important to educated the medical community in how to deliver exceptional, compassionate, humane, and dignified care to every patient. Patients must be involved in that process bc we can see what you, Dr. B., find acceptable is not always acceptable to us. It is #OurBodyOurChoice
Well said.
Like Concerned Patient, I too am more focused on matters of basic bodily privacy and respect. It was through those discussions and the experiences of others that I finally found my voice. Hopefully I have in turn helped others by my having spoken up. At the same time I do appreciate that the overall matter of patient dignity encompasses more than just bodily privacy and dignity.
Goodness, you all are so QUIET! This has nothing to do with what we were talking about but Friday our family lost an uncle to Covid. The bad thing is even though he was somewhat elderly, he was always so HEALTHY! I can't wait for this pandemic to be GONE!
JF--Sorry for your loss. It is never easy to lose someone.
This week the govt. has just confirmed that medical autonomy for patients does not exist by Biden saying he wants the private sector to mandate vaccines for employees. What is next? This is a slippery slope and certainly steps backwards in trying to preserve and increase patient dignity. The idea that individuals must show their private medical info in NYC is also another blow to patient dignity bc that signals that individuals do not have the right to medical privacy which also means that bodily privacy will be taken even less seriously than it is now. The more enlightened the medical community becomes, the more darkened the clouds become over areas of patient rights such as dignity and autonomy. It is clear the medical doesn't have to be right or even have facts but all they need is power and control to take away your basic human rights. When will normal people realize what is happening? Will they "wake" up before all of us are just processed through the medical system like cattle gone to be slaughtered? Do you really think if you cannot refuse a vaccine or do normal activities the end of any semblance of dignified care is not far behind?
JR, "medical privacy", relative to a specific communicable disease, does not apply when a possibly infected individual has entered the civic community and can potentially transmit the infections to others in the community. There are limits to "privacy". And with pandemics, virtually everyone has that potential. This is how it has been in the past and this is how it is in the present and how it will be in the future. ..Maurice.
Dr. B.,
Yes, I know that is the case. However, COVID is being cherry-picked as there are other diseases which also kill others when the infected person interacts within the community. Hep C, influenza, MRSA, whooping cough and many others the US currently do not have the guidelines. Even the common cold can kill an unsuspecting immune compromised person. Also, please keep in mind that the old saying: "Give them an inch, they'll take a foot." If people do not fight this loss of medical privacy/freedom, mores losses will follow bc the taste and need for power will cross any boundaries. Do people need to be responsible? Yes, but that is the individual's responsibility. Does this mean the door greater at Walmart now has the right to ask for all of your medical history before allowing you to enter? If you are gay man or a drug user, are you practicing safe sex and do you use clean needles? Are these questions acceptable? May I ask any healthcare worker I come in contact with their status as far as the spread of other diseases? Do vaccines prohibit the spread of COVID? No, they do not as there seems to be a never-ending need for more and more "boosters". At what point do the boosters cease? At what cost to an individual's health does the need for more and more maybe even more frequent boosters stop? I have not heard anyone saying they guarantee these vaccines will not jeopardize our long-term health? Have you? We currently have laws to prohibit drunk driving. The deaths resulting from drunk drivers has long been in epidemic proportions but yet nothing much is done. Medical harm too has long been in pandemic numbers but yet nothing is done. How is that working out? Examine the facts. Do I have the right to ask any and every food service worker their vaccine status bc food service workers have been known to spread diseases. Where does the intrusion into someone's privacy stop or does it? I say it will not stop and bodily privacy that most of here have suffered infractions of will cease to exist all together. It is that inch and foot thing.
To re-emphasize and clarify, "medical privacy" does apply to an individual's personal therapeutic decisions, generally whether to take a dose of medication for a non-communicable disease or not. But there are limits. For example, shouldn't professionally active physicians be required to inform their patients regarding the physician's use of drugs which may affect their ability to fully evaluate a patient's medical condition or performing a procedure upon that patient? Wouldn't you as a patient feel the need and along with a legal-ethical basis to be so informed? The COVID pandemic has set the same legal-ethical basis for everyone to be aware and practice. There is a limit to where a patient or potential-patient's rights end and that also includes all medical-surgical practitioners. ..Maurice.
Dr. B.,
I have long said that all medical providers including doctors, nurses, techs, etc. who are involved in patient care, should be tested daily by an unbiased company for the presence of drugs and alcohol. I believe this is the right of every patient to know their medical provider is not compromised by drug/alcohol usage. If the some of the nurses involved in the care of my husband had been tested, what happened to him probably would have never happened bc at least 2 of them from private investigation have substance abuse issues. The lead molester freely talks abt her love of Mollys (and her working in CCU) and her even more love of all things alcohol. The rate of substance abuse in the medical world is alarming bc those are more likely the ones causing patient harm by their actions. All medical providers should also be routinely tested and results made available to patients for MRSA (they test patients for this along w/ several others) and other diseases. There also should be a completely unbiased and available rating systems for all patients to rate all medical providers without fear of retaliation so we know if medical providers are compliant with patient rights such as dignity and autonomy. I am not talking abt bashing but real helpful evaluations so patients know what type of medical provider they may experience.
JR. I don't know if you'll agree with this or not but I believe that a lot of people think Covid was deliberately created. And not just by Trump supporters either. Everything isn't about him. I suspect that it may have been deliberately created also but I sure don't know why or by whom. And I want it to have been gone since last year.
I agree with Dr. Bernstein that public health considerations must sometimes take precedent over individual rights. It happens all the time without most of us giving it a second thought. At the same time I agree with JR that there is no consistency in how govt. and other authorities go about it. In the case of covid, science has too often been compromised by politics (and perhaps driven by the economics behind politics) to create mandates that come across as nonsensical. I've spoken to that with examples previously. The do as I say not as I do that we continue to get from the political elite casts a shadow on what they say, making the situation all the worse.
We were told restrictions were necessary to flatten the curve but then that wasn't the goal anymore. We were told we needed to be vaxxed so as to protect us but apparently being vaxxed isn't going to get us out of restrictions either. Viruses do not go away but instead become part of the background noise we live with. My State is about 86% vaxxed and continues to have an extremely low rate of infection and illness, but some in the political arena are now screaming we need more restrictions put in place because covid hasn't gone away entirely.
I say these things as someone who has gotten the vax and who has worn a mask when told to wear a mask and who has kept himself socially distanced so as to protect my immuno-compromised wife. I also say these things as someone living in a culture that still carries echos of our Puritan ancestors with their "personal accountability, community responsibility" ethic. The community responsibility part is perhaps why we have such a high rate of people being vaccinated and of the level of cooperation in living with the mandates, though at this point I'm not sure they'll have the same level of cooperation going forward if they start with new mandates and restrictions as some in the political arena are demanding.
JF, Biker, et al,
There are only like 5 (maybe 12) labs in the world that do the type of work that the Wuhan lab does. They have been studying bat corona viruses since 2010 (that we know of). The bats that were the source of the virus come from (I believe) 500 miles away.
No reasonable, sane person would believe that the virus came from a market THAT JUST HAPPENED TO BE IN THE SAME CITY. Even worse, the lab leak was labeled a conspiracy theory, people discussing it were censored or banned from social media.
Amidst allegations Big Tech has silenced COVID lab leak theory, we find out that Google funded virus research carried out by Wuhan-linked scientist Peter Daszak for over a decade. (Via Daily Mail UK)
Fauci has flip-flopped, lied, obscured everything about the pandemic. (It seems that he has gotten everything wrong. Fauci warned in 2017 of a surprise outbreak during the Trump administration. (via the Huffington Post)
Then we learned from his emails that Fauci (via NIH) funded bat coronavirus research at the Wuhan lab.
It is no wonder that the public does not trust the government, public health officials, or healthcare providers. Couple that with shame, bullying, mandates on those hesitant about a vaccine under emergency use with no long term safety data. (It seems the vaccine can NOT stand on its own merits.)
Discussion has been further stifled and censored about valid concerns of the vaccine. One such issue is that raised by Dr. Robert Malone, creator of mRNA vaccine technology, said the COVID vaccine lipid nanoparticles — which tell the body to produce the spike protein — leave the injection site and accumulate in organs (especially the ovaries), bone marrow, and tissues.
This was in a Japanese biodistribution study (which had been kept from the public) until obtained as a result of a freedom of information request made to the Japanese government for Pfizer data.
Here is the document in English.
There is so much more that has eroded any trust in the profession of medicine. It seems that this is an "all in" gamble for the profession, which they are going to lose...
-- Banterings
Should personal medical decisions of a patient set a sign of the dignity or undignified behavior of a patient? If so, should steps be taken by the medical profession to encourage change of behavior?
Example: Patient enters the hospital emergency room with COVID symptoms and diagnosis of varying degrees of symptoms.
That patient is known to have been unvaccinated for COVID and indeed had rejected the opportunity for COVID immunization. Should that patient be rejected treatment and hospital admission despite the United States EMTALA law? Would the reasoning for treatment be different compared with a patient that enters with illegal drug overdose? If admitted, should the COVID patient be subjected to a heavier hospital bill for the same degree of treatment compared to a patient who entered COVID vaccinated?
Under EMtALA federal law (https://www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/emtala.pdf)
How about, in the current news,
Delta Airlines imposes $200 monthly surcharge on unvaccinated staff
since "the average hospital stay for Covid-19 now costs Delta $50,000 per person."
https://www.bbc.com/news/business-58335109
Where does patient dignity (and should dignity include "responsibility") begin and end? As Moderator, I am posing the question based on current national discussion. ..Maurice.
Maurice,
If one is going to mandate shots, then they need to take liability for the adverse reactions and side effects. Here are some other issues:
The term anti-vax is a pejorative. The vast majority of these people are POR-CHOICE. They are saying, "I don't care what you do, I just choose different for MYSELF. They are also hesitant about a vaccine with NO long term safety data. These people (like myself) have received other vaccines. (I get Tdap every 7 years because I am accident prone.)
In contrast, the pro-vax crowd is trying to tell other people what to do with their bodies. This lacks total respect for the dignity of other human beings.
The mask and vaccine mandate crowd exists on the narrowest of margins in the US. The vice president is needed to break ties in the senate.
Be careful of the feet that you step on today, they may be attached to the ass that you are kissing tomorrow.
I say let them mandate masks and vaccines, destroy businesses and lives, let them censor debate and obscure the truth. When the pendulum swings the other way, the profession of medicine will only have itself to blame...
-- Banterings
Why should the average stay in a hospital charge $50 000 dollars for a Covid patient? The outrageous cost of medical care is the biggest reason people die as anything. Why can't anybody in power investigate what other countries do and follow their lead?
In 2018, the price tag for my husband's 2 day after his multiple medical assaults was well over $500K being a lot closer to $1 million if you count everything from both hospitals. I cannot understand how medical "care" has been allowed to be this outrageous.
Should a patient who is known to be a drunk driver be disallowed medical care or charged more bc they willfully chose to disregard the law? Key word here: LAW. Should a person who is injured in the commission of committing a crime be denied medical care? If they deny non-vaccinated people treatment than they'd better deny criminals treatment. And here I thought medical providers were non-judgmental but alas that myth has been busted time and time again. They are judgmental bc some of them believe they have the right to force or withhold treatment on non-vaccinated people. Some of these poor excuses for medical providers seem to be taking arrogant joy in saying they will decide what ill person is worthy of their "care". Is the oath now "Let me choose to whom I want to harm" rather than "do no harm."?
If medical providers can decide to harm patients by deny treatment than wouldn't the flipside of this be patients be able to harm medical providers who harm them? If we have medical providers who intentionally decide to harm selected groups of people and admitting to wanting to harm selected groups of people, do we not have an even larger issue with medical harm than we already do? Where would the line be drawn for the public approval of harming patients? Now, it is a silent harm bc most victims never get their day in court. The Fatas of the world don't really get consequences for the true crimes they commit but rather get some sissy slap on the wrist so the Fatas of the world would become even emboldened to harm patients. The nurses who harmed my husband would probably feel safe to publicly molest a selected male patient bc they could justify it bc the example would have already been given and accepted.
Right now, we have medical harm happening but it is done quietly and hidden from view. Now they are so emboldened they feel they can justify the harming of patients in the public arena without fear of consequence. Wow!!! I have had an extremely low opinion of the medical community ever since they medically & sexually assaulted my husband multiple time but now even I am speechless at how low they can go. The stupid fools don't follow the science themselves or else they would know the vaxxed can both get and spread COVID. Are they so upset they got the shot they want everyone to have to suffer all the unknown, long-term side effects from a vaccine we really know nothing about and isn't even doing its job well?
Archie,
As usual, beautifully said. I am not anti-vax but I do have an issue with this vaccine. I do have issues with others as they will not be totally truthful abt long-term side effects. I firmly believe my son is a type I diabetic bc of side effects. I do believe they know but do no feel we have the right to know. They need to be more truthful. They need to research testing methods to predict what side effects if any an individual may be prone to suffering. They developed a COVID shot in less than a year so you would think they'd be able to predict if someone taking the standard vaxes of old would suffer side effects and which ones. However, for Big Pharma, the money is in treating illnesses and luckily for them everything they produce causes the need for more medicines and more procedures.
Do you think that all that is necessary for everyone to get COVID vaccination would be for those who reject this vaccination but have uncertainties about their health in this pandemic should set up a Ulysses Contract with their physician?
Ulysses contract, referring to the mythology of when Ulysses had his crew tie him to the mast of the ship as they sailed past the Sirens and instructed them keep him there no matter what he said or did to the contrary.
I recognize this as a silly proposal here but there may be some visitors to this blog thread who would want such an approach to counter their fears and clinically protect their health. ..Maurice.
Dr. B.,
You are not understanding the mistrust of this vaccine goes well past the local doctor. It is Big Pharma who has lied time and time again. It is the govt which has lied time and time again. The present national govt. is acting more like a dictatorship rather than the open govt we are used to having. Many local doctors do not take the time to read abt different meds like their ingredients and even side effects. They rely on the local pharmacist to inform the patient or answer questions.
Some sites giving the vax supposedly can't even answer to the victim which shot they are getting. They don't have any literature to provide abt risks and side effects. They have no long-term data results to share. For someone like me who has seen medical harm up close and personal, all that is surrounding this particular vaccine reminds me of the secrecy and the manipulation when they decided to make my husband a victim of medical harm. Never ever again will we blindly be harmed by them. There is no trust. This is the end result of medical harm.
All involved in the vax needs to be open and honest. This they cannot or will not be bc that is something the govt and the medical community had decided. For me, I know what COVID entails and I am willing to face it. I will not seek medical care and I will not spread it. However, I do know not what the vax could cause. I do know it has side effects but do not know if I would be one it would harm. I do know the vax is not fully effective and ppl still get COVID, can die from COVID and still can spread COVID. I also know no one is willing to take responsibility for any harm the vax may cause. I also know that if the vax harms me I will not seek medical care. So my choices are to live healthy with maybe getting COVID or to get the vax and who knows what illness may occur and still can get COVID.
Medical providers currently do not abide by contracts (ie. consent forms) so I have no faith that having a Ulysses contract would be any different. I know of too many people harmed by medical providers defy the scope of consent or as in my husband's case, having no consent but refusal. It would be great if medical providers would keep their word and not breach contracts but this will not happen. It is always abt them preserving themselves at the expense of the patient.
Dr. Bernstein, ignoring personal experiences and anecdotes, the pandemic seems to have been the final straw for a wide swath of the general public as concerns blind trust in public health professionals. The abysmal and grossly incompetent level of readiness for and subsequent handling of the pandemic was plain as day. Public health thus joined a rogues list of govt. entities that also squandered public trust over the past generation. That they are being congratulatory of their efforts rather than self-critical over what went wrong tells me that the next pandemic to come through will not be managed any better.
Though I took the vax myself, I understand where those who have chosen not to are coming from. My son is amongst them. I spent a few hours in the ER yesterday and both coming and going saw a good crowd of what I assumed were hospital staff protesting a vax mandate that has been imposed. What their roles at the hospital are I don't know but presumably any doctors and nurses amongst them are educated enough to have done their own research and come to their own conclusions. Time will tell which side is right, but by then it will be too late for those who made the wrong choice. That is the truly sad legacy of what happens when trust is lost.
Biker, "when trust is lost" is not only "sad" but may lead to danger. Trust in something like COVID must be based on facts and science and not politics, political diagnosis and political based treatments (https://www.nbcnews.com/politics/donald-trump/trump-suggests-injection-disinfectant-beat-coronavirus-clean-lungs-n1191216). ..Maurice.
Dr. Bernstein, I absolutely agree that public health matters need to be managed based on science and not politics (or underlying incompetence). That said I am still waiting for the science that said to lock down the nursing homes tight in my state while saying it was safe to send infected patients into nursing homes in the state just half an hour west of where I live. Science shouldn't change when you cross a state line, yet apparently we're supposed to believe it did.
I'm as well waiting for the science that said it wasn't safe for me to buy a shirt in the sole proprietor men's clothing store in town that I've never seen more than two people in at a time, while the science said it was safe for warehouses with hundreds of people in them to ship me a shirt instead. Then there's the science that said it wasn't safe for the property mgt. company to send 2 guys with power sweepers to brush the winter's accumulation of sand & gravel back into the road along my 1/3 mile of frontage but it was safe for me to go into town and into a store to rent a sweeper to do it myself. I suspect with 1/3 of a mile of frontage those guys could have maintained a proper social distance from each other outside, but who am I to second guess the public health scientists?
My guess is everyone has these kinds of examples of supposedly science-based mandates. It shouldn't come as a surprise to the powers-that-be that the result is that many people came to not automatically believe anything they say. Then there was the oddity of WHO having different science than the CDC and the CDC having different science than State Health Depts, where of course each State had different science than the others, and of course our major cities then having different science than their state govts. And they wonder how the public has lost trust in public health?
As I said, I got vaxxed but I understand the skepticism of others. I do not have any faith that public health at any level of govt is up to the task of adequately managing whatever the next public health crisis is that comes over the horizon. They blew it big time with the current pandemic and they need to earn back the public's trust.
Biker, I suspect what you were describing as "different science" was in fact "different politics" and such geographic differences which you describe are set by politicians with their own decisions based on how they evaluate popular opinion or set by their own political goals. Unfortunately, science is constrained by political decisions both in terms of what is allowed to be studied (studying requires $$$ of from governments in one way or another) and how the results of the study is expressed and carried out. Thus your argument, unfortunately, does not at all surprise me. But, at present, "that is how it is". ..Maurice.
I agree Dr. Bernstein, but given the extent to which politicians have co-opted and distorted science to their own purposes, the public has grown leery of automatically accepting "science" as actually being science. It is sort of like the boy who cried wolf a bit too often. Of course in the background are economic interests who are funding politicians and their families so as to get those interests made into "science" based public policy. There are as well scientists who distort things so as to get funding for their own operations and institutions too. Pose it as a large enough threat or looming crisis and politicians will throw money at you.
Bottom line is public health took a beating during this pandemic and lost a lot of public trust.
Dr. B.,
Don't forget Joe Biden said early on if we were good and got the shot, he "might let us have a 4th of July cookout" this year. Don't forget Nancy Pelosi mandated masks to be worn in Capitol Bldg but has been photographed not wearing a mask in crowds herself. Don't forget we have been told to get the shot to "stop the spread" but even the vaccinated are still spreading COVID. Don't forget some of the liberal lawmakers are now wanting to mandate mask wearing outdoors when even the CDC has said they do not have any confirmed cases of COVID being spread via outdoors. So where is their science? I tell you where it is--it is a matter of politics. I know there has been a lot of misinformation spread and you cited it about Trump and bleach. Here is the myth buster on that: politifact.com/article/2020/apr/24/context-what-donald-trump-said-about-disinfectant-/ I'd be happy to cite things Joe Biden says but I am afraid we'd not have enough space starting who do I need to call in the DC area about a blatant case of elder abuse. But I should thank you for clearly showing how the medical community misuses information to show their political bias in order to justify a "science" that cannot be justified. For ppl like me, not getting the shot is not a political statement but rather based knowing these vaccines are not truly vetted yet.
The fact is many ppl like my husband and myself do not trust the medical community and the lies and misinformation they have been foisting upon does not help. Our distrust was earned by them through real life actions. I don't care if Trump (suggesting) or Biden (mandating, threatening) is talking abt the safety and the need for the shot, I have no trust in it. My reasoning is not bc of politics (although admittedly Joe's blundering and tyrannical behavior doesn't help) but bc I want true informed consent and I am not getting it. No one can tell me for sure which ppl the vax will cause an issue in and what are the long-term side effects. They won't even be honest abt the currently accepted series of vaccines provide this info and of course, Big Pharma is immune from harm caused by them. Again, years and years the FDA has approved dangerous drugs that have harmed so many ppl only to have these drugs pulled from the market yrs later. Some dangerous drugs are still on the market bc lawsuits have been dismissed bc of technicalities (am thinking of one particular blood thinning drug).
I realize some have a hard time understanding not everyone believes the doctor and the so-called science is never wrong. It was just in the 90s I believe that most older ppl were put on calcium for their bones only to find out it caused heart issues which of course led to heart procedures. Science said this was needed but science was wrong as you have to weigh the benefit against the cons. Also, one blood thinner in particular was given to older ppl which caused fractures which caused falls. I know bc my father was a victim of this.
It is just this vaccine I have issues with but there are so many other examples of the medical community, science, and politics harming us that I must do what I need to do to protect myself from more inflicted harm. I am conscious of my civic responsibility but I have also conscious of my right to personal dignity is my right to medical freedom.
Please note, as I stated earlier, I am NOT antivax.
Why the surprise about vaccines and human dignity in healthcare? Read The Hospital: A Human Rights Wasteland by George Annas (where the care of patients ranged from benign paternalism to medical experimentation).
Read my post above about the Japanese biodistribution study and Google funding viral research (all tied to the Wuhan lab).
Now we find that the Gates Foundation helped raise China's voice of governance in Africa and various ways according to a newly-released batch of emails from the National Institute of Allergy and Infectious Diseases under Dr. Anthony Fauci, obtained by Judicial Watch through a Freedom of Information Act request.
All of this shows big tech has a financial interest in the Covid narrative (censorship) due to ties with China.
Now Christina Parks, PhD (Cellular & Molecular Biology from University of Michigan 1999), her testimony for Michigan HB4471 (8/19/21), lays out the truth on how vaccines really work.
PLEASE WATCH THIS VIDEO
Then in 2012, CDC’s Dr. Willam Thompson stunned the scientific community by saying that he, Dr. Frank DeStefano, and other CDC scientists committed fraud in a major vaccine autism study. According to Thompson, he and his fellow CDC scientists covered up a link between MMR vaccine and autism in African-American boys. The omitted data suggested that African American males who received the MMR vaccine before age 36 months were at increased risk for autism, Thompson later testified.
Guyer et al. (2000) reviewed a century of annual vital statistics for the U.S. and found that about 90% of the decline in infectious disease mortality among U.S. children occurred before the introduction of mass vaccination campaigns. The large gains in life expectancy over the twentieth century were mostly the result of the construction of water and sewer systems, improvements in food safety, hand washing, improvements in housing, and decreased crowding in U.S. cities.
Children born in the 1940s, 1950s, or 1960s got 3 or 4 shots. Children born in the 1970s or 1980s got as many as 12.
Today, the CDC recommends children get 53 shots with 74 different antigens by age 18.
...but everyone says this experimental vaccine is "safe."
-- Bantering
You all should read my 2012 blog ethical issue post titled
"Coerced Medical Care: Is That Ethical?" which is very pertinent to what all is being discussed here. Also, the last Comment was from Anonymous December 31, 2018 but her story sounded just like what could have been written by JR!
Coerced medical care.. is that what is happening now and a mechanism for the obliteration of patient dignity? ..Maurice.
Dr. Bernstein, the parallel of that one woman's comment that you pointed out is uncanny in its resemblance to what JR's husband went through. It affirms again that what JR & her husband went through was not a one-off anomaly.
The examples from banterings post about forced intimate procedures are also additional cases of healthcare staff willingly going along with what amounts to rape simply because some cop or deputy told them to.
One can only assume that the vast majority of such instances never gets any media coverage.
Derogatory slang used in medical professional conversations about the patient and patient care does not in any way enhance patient dignity. Correct? ..Maurice.
Saying derogatory things about other people is abuse. Even if thr person is unaware of it because it influences how other people feel about them. I remember how when I was a new aide at my first nursing home job. Another aide told one of the cooks that Hope didn't need a supper tray. The cook said Why not? And the aide said She's dead! The cook started complaining about having dished up her tray for nothing.
If that had been my family member and l heard staff talking that way l would have been really hurt by their callousness.
I also am aware of doctors shouting at nurses and it creates a strong negative influence and shouldn't be tolerated. Not all bad behavior should actually be punished though. Just let it show up in the evaluations and listed as the reason raises are with held.
When nurses use derogatory slang (and they do it all the time when talking about their patients), & the patient figures it out, the nurse has destroyed any bond of trust that might have existed between the two & they won't get it back whereby putting the patient's care at risk.
Worst part about it is the people in charge don't put a stop to it.
Regards,
NTT
JF and NTT, I couldn't be more in agreement with your conclusions. ..Maurice.
Dr B. It's 9.11 again TWENTY YEARS LATER. But it seems more like 10 years. Two family members had just died. Two major roles. And multiple people were alive and healthy who have since died. Family and friends.
Maurice,
In the late 90's and early 2000's I did business with a company across the street from the Twin Towers. I had been there many times when the towers still stood and after they were gone.
-- Banterings
It's hard to believe 20 years has gone by. I remember working that day. I was assigned to the patrol division in the Police Department of a major Florida city. I still have a copy of my patrol log for that day.
Soon a call went out for volunteers to go to New York to help with the rescue efforts. I was team leader. We mostly worked check points and station house security to give the NYPD guys some time off. Then it came time for a group of us to be assigned to work in Ground Zero, also known as the pit. My team recovered an intact woman from the parking garage below the plaza between the towers and close to where the sculpture was. We also recovered numerous human fragments which were placed into biohazard bags and put in a special container. I recovered an aircraft fuel line which was stored separate from the rest of the wreckage.
Many years later my wife and I went to NYC and visited the 9/11 Museum. The whole area was still under reconstruction so we didn't get to see it as it is today. The museum was open though, at least what it was then. I found a picture of the lady my team had recovered in the pit. I looked at her for a really long time, just remembering the whole experience. A lady volunteer came up to me and inquired if I knew the woman in the picture. I said that I did not but I was a part of the team that recovered her. The volunteer turned out to be the lady's mother! But it was good for us to meet each other.
I want to go back to NYC and see the memorial now that it is finished. A friend that has seen the memorial said that he thought he saw my fuel line on display. I would like to see that.
58flyer
I wrote the following to a bioethics listserv on Saturday 9-11-2021 titled "On This Day of Remembrance: Anything to Learn for Our Pandemic"
Perhaps, I should start by attempting to answer my own question. I am not sure that "underestimating" is
the correct word to use but as I see the basic elementary pathology of the New York portion of the "9/11" was that we were ignorant and unprepared with regard to the fragility of skyscraper constructions and, in addition, its design for emergent evacuation at that time when struck by a large aircraft. Could there be also a form of "fragility" with regard to our full pathologic and sociological aspects of pandemics. As with the skyscraper example, do we need necessary re-evaluation of our current methods of management and prevention?
Do you find this analogy worthy of considering?
..Maurice
What could have been done to prepare? Nobody saw it coming. Maybe giant slides like at Amusement parks? Probably parachutes wouldn't work either. It wasn't high enough to activate them but nobody saw it coming. In one of my Devotionals I read that more people had called off that day than at any other time so that either had to do with premonition of danger or people praying for safety.
Also for the towers to have caught on so much fire there MAY have been people plotting and scheming inside of the buildings placing explosives in .
So far as the Corona Virus we don't know if someone is attacking us or WHY this is happening. I have kind of hoped that some of the work that medical staff has been doing could now be done by NON medical staff.And by people who aren't looking for a safe legal way to sexually abuse patients. Much of that could be achieved by giving the general population more voice about voting laws in and out.
No, I don't think this analogy is totally worthy of considering because you forgot the most important aspect that no matter how well prepared you are, there is evil (people) who are probably better prepared. This not only applies to 9/11 but to the medical profession also as there is evil within it that intends to harm.
In the 9/11 horrific situation, they studied to find the means to cause the most destruction. If they had not targeted those buildings, they would have targeted something else to be just as horrific. Their main intent was cause to mass death and they did.
As for the supposed pandemic, yes. We should have kept a better watch on China. We should have known that at some point something like this would as even Fauci said an epidemic would occur under Trump and it seems that out of all the false statements/predictions he had made, that one was right. That in itself should cause thought but it doesn't.
At school, we practiced fire drills every month but we were warned. However, one was set off by a mother who wasn't watching her toddler, and all hell literally broke loose. So even the bad laid plans have snags in them. Same with active shooter/invader. We had a kid come back and sneak to get revenge on his ex-girlfriend's new boyfriend, and again after all the practice, he too went wrong. Exactly how do you plan for a commercial plane to hit a building?
As for COVID, we had Biden and Harris both saying they didn't trust a vaccine originating from Trump's time in office and now senile Joe wonders why many do not have confidence? He helped instill that distrust. But also we have Big Pharma to thank for the lack of confidence in their truthfulness abt adverse reactions and long-term side effects. Should I again name some of the criminal fines and the medicine that have harmed many, many people?
As for evil in the medical community, it is denied it exists and everything is done to cover it up. Dr. Death in Texas killed people but is not charged with that. He is said to have committed "gross malpractice" but malpractice is not defined as being intentional harm. He murdered 2 people. He even said he was "ready to become a cold-blooded killer" but still not charged with murder. The medical system along with govt. and the legal systems have failed medical patients time and time again. It doesn't matter if the building was sturdy or an evacuation plan was errorless if you have true evil just like saying if a patient had done this or that, they would not have been harmed. Many patients who have been harmed are ones who spoke up and out about their right to autonomy.
The girls who swing from monkey bars ( gymnasts) and accusations against Dr Nassar are now pointing fingers at the FBI. Would the FBI investigate complaints against say the ent who performed genital exams against Dr Sparks? I highly doubt it.
PT
PT welcome back to our blog thread. My understanding regarding the FBI's involvement was that Federal Child Pornography Charges had been made to Nassar. I suspect the Sparks matter was primarily a state issue. But I am no legal expert. ..Maurice.
Dr. Bernstein, I think PT's point is that law enforcement very rarely gets involved in any kind of sexual abuse if the perpetrator is a doctor, nurse, or other healthcare "professional". When such events play out in the media the response is almost always "no laws were broken". In part, this may be because the hospitals act as if whatever happened wasn't a big deal.
Here is an exception to the rule where the hospital took prompt action and law enforcement took it seriously, though I suspect this is because the known victims were hospital staff rather than patients.
https://www.burlingtonfreepress.com/story/news/crime/2021/07/15/former-uvmmc-doctor-pleads-guilty-voyeurism-lewd-conduct/7975970002/
This having been fairly close to home for me, I had followed the media coverage. Though the charges included voyeurism and child porn, I don't recall the investigation including looking into his behavior with patients in the ER. What are the odds he had a camera in a staff bathroom and child porn in his home, but he acted in a purely clinical and professional manner with patients in the ER? Not likely, but there doesn't appear to have been an investigation looking into it.
Why? Was it because this hospital is a powerful presence in this State; it being the only large full service hospital & Level I trauma center in Vermont and it being the largest employer by far in the State?
My point was If these monkey bar enthusiasts were men and the perpetrator was a female Doctor do you think the FBI would even think about looking into the matter. Dr Sparks behavior clearly demonstrates that. Even the local Barney Fife wasn’t going to waste his time.
PT
Good Evening:
PT, I agree with you. Had the gymnasts been male the FBI would have written it off as can't happen & moved on.
Biker, I suspect there was no further investigation because the University of Vermont Medical Center wanted the story out of the paper & people's minds so as to limit any further bad press.
Regards,
NTT
NTT...exactly. Any hospital or medical practice thinking that avoiding bad press is more important than doing the right thing by patients is no different than the Catholic Church, Boy Scouts, Olympic Committee, and who knows how many other organizations that swept sexual assaults and pedophilia under the rug rather than protect the kids.
To be clear, in the UVM case, I only know what I saw in the media. I don't have any inside info, but in the media I didn't see any effort to investigate this doctor's actions with patients.
I also wonder did this guy not raise any behavioral red flags during medical school or internship, or while working as an ER doc? Did anyone ever observe improprieties but chose to not say anything?
The FBI was involved because some of the assaults happened in multiple states and out of the country.
-- Banterings
Here is an explanation of why one can argue that a physician denying a patient's request
for a treatment which the physician understands is a wrong or unproven treatment is still in keeping with preservation of patient dignity or maybe even a decision toward preservation of the patient him or herself
From January 11 2012 issue of the Journal of the American Medical Association
Patients frequently express strong preferences for medical tests or treatments of their own choosing, even when physicians believe that those interventions are not beneficial. Physicians grant such requests for various reasons. One compelling reason is to avoid confrontation: patient-physician relationships flourish in an atmosphere of trust and goodwill, and physicians rightly worry that disagreement will threaten those relationships. Moreover, explaining why an intervention is not beneficial takes time. For patients with the common cold, granting requests for antibiotics is far less time-consuming than discussing viral microbiology and harms of antibiotic overuse. Although patients' preferences are key factors in clinical decision making, a patient's preference for a diagnostic or therapeutic intervention is not decisive unless a modicum of potential benefit, viewed from a conventional medical perspective, is present.1 When diagnostic or therapeutic choices are consistent with such a modicum of benefit, patients' preferences should drive decisions. In contrast, physicians should not provide interventions that do not meet this criterion.
Does this point of discussion sound familiar in the current tensions between patients and the medical system in these COVID infection days? ..Maurice.
Dr. Bernstein, I don't see the covid debate between the medical system and patients as the same as the more general propensity of some patients to play Dr. Google. What I think makes it different is there is a component to it that has roots in a general mistrust of our societal institutions that has grown over the past several administrations. The power-by-any-means that has permeated the political class has had the effect of politicizing and corrupting formerly trusted govt. agencies, media outlets, corporate institutions, and even the scientific and healthcare communities. Their intent may have been to gain ever greater spoils that come with power but it came at the price of destroying trust.
The corporatization of the healthcare world in recent decades had a major unintended effect as well. The "profits over patients" perception that was created squandered much of the blind trust in doctors and healthcare institutions that my parents generation had.
I believe what Biker said in his last post is very true. They have caused the erode in trust by their actions.
I read an interesting article that said medical workers were being fired for not being in "compliance" with mandates for a vaccine. It is now coming back around to bite those who have been mandating patients be compliant. It is amazing to watch this happen as many of us can well identify with this feeling of hopelessness and anger those being forced to be "compliant" are experiencing but in the same sentence I can say I have very little sympathy for them as they didn't have sympathy for patients being forced to comply by any means available including criminal means.
Biker is also correct in saying the "blind trust.....my parent's generation had" is gone. Back in the day, a patient's dignity was protected. Women were attended to by mostly women and men by male orderlies. There was a sense of preserving bodily privacy but nowadays the aspects of #PowerControlGreed dictate patients are objects and therefore not entitled to have or even expect bodily dignity. Even though medicine is thought of as being progressive it is actually slide backwards as far as patient rights are concerned. Informed consent is viewed as being whatever the medical community defines it to be & the patient must be compliant with this attitude. Attitude is patients do not have the right to refuse medicines but must ask their doctor for the latest, greatest medicine advertised on media outlets. In other words, you don't have the right to know which drugs are being used for a procedure or refuse those drugs but make sure you get the newest drug advertised on tv for your condition.
Why is getting medical treatment more like surrendering all of your basic human rights that you would never give up otherwise? Why has the more progressive in thought we are said to have become actually resulted in having less basic human rights?
Why is it acceptable that medical harm stories remain silent while other stories of harm (ie. out of control cops, missing women, etc.) get blasted in the headlines for days, weeks, years? When did the medical community morph into becoming the medical mafia where no words or actions to the contrary are allowed even within their own ranks?
As for an earlier comment when Biker asked if anyone ever seeing anything wrong did anything the answer is a no in the majority of cases. Think abt all the issues we have talked abt and nothing has changed. The medical community has made it an acceptable side effect of treatment for the patient to fully exposed whenever they want it. Patients being exposed is commonplace. It is common to be exposed in mixed company and while sedated. Patients are objects and there is a sense of ownership over a patient. It only takes one woman to become missing in a park for police involvement but 100s or even 1000s of patients have to be harmed before an investigation will even commence. No wonder most forms of medical harm are thriving. The atmosphere for it has been allowed.
JR, if all which you wrote is realistic and true, then what is the treatment or antidote to rid medical practice of all of what you described? Is the prevention, something we should be teaching medical students which has been, at present, absent? Or is there something which can be poured upon the medical profession which will provide a cleansing? What is the antidote? ..Maurice.
Dr. Bernstein, currently I think the only option realistically available to patients, especially male patients, is to advocate for themselves. Of course that is only possible if they are conscious and otherwise in a position to advocate for themselves.
Women's groups would not tolerate any hospital or medical practice giving hiring preference to males so as to better provide intimate privacy for male patients. They know that the courts will support them if push came to shove. One need only look at the court rulings that deemed male college & professional athlete rights to locker room privacy are non-existent to the extent it infringes on the rights of female reporters to ogle them. They've done the same to male prisoners, to teenage boys living in group homes, and to released prisoners living in transitional housing. In the latter case the courts ruled against a male in transitional housing who objected to female staff watching him provide a urine sample for mandated drug testing.
What school system is willing to face the potential ire from feminists if they specifically sought only male staff to do the boys sports physicals?
If there is anything that the healthcare industry could change that women's groups would be hard pressed to object to, it would be defining that "profesionalism" includes minimizing patient intimate exposure in terms of extent, duration, and audience. It would be difficult for them to demand the right to needlessly expose patients. Of course they would say they already minimize exposure, which begs the question as to whether any hospital is brave enough to enforce such a professional standard.
My definition of professionalism could be taught in medical & nursing schools and in other training programs, but again, who among them is brave enough to advocate for male patients in light of the deeply ensconced mantra of "healthcare is gender neutral".
How hard would it be to teach sonographers that a male patient's genitals should never be fully uncovered? They could be taught to only expose as much of the testicles as is needed to do their scan rather than fully exposing the patient and them partially covering him back up? How hard would it be to teach doctors and nurses to pull gowns up from underneath a sheet so as to only expose the abdomen when that is what they need to see? There is no need to pull up the gown fully exposing the patient and then covering the genitals back up. Healthcare "professionals" can be taught to minimize exposure far better than they currently are.
Society remains loath to challenge the premise that donning scrubs makes one both a professional and asexual; that interactions with patients are always entirely clinical. That ultimately is what allows it to go on and on.
Dr. B.,
I don't have a magical cure as not only is the issue with the institution itself but also with the people within the institution. Supposedly there are now laws which address these issues but the laws are not enforced and the issues get silenced.
As for something to be poured upon the medical profession for a cleaning, that could be a combination of many different things. First of all--the medical industry needs to be transparent. No more hiding or dodging but complete truthfulness. There needs to be national standards of patient care that have been carefully researched including having the majority of feedback from real patients such as those of us here on this blog and elsewhere. Rules and laws should be enforced with medical review boards having patient-friendly complaint systems along with non-medical/legal members. Much malpractice suits and such would be eliminated through fair laws and open dialogue. I have said this time and time again that medical students need to be exposed to having to interact with harmed patients/families of harmed patients such as Biker, Banterings, and others who not only write on this blog and many others from Twitter and other groups. They need to be able to comprehend what their harmful actions really look like like MADD does with their program. There are lifelong consequences for their actions.
I do know from looking at textbooks, class descriptions and even going so far as to having discussions with medical workers, that patient dignity/autonomy is taught and addressed in the learning process. However, something goes horribly wrong in how it is actually applied in the real patient scenario. I believe it is a combination of the administration and along with the "forward/progressive" thinking of the medical providers themselves not to mention many patients will simply accept being abused as a side effect of medical treatment. I did send you a rather lengthy paper on my thoughts as to areas medical providers needed to pay close attention to and correct.
There is no simple cure as it has taken many years for public trust to erode and many years for the medical community to become comfortable in disregarding human dignity and autonomy. As for if all I have said is realistic and true, I believe harm told to me by others to be told and I know without any doubt the harm inflicted upon my is husband is true along with any harm I have personally witnessed done to others. Knowing this is why I do believe other's stories of harm because I know without a doubt it does happen. However, I know the cure is not a simple process for always we are dealing with humans in the medical industry and humans can decide at any time to commit heinous acts and mistakes also can happen whether it be human or computer error.
Maybe all doctors and nurses should understand that "we are consultants to our patients, not their masters" and in every respect of our interactions with them, all doctors and nurses should keep that principle in mind. How's that JR for a start? ..Maurice.
My friend Mel and her best friend were traumatized by a surgeon who (supposedly) specializes in transgender care. She is sending a letter to him and the president of the healthcare facility that he works for.
If she does not get the concessions that she is asking for; holding the surgeon and staff accountable, having them atone, and putting safeguards in at the facility, she is going to organize those who "peacefully" protested at "Black Lives Matter" events.
Many of these people are currently focussing on the anti-transgender laws in southern and midwestern states. Many subscribe to the "antifa" belief of anti-fascism.
We are beginning to see that the liberals are tiring with public health and elected officials over vaccine mandates.
I had suggested this strategy to her. I will keep you apprised of how she is making out.
-- Banterings
What I think would be a partial solution would be staff meetings where harmed patients and their spouses talk about our issue. A lot of what's been said on this blog explains it well. One inservice wouldn't be enough because somebody has to be working around the clock. Also ban questionnaires that limit what is asked..Let PATIENTS work on making those questionnaires.
I know that Banterings has written here about his female transgender friend but I wonder if there is more to discuss regarding the matter of patient dignity with respect towards the way the medical profession behaves when dealing with the medical and surgical aspects of clinically following through with a potential or a medically-surgically completed transgender human. How does or how should the public react to maintain that transgender's dignity? How should the transgender individual themselves react to maintain their own dignity? To the best of my recollection, I, myself, have never dealt professionally with a known to me transgender patient.
What is the public or medical profession doing wrong which tends to impair or damage that individual's dignity? What should we all "do right"? ..Maurice.
Dr. B.,
That sounds good and that should be how it is done. However, when we have a President who says a woman has the right to kill another human being injected into her body but no one has the right to refuse a vaccine injected into their body, we have a big issue in the perception and the actual workings of patient autonomy. The tone has been set for patient autonomy only to be recognized IF the medical, govt. and legal communities will allow it. We have take giant steps backwards in a very short span of time. We have seen the medical community lie time and time again but we are chastised and silenced when we express our doubts. The funny part is now some within the medical community are being attacked by their own (ie. being fired bc they do not want the vax for whatever reasons). They are now finding out what it feels like to know your bodily autonomy is not respected and really most do not view you having the right to bodily autonomy. The not so funny part abt out this the ones leaving the medical community bc they refuse the vax are the ones with principles and morals and most left will be the ones who have no issue in committing patient harm.
If I am to believe you in saying you taught your students basic dignity principles then something bad is going wrong somewhere between their learning and their applying in real life what they have been taught. This is clearly a "human" problem and fixing that is really, really hard bc as society grows, the lack of empathy, respect for fellow humans, compassion, following basic human rights principles, etc. is eroding. So Dr. B., how can the medical industry fix a basic flaw in the human character of the ones it is accepting to be able to give medical care to other humans? We have laws--they don't work. We have regulations--they don't work. We have education--it doesn't work. What we do have is plenty of patient harm victims and plenty of medical providers who clearly should not be delivering medical care to humans.
I see that JR's last post was referring to my posting yesterday where I wrote ""we are consultants to our patients, not their masters".
I want to add to my last post regarding those humans who are designated as "transgender". My additional question is: should "transgender" be considered a descriptive term regarding an individual even if at the time "he" or "she" are not "patients"? ..Maurice.
Thr problem can't be completely cured because some people specifically pursue that kind of job BECAUSE it's sexually thrilling to them. Other people possibly don't get SEXUALLY pleased but are abusive and enjoy humiliating other people. And in the presence of other people. The more the merrier.
JF,
Thanks for saying what you did in the last post for I believe for some medical workers that is very true. We know there is no reason for all the patient exposure that is happening. Some get a sexual thrill. Some get a thrill from having the power and control over a patient. Some get thrills from whatever else reason they do it. It is the human factor which is the problem. We have laws, regulations, and training but they are not working. We even have garments made for limiting patient exposure such as COVR which are used by very few facilities. So yes, the biggest issue is the human factor.
Dr. B.,
For me personally, I don't need to know if someone is gay, straight, transgender, or anything in-between. That's their business until they make it my business. The one presidential candidate who ran in 2016 mainly on being the first openly gay and married man didn't mean anything to me as who he chooses to have sex with are not the qualifications I am looking for in a President. Bill possibly slept at least once with Hillary but I still voted for him.
Referring back to your master/consultant post, the medical community does seem to believe they have ownership over their patients. CS and I are currently doing a series of discussions on Informed Consent (or more precisely the lack of) and the actual consent form. Neither of these are patient-friendly and does show a need for the medical community to own the patient while at the same finding a way to not claim responsibility for any wrongdoing. Of note, back in 2004 tightened the guidelines only to cave in years later and lessened the guidelines per massive complaints from the medical industry. Thus is why we now have such a biased, unfriendly to the patient Informed Consent process. If we examine how slave owners treated their slaves, you can see the similarities between patient/medical provider relationship. It is a relationship with a very marked imbalance of power which allows abuse to multiple/grow. I talked abt this in the paper I sent to you.
Just yesterday, I had a medical provider saying she knew MRs were routinely falsified. She has not been the only one. This is a huge problem which in turn allows for other harm to befall the patient. There are no real checks and balances in the medical system. Everything is tilted in favor of the medical provider. Read an interesting article from Expert Institute abt why malpractice cases aren't taking which then answered why so many of them fail. All very interesting stuff which again tie in to many of the things we talk abt here on this blog.
JR,the only thrill I experienced in my practice of medicine was a palpatory one (a loud murmur or vibration producing sensation which I could feel laying my hand on the skin over the origin of the thrill).
Sorry, no emotional "thrill" except only the a pleasant feeling of satisfaction when my diagnosis or treatment was correct and effective. Emotional "thrilling" can misdirect the attention of the physician and nurse away from the patient and instead emotionally applied to oneself. ..Maurice.
The publish button just sits there. This is what I wrote 3x. Trying to publish it.
There was recently a question on Quora about letting family follow the patient through the entire surgical procedure. Of course nurses were against this. When you had an opposing view your comment was deleted and commenting turned off. The nurses not only want control of your body, but your thought as well.
Pre op: nurses. We are too busy getting the nervous/anxious patient ready for surgery. Having a family member there would calm the patient down instead of being left alone thinking about the unknown. Oh wait. Then you may not need versed.
OR: nurses. Too many smells/ sounds/ bright lights. Seeing your loved one strapped down, hooked up to monitors. You mean like we see in the ICU when we visit other family?
We don’t have time to talk to you, explain what we are doing, you May touch something you shouldn’t. You mean like you do to the students that go into observe the surgery? We aren’t kids who would go around touching everything. Unlike a student who’d have questions.
Recovery. Nurses. The family member would be traumatized watching the patient who wakes up frantic and confused still hooked up to monitors. We need to check the patient for bleeding and swelling, privacy issues. You mean having a loved one hold your hand/speaking with you while waking up is worse then strangers poking and prodding you or not there at all because you are also monitoring another or speaking with your co workers? Looking for bleeding. That’s the red stuff right? Swelling.. I’m pretty sure I’ll know if my husband is swelling. Privacy. You mean like how you speak to your coworkers in between the dividing drapes about all the patients you have so they can all hear you? I’m pretty sure I’d be paying more attention getting my husband awake/aware then Mrs Smiths gallbladder. The nurses complain about being overwhelmed/worked. Wouldn’t a loved one being there to help the patient take the pressure off you? Who do you think is taking care of them once they get home?
Nurses.. I don’t want to be monitored and have my performance questioned. Guess what honey... many many employees in many professions are monitored. You are ones that need it the most.
My solution would be a week or so before the elective surgery, both the patient and family member have a meeting at the facility. This is where EVERYTHING is gone over HONESTLY. Pre op/drugs/ skin prep/ draping/ exposure. The patient can make their wishes known, same gender team, no versed, no students, etc etc. then the facility gives the informed consent for the patient to take home and read. They can take a tour of the OR so things are explained what you will see/hear. This way the OR team doesn’t have to worry about the spouse not knowing.
Why the lies about skin prep? We only expose what we need to everything else covered and you are covered as quickly as possible. Only the surgical site is left uncovered. This is misleading and a lie. Once you are unconscious the gown comes off leaving you laying there naked. Oh but they cover you. Thank God. I was so worried about my knee caps exposed for all to see. Once you are out and the gown comes off... you get positioned that takes a few minutes. Then they assess your skin another minute and can get intimate. Then the wash/prep you a couple of more minutes. It takes 3 minutes for prep to dry before they can drape you. So, over 10 minutes is as quickly as possible? What is everyone doing for that time? Especially the 3 minutes before drapes can be applied? Whose there?
Why is the sterile field so large? Laparoscopic is 3 incisions near the bellybutton. Nipple line to mid thigh? In case it turns open.. again that’s still above the waist. Femoral artery. You can wear the surgical underwear and still get to the artery. Patient or spouse can paint them and get into the underwear in pre op. Foley May be needed. Most time it’s not, but they do it anyway. Why? Convenience. They say it only takes seconds. Well if the patient paints themselves, I’m sure there is some sharp object in the OR that can be used to cut off the underwear in an extreme emergency that would only take seconds.
More to come from Catfostermom. ..Maurice.
The family member in the OR would be there to keep the exposure truly to a minimum. Not exposing for the staffs convenience. Then after draping, before the timeout and first cut the family member is escorted to a room off the OR into a private room to watch the surgery on CCTV with sound. They can then choose if they wish to watch/listen or whatever. OR staff... the conversations in there is private... yeah, so is the patients sexual organs that you are laughing at making fun of telling other coworkers about.
Then before the drapes come off again the family member is brought back in. Since you are again exposed then. This time the cleaning crew may already be in there and they certainly don’t have the right to see the exposed body. The family can also clean off the patient and regown them. Another way of relieving the over worked hospital staff. After all again won’t the family member be doing this at home?
What pisses me off the most.. every once in awhile you get a nurse who comes and says the patient doesn’t need to be exposed like that. During recovery assessments for abdominal surgery you can push the sheet to the waist and pull the gown up only exposing the incisions. Meanwhile others just lift the sheet from the side and pull the gown all the way up exposing every 15 minutes unnecessarily. If it can be done another way what is the patient supposed to think? Of course they are going to think it’s sexual not clinical. Obviously if you are having surgery on your genitals then they will be exposed. But, as a nurse said even for ingunial hernia repair, open or laparoscopic genitals do not need to be exposed at all yet routinely are. Staff convenience needs to stop. The best outcome for recovery is both mental and physical. To many patients have more mental scars then physical after surgery. Esp if they find out what happens to their body once unconscious, that they had no clue about. Nurses are not the judge of us to determine what we need to know and what we do not. It’s time they learn this. Also just because they are comfortable exposing a patient doesn’t mean the patients are comfortable being exposed. Not every patient will care or have modesty issues. But, the ones that do need to be protected against the higher then thou attitudes of many medical staff.
For our visitors' information: The last 2 postings by Unknown was actually written by Catfostermom and completes the text of her entire posting. To Catfostermom: Please continue in future posts with the same pseudonym so we all know who has participated with their views. ..Maurice.
Sorry. I used a different phone to complete the posting. It must not have linked the account.
While I myself don't want to observe a loved one's surgery, or have someone watching mine, catfostermom makes excellent points in her series of posts. Going with her example of abdominal surgery, it does not take any more time to lift a gown from underneath a sheet in order to observe the abdomen as it does to pull the sheet down and then fully lift the gown needlessly exposing the patient's genitals. In fact it might be faster. So why do they do it (and many other medically unnecessary exposures)? It could be as simple as poor training or it could be they want to expose the patient. Likely it is some of both.
A few years back when I was allowed into the post-op recovery area following my wife's surgery, there weren't any curtains separating the patients. It was instead a large open room with rows of patients. There was no attempt at providing patients with any kind of privacy. Family members such as myself that were allowed in could see that which we shouldn't have been seeing. Even if family members weren't present, the patients were still being exposed to staff that had nothing to do with their care.
Back when I had bladder cancer surgery and was left with a catheter in for a week, when I came to in the recovery area, I had to get up and get dressed (tee shirt and pajama shorts) as it was day surgery and not inpatient. I had to get dressed in the totally open area exposed to staff and other patients. Still being groggy and in pain, getting dressed took me longer than would normally be the case. How much would it have added to the cost of my surgery to have moved me to a private spot to get dressed? Or to have curtains separating patients in the recovery area so as to allow some privacy for dressing?
The endless needless exposure can only come about from their not caring about patient privacy & dignity or there being an undercurrent of voyeurism wanting to see patients exposed. Neither alternative speaks well of the healthcare industry.
At least where my husband had his day surgery the recovery room where draped on both sides with the front open to the large room. From what he remembers ( thanks to versed) you couldn’t see any patients across from him, but they were next to. He wouldn’t have been paying attention while he was being wheeled out if they took him passed the other “stalls”. He would have put his underwear and sweats on with the gown. See, even a groggy patient knows how to protect their dignity.
Dr. B.,
Could you reach out to Catfostermom as Cindy and I would like to include her on the weekly radio show we do abt patient harm? Her posts were very well thought out and need to have a larger audience. Pls. feel free to share my contact info with her if she would like to talk with me. Jeane
JR- as you know, I did. I am pleased that this blog provides a resource for not only disclosure and debate but also a resource for providing personal communication. ..Maurice.
Dr. B.,
Thank you for so promptly handing my request. Yes, this blog and other ways we get our message out there is extremely important. People who have been medically harmed need to know they are not alone. Medical PTSD is a side effect of medical harm. Before I talked with Archie from meeting him on this blog, my husband and I had no idea what was happening to us as a result of him being medically harmed. Archie was literally a lifesaver and prompted me to not just whine and complain but to take action. Since I started here, I have talked to nurses and even doctors who agree there is more patient harm taking place than we can ever imagine. While you say you have not personally encountered a patient being exposed unnecessarily I have had nurses and even doctors admit this is happening at even a rate we cannot imagine. I have had mostly nurses say they have spoke up and have done their job (oath) of trying to protect their patient from harm only to be silenced and sometimes punished. I even had the one nurse admit she and several others exposed men having hernia surgery on purpose to humiliate them. While you claim you haven't witnessed this (and your world must be very sheltered) it is happening out here at an alarming rate. We aren't outliers nor are we alone. It is more common to be sexually abused during procedural encounters but can and does happen during office visits as witnessed by men here on this blog. All I know, this is a very preventable harmful side effect of a medical encounter and needs to stop. The exposure is not accidental but is a pre-mediated, learned behavior for most but for some it is a mental illness within them that signifies they should not be in patient care. Of course, the other issues I talk abt a lot are Informed Consent/consent and falsification of medical records and these too are very preventable issues and needs to cease immediately.
Even though from time to time, the blog slows down it is still a valuable resource. Thank you for making this resource available bc many, many times harmed patients feel alone and have no where to turn for information/help.
It’s actually sickening to hear nurses talk. We will expose you to how we see fit. Don’t like it go elsewhere. More nurses need to be fired by their patients or be refused for certain type of care. It seems the older/retired nurses are the ones that held their oath to dignity in higher regards.
Medicine has always been about advancing treatments. What you can have done with pills or transfusions these days would have killed you not that long ago. Hands hold care is either at a stand still or going backwards. Nurses must be held accountable. Coworkers need to know they are safe reporting such behaviors. They also need to know their voices matter. Patients need to know who to bring up complaints to and know they will be heard. I have not necessarily enjoyed reading this blog. Don’t take this the wrong way... but.. if I were a tea pot you’d be hearing me whistling on the west coast ( I’m on the east). Just knowing this has been going on for SO long is infuriating. It seems the more the patients complain the worse it gets for them. Nurses... in my 35+ years of nursing I have never once seen or heard of this. First in that 35+ years how many hospitals have you worked at? How many shifts have you worked? How many people on the opposite shift from you do you know? How much have you heard in the break room/nurses station but choose to ignore? Not once in any of my reading, asking questions as a nurse EVER said...ya know what..I never thought about it that way. I see your point. I can do it that way and teach my coworkers that. Never. What needs to be done? How? How can new nurses be taught respect? How can they be held accountable? Does it need to be a specific course, pass/fail?
Good Afternoon:
JR is correct.
The Marcus Welby's & Florence Nightingale's are almost non-existent in today's medical profession.
Patient's have to be on their guard from the moment they walk thru a medical professional's door until they turn around & leave.
It shouldn't be like this. All we can do, is keep pushing back.
Regards,
NTT
NTT's comment about patients having to be on guard says it all. That is a learned behavior that comes from experience. The question is why aren't healthcare staff at all levels taught to minimize patient exposure to that which is necessary and to recognize patient embarrassment? Is poor training the problem or is it instead simply not caring about the privacy and dignity of patients? Or is it in some (many?) cases coming from voyeuristic proclivities?
Another aspect of their training that defies logic is how they come to think their being comfortable with patient exposure should translate into the patient being comfortable being exposed.
Define minimize? To them exposing you for 10 min on the OR table is minimum. Lifting your gown up to check your abdomen after surgery every 15 min is minimum. To us it’s unnecessary exposure.
That last part about them being comfortable with the exposure totally gets me pumping and just want to ring their necks. Are they taught to just totally disregard the patients feelings? They need to be nude in front of these patients after all isn’t the scrubs they wear from room to room, to lunch, to outside to have a smoke. Aren’t they getting contaminated?
catfostermon, the definition of minimize becomes the problem. Patients see minimize as exposing the least amount of skin as necessary for the least amount of time and to the least audience needed to get the job done. Healthcare staff see minimize as meaning whatever is most convenient or in the case of the voyeurs amongst them, how much they want to see.
Here is an example of minimize. I have had a couple dozen cystoscopies. After I am prepped the doctor is alerted that all is ready for him, but depending upon what he is doing it might be few minutes or more before he arrives. Minimizing my exposure in this example entails putting a cloth over my penis while we wait. The male nurses that have prepped me did this. None of the female nurses ever did except for the last one I had that I specifically asked to minimize my exposure.
Using the same example, while the doctor is doing the cystoscopy, there isn't anything for the nurse to do. The male nurses have busied themselves elsewhere in the room rather than watching the procedure. The female nurses have stood right at my hip never losing eye contact with my penis. The male nurses thus minimized the audience so to speak whereas the female nurses haven't.
I will note that when I spoke up to the female nurse at my most recent cystoscopy, she absolutely minimized my exposure. I had been scheduled for a male nurse but he wasn't in that day. She apologized, but I told her it wasn't her fault that there wasn't a male nurse available but that I am very modest and ask that she keep my exposure to the minimum necessary. Her degree of empathy and respect for my privacy was such that I wasn't embarrassed despite the extremely intimate nature of the prep. That surprised me, but I hadn't ever experienced that degree of respect from a female nurse before.
Banterings, we haven't heard from you in
2 weeks, we hope you are feeling well and
still interested in preserving patient
dignity. ..Maurice.
Good Afternoon:
Doctor Robert A. Dowling, MD a urologist was recently on the patient side of care. He says there's room for improvement.
They might teach patient dignity in nursing & medical school but there's a disconnect when they come into the "real world of medicine".
I believe it the culture established from the top on down in each facility that is causing this and that culture being established is being guided solely by the almighty dollar.
They've taken the "human" element out of the equation.
Here is his story.
https://www.urologytimes.com/view/a-urologist-s-experience-on-the-patient-side-of-care
Regards,
NTT
Excellent. Now what is he going to do about it?
NTT,
Thanks for the article. I tweeted it out. Some of the medical providers I have talked too say the same thing--it is very different when they become a patient. The thing that bothers me is nothing is ever done about it. They write their article and silence reigns again. I believe not only do harmed patients have to be pro-active in bringing abt change but those within the system have to be pro-active too. The younger ones are the issue and at this point in their lives, they haven't experienced the system as a patient so they have no need to change how they are treating their patients. The dr. in the article confirmed what I have been saying abt. informed consent. It has evolved into something that protects only the provider at the patient's expense.
I tweeted out some articles I found on why nurses kill and I can say I recognize some of the abusive behaviors in those who harmed my husband. I believe the current medical provider/patient relationship is an abusive relationship bc of the imbalance of power. They take certain actions such as how they address the pt, the tone/manner of the encounter, notes in the MRs such as "compliance", etc. to set the stage. The key factor is many do feel a sense of ownership/entitlement over a patient. They can unnecessarily expose a patient and rarely get an push back. I believe this is done to achieve their ownership goal of a patient being property rather than an autonomous human being. Objects are owned and do not object or question which is how many like their patients to be.
This past week CS and I did our podcast on how when medical providers decide to not treat the ill patients who are unvaxxed (rather they have COVID or not) they are decided to use their personal biases to intentionally harm. This is dangerous bc we do not know where their personal biases will lead to the harm of any patient. Are they in the business to aid sick people or are they in the business to only treat the sick people that meet their personal criteria? "Do no harm" has left the building.
Hopefully the word is not only getting out but sinking in for both the patients and the bullies.. oops I mean medical staff
I can't seem to open that urologytimes article. Probably something to do with my security settings. What is the gist of the urologist's experience article?
Biker, here is the last paragraph of the article and conclusion of the experience:
Bottom line: Being a patient has convinced me that providers do not always treat patients the way they would want to be treated. Some may see this as an unavoidable compromise in a dysfunctional system over which they have no influence; I see that as an excuse, or maybe a symptom of burnout. My experience has taught me there are many opportunities for positive change that require no significant investment of money or time—only for the provider to wear the patient’s shoes. Take a fresh look at how you communicate, maintain a safe environment, and ensure optimum quality in your practice—you could be the next patient.
..Maurice.
Makes me wonder if this urologist was guilty of practicing the "strip as you go" prostate exam along with the female chaperone in tow? I would imagine so. I had talked to another urologist via an interview I did on YourFreedomHub.com who was trying to deny medical harm in form of unnecessary exposure existed. He said it didn't. I said what do you call the "strip as you go" exam? One basic rule is no medical provider should be in the room while a patient is dressing/undressing unless there is a need to judge they are physically competent of dressing themselves which these exams are not. I also mentioned the female who basically is just there to stare at the man's genitals and watch him wipe his behind and do the clown routine with his pants/underwear around his feet. I did render the urologist speechless until he said that was the way he was taught. So naturally I had to come back and say over the years in your normal life have you changed the way you have done things? I also mentioned that slavery used to be "legal" and accepted but now we know it was wrong (and truthfully they too knew it was wrong then like we know how male patients are treated is wrong as we don't demand this of female patients). I asked him if the medical community is exempt from learning and changing how they deliver healthcare to patients? Again, I got quiet as I received no answer. Emails finished. Seems I hit the target.
It is blaringly strange the doctor in this article didn't address the personal bodily indignities he likely suffered. I wonder why? We know there is a certain amount of exposure needed for urology procedures but there are dignity sparing methods of accomplishing them. Biker has told us of some ways it has been accomplished for him. Even outside of the blatant sexual assault my husband suffered, few of the others seemed to cared if they exposed his penis while looking at the femoral wounds. Why do they not care?
I printed on Twitter a link to stories why nurses harm. One is an interesting article done by the BBC with a professor giving his research input. Why is it other countries will address issues like this but the US remains silent?
I’m not on Twitter. Can you post the links or email them to me?
Good afternoon:
Doctors who have the unfortunate circumstance of coming over to the patient side during their career, will not do too much talking about their experience while a patient simply because they know if they do, they will become outliers in their profession.
If it's not mandatory, teaching patient dignity in nursing & medical school should be.
What is happening is people's school training is being replaced by real-world peer pressure and that peer pressure is there as a result of the culture that's been established in most medical institutions in the US.
The culture in almost every facility in our country today revolves around the almighty dollar NOT the patient like it should. Get it done quick, & efficiently as possible even if the patient is somehow violated along the way.
If this culture can't or won't be changed then patients will become nothing more than objects and you'll see more & more men walk away from critical care that's needed.
It's time to STOP trading patient dignity for the almighty dollar.
That means going forward, dignity violations can no longer be ignored or swept under the rug.
It's time nurses and doctors got back to their original school training.
So, now how does one change the culture of virtually an entire industry?
Not easily because people get set in their ways & you've got people in their right now that love the power trip they get when dealing with patients.
One way to start is let employees know we are going to go back to the basics you were taught in school.
A company's culture usually comes from the top. That would normally mean senior mgmt. would develop a plan for the entire organization then disseminate said plan down through the ranks.
What if the entire organization had a hand in developing a culture where employees worked together to help one another & moral was high. That in turn would lead to better patient care.
What if each department came up with their own plan then submitted that plan to mgmt.. Then using the organizations ideas, mgmt. built a plan from which would come the organizations culture going forward.
Ladies & gentlemen to build a caring healthcare system you have to Do No Harm & give CPR (Choice Privacy Respect). You can't have one without the other & build a successful healthcare system.
I know this is just a pipe dream but it’s a nice one.
Here's three more links to recent stories.
https://www.webmd.com/men/news/20210706/men-less-likely-to-see-doctor-study
https://investors.aflac.com/press-releases/press-release-details/2021/Aflac-Study-Mens-Health-Often-in-Womens-Hands/default.aspx
https://www.medscape.com/viewarticle/961239
Regards,
NTT
Catfostermon
https://www.bbc.com/news/world-48600478
https://www.crimetraveller.org/2018/06/healthcare-medical-serial-killers/
https://nationalpost.com/news/canada/cases-of-patients-being-killed-by-health-care-workers-may-be-shocking-but-arent-unusual
It all goes back to just about one thing: #PowerControlGreed The Doctor/Patient relationship is similar to the relationship of an abusive spouse. There is an imbalance of power and the law is slow to step in and when they do it is sometimes too late. For patients, it is worse for they are unlikely to be believed. Many patients have to be harmed and even them as with the Nassar case, law enforcement can sit on it for whatever reasons so more can be harmed. There are probably many, many medical providers who harm patients but have remained under the radar than of those who have been caught. Many times, even when caught, they are set free to harm again. Medical providers who unnecessarily expose patients are serial harmers. It is a sickness they have to do this no matter what their reason or "justification" is. There is no satisfactory or justifiable reason to routinely expose patients except to say it is a criminal activity. However, like the woman who was raped on the train in PA, everyone is aware of this happening, they watch, and they remain silent and do nothing. This is not about modesty (maybe for some) but more about the bodily rights of person being taken from them. And then there is sexual assault of patients....
We will continue to harm happening to patients as long as the medical system is operating status quo as it creates the atmosphere where abuse of patients is accepted and even thrives.
Everyone who comes to this blog topic should read the following current article Medscape titled "What If Your Patient Refuses to Take Off Their Clothes?"
The article covers and details just about everything we have repeatedly been discussing and discussing on this blog thread specifically patient modesty and patient dignity. What do you think? And read the professionals responses in the Comments section of the article. ..Maurice.
Good afternoon:
Dr. Bernstein, in regard to the Medscape article, it shows some physicians are thinking about maintaining a patient's dignity but as far as system wide goes its still a crap shoot especially for men.
Until they bring the healthcare system more centered instead of leaning towards women men will have to speak up, put up, or continue to walk away from needed care.
They know men are staying away yet very few try to do anything to make them want to come in.
Some of the bigger medical institutions have tried forming men's clinics but last I heard there were less than 5 with all-male staffs so they aren't doing very well.
They talk about a men's health office in the federal gov't.. That is all it is though. When I bring it up to anyone in congress I NEVER get an answer. I know for a fact, women in congress are against the idea because they feel they will lose what they've gained since their office was established.
Due to state law, if you live in Alabama, Delaware, Georgia, Montana, New Jersey, Ohio, and Tennessee, you're stuck with a chaperone in the room like it or not. That should be changed.
I'd like to get all the doctors that talked in the article in a room together & ask them how do we change the system so that all healthcare works treat their patients with the same level of respect that they give their patients.
Their answer I bet will be along the likes of its the culture that's allowed to blossom & flourish within the organization.
One thing I disagree on is I believe most men would NOT have a problem going to a female doctor for anything provided scribes, chaperones, & nosy assistants are kept out of the room at all times.
So for the time being, we just keep pushing back.
Have a great day all.
Regards,
NTT
NTT. Much of the problem is there's no place better to go. Or anyway it can't be known if someplace is better until you get there and someplace else could actually be worse.
Where I work at is an assisted living home. In recent months the place has been rapidly filling up. There isn't enough staff to take care of so many patients but we're constantly getting more patients anyway.
One of our new patients is in his late 50's or maybe early 60's and doesn't even look like he'd be in this kind of facility. If you saw him walk past you at Walmart you'd assume he lives at home and drives. ( If you have it a thought at all ) This past month has been busy for him. First he assaulted a CNA on nightshift. A week later he assured two other workers because they brought his roommates wallet to him when they found it in the dining room. He chased them out and unfortunately for us they laughed while they ran from him. But just so I'm not skipping the part that makes our staff look bad one of the girls evidently hit back and gave him a black eye. So both of those workers are gone but our entire staff and patient body are unsafe because HE is still there. We are working SO short-staffed that we're forced to start getting patients up at 4AM. Not our bully though. He gets up on his own. A couple of days ago about 2 weeks after the last incident an elderly woman came into his room and he punched her and knocked her down and I believe he broke her hip. Because of shortness of staff now our patients are dirty again. It can be noticed the most in how dirty their hair is.
"Unknown" from today's posting, please identify yourself with your pseudonym. Thanks. ..Maurice.
Sorry. It's JF.
JF, I suspected you were the author of the "Unknown" post and it really was very informative about a description dynamics of patients' behavior that challenges the caregivers as well as others. ..Maurice.
One aspect of preservation of patient dignity which has not yet been discussed on this blog topic is that of the medical professionals' use of humor in their communications with the patients or in the presence of patients. Here is the link to a dissection of the issue of humor in medical practice and a copy of the abstract. Should medical practice between professionals or heard by or spoken to patients be acceptable component of medical practice? ..Maurice.
Abstract
Medical professionals seem to interpret their uses of humor very differently from those outside the medical profession. Nurses and physicians argue that humor is necessary for them to do their jobs well. Many (potential) patients are horrified that they could one day be the butt of their physician’s jokes. The purpose of this paper is to encourage the respectful use of humor in clinical prac-tice, so as to support its importance in medical practice, while simultaneously protecting against its potential abuse. I begin by examining two extremes of supporting or chastising the use of medical humor. I look at these views through the lenses of popular theories of humor to help explain their theoretical bases. In this second section, I explain the emotional aspect of humor as an embodied and embedded transformation of the world. This clarifies the role that humor plays in our daily lives, as well as why the ethical or unethical nature of its use is dependent on context. Third, I address the potential problems in the relationship between humor and clinical sympathy, and how this further affects the relationship between medical professionals and their patients. I conclude by arguing that humor can conflict with clinical sympathy, but this need not be the case. If medical professionals actively engage with clinical sympathy and focus on using humor in a way that is respectful towards their patients, then humor can continue to be a positive force in their lives while still providing the best care for their patients.
Humor can be helpful or it can be harmful, and thus in a healthcare setting the staff must be extremely careful. Despite the staff member thinking that they're funny, the patient might not see it that way. If you haven't established a relationship with the patient to the degree that you can read the patient and the patient can read you, save the humor for later when a relationship has been established. You risk that worried and sick patients might interpret your attempt at humor to be making light of their condition.
Same with humor that makes the patient the object of the humor. Make fun of yourself, not the patient.
Sexual humor is never appropriate in a healthcare setting. Never.
While I agree humor is an important part of keeping one's sanity and stress level low, humor should not involve the patient. Oftentimes, the patient is in a vulnerable position (naked) and thus any humor abt the patient is offensive especially if those comments are made abt sexual parts of their bodies. Not only offensive but could be considered sexual harassment. If you were at a store and the cashier made a remark abt your weight and the number of Twinkies you bought, I would imagine you would think the remark was not funny and would be offended. Furthermore, although the remark might be true, it is not the right of the cashier to try to make something "funny" out of such cutting and really none of their business remarks. If some man whistles at a woman going down the street and he says "nice racks" she would be offended and could file a sexual harassment complaint. So what is the difference? None except I see the infractions by medical personnel more serious bc they hold a certain amount of trust in their hands and are expected to have higher standards than say a construction worker.
In the article, can you imagine if ppl in the ER waiting room heard the "joke" abt the pizza delivery man dying and they are joking abt if they should still tip him? Not only that but they picked up the pizza where he dropped it? Perception is everything. If I had heard that joke, I would have thought my loved one's ordeal could be misused in the same way.
Also, even in telling generic stories, many times a patient can be recognizable as the story travels through the grapevine. Isn't what a pt tells a dr suppose to remain confidential? Is it confidential if the dr. leaves the rooms to tell another the pt's story even without the pt's name? I think it is a breach.
There are a lot of things we can have humor about and patients are not one. There is politics. There are plenty of newspaper stories. Would it be considered funny for a cop to say Gabby P. was strangled bc Brain L. had to find a way to get some silence from her or is it only acceptable to make patients literal butts of jokes?
I am so tired of the medical staff getting away with so much. WHY? No other employee in any other job would get away with what they do. Since reading here I know this is pretty much the same people. I’m just glad we have people getting the word out to both doctors and possible patients saying we aren’t going to take it anymore. Even if just one doctor changes how he examines patients, one nurse says hey... we don’t need to expose the patient for that, it’s a step closer.
Now I was reading about to Covr Pants. Even if you wear them is your groin still prepped? We shower at least 3x prior to surgery using the soap they give us. Obviously, this is elective surgery not emergency. We can prep our own groin ( or spouse can prior and help the patient into them if necessary. The drapes go over the underwear so I don’t see a need to prep. Otherwise what’s the purpose? Then I read about a person getting a colonoscopy and the nurses making fun of his genitals. Why are you exposed for that? What is the pre op prep and I’m not talking about the lovely drinking to clean yourself out.
Cat:
The nurses shouldn't have seen his privates. How did he know they made fun of him? May I have a link to the article?
The colonoscopy patient probably didn't know there are garments available to the public from a couple of sources for his privacy & just went with the flow to get it over with.
Normally they tell you to strip all the way down to your socks & put a johnny gown. Women are usually allowed to leave their bras on as this is a clean procedure not a sterile procedure. There are some facilities that just require you to be nude from the waist down for a colonoscopy.
While he waiting for his turn they usually start an IV drip with something in it (usually valium), to calm your nerves. When they're ready they'd bring him into the exam room, hook him up with either Versed & Fentanyl or propofol so he doesn't feel any pain, is compliant, & doesn't remember a thing.
Then they only real prep left is the tech will do a DRE on the patient just to verify the cleansing did its job. Then it's just a matter of scoping the colon.
Many facilities don't carry privacy garments for intimate procedures & then there are some that have them only for the Ladies.
Guys have to know in advance what they are getting into & ALWAYS be prepared to put a stop to something they are uncomfortable with. You're not being weak. You're standing up for your rights.
I watched the Cath lab video on Covr's website. They have a male on the table & he's wearing their bilateral medical garment. They adjust the panels to expose the femoral artery area on each leg then they proceed to prep him without exposing his privates. After the prep the garment is covered over with what looks like a folded towel then they do the draping.
These garments are only held in place by a velcro patch on the side so I suppose if you had a nurse or tech with an attitude, they could just release the velcro patch to get the garment out of the way (even though the garment does not hinder their prepping the patient in any way), then leave the patient exposed until they did the prep then close the garment back up.
Medical staff get away with it because that's the culture that's been allowed to flourish in the institution. People don't like snitching on fellow employees because they don't want the backlash that usually goes along with telling. They can become an outcast.
Very few places have a culture in place where everything revolves around the patient & their well being.
If Medicare & Medicaid would start financially punishing facilities for patient modesty violations, this crap would end real quick because now their actions are effecting the company's bottom line.
That's it from me for now.
Best regards,
NTT
Why is it so difficult for the medical society as a whole to acknowledge we are not for their use as they see fit? Why do they believe they have the right to deliver medical care however they see fit? They would not tolerate the cashier at the supermarket throwing their change on the floor bc it was easier. They would not tolerate a mechanic inviting strangers to test drive their BMWs to see if they were fixed probably or to fix them in the first place. They would not tolerate their maid having her friends over to rifle throw their underwear drawer. So why do they think they have the right to strip patients but not only to strip them but to actually use them as group entertainment? They are taught otherwise. They know the proper techniques. They know there are garments out there such as COVR that preserve patient dignity. Dr. B., do you know of any of your peers who can justify all the unnecessary exposure done to many, many patients?
This info coming out on evil Fauci again drives home my point that the medical community is not compassionate. Fauci has sanctioned the torture of animals for experiments that didn't need to be done. Why would any human believe doing what Fauci sanctioned done to the puppies is acceptable? This type of inhumane treatment of an innocent animals parleys into the mistreatment of innocent human patients. They are taught to disregard moral/ethical behavior bc what they do is so important. It is not. People like my husband and I who have suffered at their hands would rather forego medical care and die than to become a victim once again of their torture. It is a twisted society that would look the other way at how Fauci condemned those animals (beagles) to die. Hopefully, karma is alive and well and will deliver a big bouquet to all those thinking they are justified in harming innocent people and animals. Fauci is no hero but he is an evil, vile, little man along others in the medical world who act as he does. We don't need psychopaths working in the medical field but we do seem to have more than a fair share of them from the ones who expose unnecessarily to those commit torture of innocents to those who kill and all in-between.
I just read a guy on Quora who had a procedure done and another woman was in the room talking to the tech. while his butt was exposed. Then that woman disappeared. He asked who it was and the tech denied there ever being someone else there. Blatantly lying to him.
There was also a Dr who had a small procedure at a day center he wasn’t affiliated with ( gee why did he go there and not his hospital), the OR staff was laughing when he woke up. He asked what he said... NOBODY would tell him. Well what he said got around the floor other nurses wanted to see what he looked like. Then at some other time he saw the anesthesiologist walking down the hall and the guy told a group of nurses “that’s the guy I told you about”. The doctor/patient said he is refusing versed from now on. I’m waiting for an answer on if he reported that behavior as he KNOWS it’s wrong.
Another nurse was in the ICU naked hooked up to tubes.. her friends coworkers never bothered to cover her. SHE was embarrassed. Her co workers gave her the same excuse you know we’ve seen everything before. This is all BS. I hate them. They all need a dose of their own medicine. They are not hero’s. They are sickos. Everyone needs to put them in their places far and wide. Tell them we aren’t going to take it. Post everywhere and everywhere. The more you read the more you find out how many people do mind, but don’t know enough to speak up. This has to stop.
Catfostermom. A DOCTOR was treated that way? Sometimes doctors are given better treatment than general patients. Anyway that's what I've heard on this blog.
However, where I came from one of our doctors wife believed he was stepping out on her. Obviously WE can't know if he was or not. But while he slept she super glued his genitalia to his leg. He wouldn't go to the hospital where he was employed to get treated but he still didn't go far enough. HIPPA laws should have kept the staff from broadcasting it all over but they broadcasted it all over the city anyway. As a CNA I can tell you that the we run into past co-workers from prior jobs all the time. I moved an hour away twice when I lived in Ohio but still former co-workers hired in at my newer jobs. Or just worked there through agency. Now that I moved to Florida I never see any former co-workers though.
Does anyone here want to discuss the role of racism in medical practice that certainly might affect the preservation of patient dignity. Here is an example of recognition of the issue by the American Psychological Association and here is the link to the Association's current awareness and apology. If you put racism involved in patient care on a scale which includes unnecessary genital exposure, which behavior is more worrisome regarding patient dignity? Which would leave the more longer lasting damage to that intrinsic dignity? Or is concern about racism in treatment of patients trivial or not pertinent compared with unneeded genital exposure. I think it is important to define where misbehaviors stand. ..Maurice.
Dr. Bernstein, I am not anxious to introduce racism into the dialog here. The national discussion has reached a point that there is no real discussion anymore. It has devolved into histrionics that only serves the purposes of the grievance industry that has emerged to feed off of it.
APA's apology that you attached is typical of what is expected of every organization with any visibility. It is a non-apology in that it never says what they are apologizing for nor does it say what it is they will do differently going forward. My guess is that they haven't any idea what the answer is to either question but they do know that such pre-emptive apologies are now required if they hope to avoid the wrath of the woke mob. What will ensue will be the hiring of very high priced "experts" and public admissions of unearned privilege and undefined past sins. The APA will fund whatever the mob tells them to fund so that they can be absolved of that which will never have been defined or documented.
What we discuss here can be and has been very well defined. The grievances are not ambiguous nor are the suggested solutions designed to enrich anyone. The only parallel is that we too get non-apology apologies that never admit anything was done wrong nor commit to making any changes.
I’m not sure how relevant it is to some unless it’s carried over. My husband had all white medical team and we are white.
First of all, I will say no one should have to suffer any ---ism, etc. in any aspect of life. Does it exist? Yes, it does but it does affect us of all in some way.
My husband is an older white man. He was a victim of racism, sexism, and homophobia. I have read many articles abt how black people say they have no medical provider that looks like them but my husband could say the same from the night he was assaulted. The first ER doctor was Hispanic. The doctor at the hospital from hell who ghosted his H&P was from Ghana. The doctor who committed the actual assault which was from the careful planning of the other two was from Pakistan. All those doctors involved did not look like him. Isn't this also racism because as a result of their behavior towards him, he was medically assaulted. Was it also because of how they set their hatred of him in motion that is he was sexually assaulted?
Genital exposure often occurs because of sexism at least where male patients are concerned especially if you are a white male. Individuals from different cultures often have their dignity protected more than the average person would. So yes, there is a definite bias present. My husband was assaulted by white, female nurses ranging in the ages from 30's to 50's. Some of them have very progressive political beliefs and we are from a part in the state known to be "red". He was also labeled being "gay" in a catholic hospital system known to be anti-gay. So with his genital assault, there were many aspects at play but sexual crimes are crimes of power and control. Would they have done this to a black man? They may have exposed him but not to the lengths they went to in my husband's case bc all of them were white so they would have been more careful of their abuse of him. There is a difference in the degree of exposure experienced by a patient although any unnecessary exposure is wrong and devastating. Furthermore, they are fully aware of this.
All humans have the ability to exhibit bad behavior especially in light of what today's political and media climate is teaching and that is it is okay to hate others as long as you are not "white". This is twisted because we should be teaching not to hate/harm anyone as that is how I was raised.
When I read the articles where a black person says that want a black medical provider, I know racism does exist because they just confirmed it. But if I were to say being white, I wanted only a white provider than I would be called racist. This is what I do not understand. Rule for me but not thee is what I am seeing a lot of in these times.
Genital exposure can happen to anyone of any race or sex. However, if it is a white person doing the exposure, I believe they are more careful in how they do it if the person is non-white. In all of the stories I have had access too, I have not come across any stories of anyone other than a white person being exposed. However, sickos like Nassar assaulted young black women so sexual abuse does happen but this is a different degree of sexual assault than unnecessary exposure.
Maurice et al,
I am fine. Been busy with work (coming back after the shutdown).
To NTT I say state law requiring a chaperone is NOT absolute. The Americans with Disabilities Act (ADA) is a federal law that supersedes state law. My friend, a transwoman, gets her HRT WITHOUT doing bloodwork. She simply invoked her rights at her first appointment.
Patients can opt out of a chaperone by invoking their ADA rights. The patient is under no obligation to disclose their disability let alone have to prove it. In fact, for a provider to ask for either is illegal.
The only caveat is that it must be a diagnosable disorder. PTSD is one such disorder found in the DSM.
I have purposefully avoided discussions related to the pandemic such as masks and vaccines, but this is VERY relevant.
Politicians, public health officials (many of which are physicians), and providers do NOT believe that our bodies belong to us, they believe they belong to the profession of medicine and/or the state.
I am referring to the vaccine mandates.
As a Constitutional scholar, they ignore the rule of law. Many ignore the Constitutionally protected right of the religious exemption. They ignore the science of naturally acquired immunity.
The OSHA mandate is in violation of the Federal OSH Act as there is no imminent threat (people have been working the last 18 months) and this is not a workplace specific threat.
*** I do not want to debate these issues and I can provide links to validate the assertions that I have made. ***
-- Banterings
The only thing racism even is, is a desire to treat other people badly and to feel like you are better than them. All races have members who are racist. A white person who is racist will ( if they find themselves outnumbered ) will quickly find a safer target.
The only problem is they do not see it as unnecessary exposure. When we to get them to see it is unnecessary. The worst is when you are unconscious and can’t speak up.
JF and Catsfostermom,
I agree. Racism is the desire to treat someone badly just as we see being done everyday on network tv. However, by some strange reason that seems to be accepted by those spouting they are anti-racist, they believe they have the right to label others thus sealing their right to treat them badly. Labeling someone is convenient for those hiding their hate for others who do bend to their will. My husband was a victim of racism/bias/sexism (or whatever you want to call it) for it suited their narrative to justify the mistreatment of him. It was not a pretty thing. Anyone of any race or background can be filled full of hatred towards certain characteristics of humans. They justify their hatred by using labels. Older white men are an easy target of hatred except if you are an older white man who actually has used racist statements and supported racist views you can deflect your tendencies to innocent older white men.
We have seen the #MeToo movement and the George Floyd movement glorify hating mostly white men. We have seen medical workers join in those riots as some even wear their scrubs and id to the riots. Do they riot before or after their shifts when they are attending to the very people they profess to hate? The BS that they can leave their personal biases at the door is exactly that---BS. My husband was targeted for intentional sexual harm by female nurses during a time when all men (especially older white) were being blamed for sexual crimes against women. Those RNS most likely felt vindicated in harming him as a win for womenkind. They believed the use of versed would not only restrain him and allow him to suffer during the moment of abuse but would erase the event from his memory so there would be harm but no foul. This type of behavior is being nurtured by those who love to label others such as those labeling someone racist who says "wait a minute what you're doing is not right." If my husband had been able to slap or hit those women torturing him, he would have been the one arrested. They know this too.
Hatred of certain groups of people does influence how those hated certain groups of people receive medical care. The providers are humans and are influenced by the society they live in and associate with. It does carry over to how they personally deliver their services. Older people in this country (w/ the exception of those at the top) are a group likely to be more disliked. If you add to this a white male then you have the perfect victim of being abused. The obvious reason is most will remain quiet abt the abuse of him. Also, another benefit is few will believe he has been medically harmed (unnecessary exposure is intentional medical harm). In the past, many black ppl were denied care based on their skin color. Today, any person is likely to be that victim based on whatever characteristic the medical provider may have a personal bias against. However, hate crimes against most white people will go nowhere as it is legal to discriminate against whites. It should be a crime for anyone to discriminate against anyone but it is not. All may be created equal but it seems in life we don't value all equally and that is the issue. So again, racism, etc. does exist in medical care and anyone can be the victim of it.
Dr. B., it goes to show how the medical community loves to continue to throw fuel on fire by making this rather hypocritical apology. Why don't they apologize for all the harm they have done to every MH patient over the years but then that would open the door to shed light on the real issue of how MH care is delivered. Shame on you for being part of one contributing fuel to hide the real issue.
Changing the subject here for a moment. I got a press ganey survey electronically for an MRI I had last week. I was interested to see two questions included:
- Staff treated you with respect and dignity
- Response to concerns/complaints made during your visit.
And they had a space to write in comments. These are the kinds of questions I want to see. I didn't have any concerns or complaints to express with this visit, but hopefully I'll get a survey when the time comes that I do.
We have now over 170 postings on Volume 119 and it would be appropriate to continue the discussion on Volume 120 which can be accessed with the link:
https://bioethicsdiscussion.blogspot.com/2021/11/preserving-patient-dignity-formerly.html
Volume 120 starts off with the expression "Leave Your Dignity at the Door".
This declaration might be appropriate for the action of both the patient and the potential caregivers. Correct? Don't respond on 119, it is now closed, but go on to Comments on Volume 120. ..Maurice.
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