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Preserving Patient Dignity (Formerly Patient Modesty) Volume 124
Since December of 2007 when Patient Modesty, as part of this bioethics blog begun, my question arises to my contributors and readers here: has there been any changes to the good or to the bad regarding how the matter of bodily modesty of patients male, female or otherwise have been interpreted and carried out? Any changes?
It will be of interest to read about any changes within the past 15 years in behavior both of the medical system and the patients themselves with regard to this matter. ..Maurice
213 Comments:
Since December of 2007 when Patient Modesty, as part of this bioethics blog begun, my question arises to my contributors and readers here: has there been any changes to the good or to the bad regarding how the matter of bodily modesty of patients male, female or otherwise have been interpreted and carried out? Any changes?
It will be of interest to read about any changes within the past 15 years in behavior both of the medical system and the patients themselves with regard to this matter. ..Maurice
Funny how the start of this topic started right after OBama was elected. Of course, he had been pushing for OBamaCare which prompted many hospitals to start consolidating which in turn made them into corporations. They are corporations with huge legal and PR staffs that can smooth/control just about any adverse situation because they are much akin to being a mafia/cartel. Big corporations do not care abt individuals as they are so big they do not have to care bc there is always another customer to take their place. With OBamaCare, it added customers to their base bc the govt. was willing to pay by making others pay for the care through the OBamaCare tax/premiums. The Obama years also taught hatred of certain groups was okay thus why dignity care for women improved in some areas such as having females in labor or for mammograms while dignity care for men took huge leaps backwards.
However, with the Internet being used more in the past 15 yrs., abused men know they are not alone in their feelings of being medically and sexually abused and discriminated against. Men are starting to speak out and wanting to gain the same rights as women. However, the medical cartel is strong and will not give up without a huge war.
It is to safe to say that I think the overall behavior of the medical system has worsened in the past 15 years. They do not care abt patients but rather abt their reputations, finances, and power/control. I think we have seen some extreme cases of patient frustrations by the violence they have carried out on medical providers bc they must have felt the system left them no other choice. I think there are more stories of medical harm to patients that we will never hear about bc it is so difficult to get those harm stories out bc people are afraid and the ones who are vocal are silenced by the medical cartel, the media, and the legal system.
One thing that covid has taught us is the medical mafia believes we must follow their orders even though they may be unsafe, unproven, and dangerous. We also have clearly seen that although they may make real mistakes, they do not own those mistakes and seemingly never learn from them. I think this covid period is one for the history books on how the so-called scientists did not follow the science nor did the govt or medical community care abt the long-term safety of people but rather profit and power. We also have clearly seen how the medical community is willing to lie to get what they want.
JR... such is the case of nurses walking out of the job, because a nurse who KILLED a patient by giving her the wrong medicine. Instead of standing behind the legal system, saying it was murder or involuntary manslaughter, they stood behind the nurse saying mistakes happen. Slap her hand and tell her to be more careful. Or revoke her license and make it impossible for her to get a job in healthcare ever again. You arent talking giving her an extra dose of Tylenol. She was even training new nurses. Im not sure, did they try and say something about the meds? Cat
Cat,
If you are talking abt Radonda, the prosecutor said she made up to 17 mistakes that day. My question is at what point is too many mistakes? Apparently, the nurses standing with Radonda don't think a nurse can make too many mistakes. I personally think Radonda should be in jail just like Kim Potter the cop who just made one mistake that killed a man. Radonda should also never be allowed to be around patients again by losing her nursing license. It is very telling and scary that Radonda and others like her are "training" new nurses to forget what they have learned in nursing school and do it this way. School teaches one thing but the job says another.
Most nurses know that patients are subject to hypothermia when they are unnecessarily exposed in pre-op and post-op. They know still could lead to death or slower recovery times but still they do not care and they keep doing it. They say they use warming blankets but this is only after a patient has been exposed. I know my husband remembers violently shivering during what he now knows was the procedure and his temp. when it was finally recorded 5 hours later was still below normal. Cindy's temp. was also below normal due to the excessive exposure. You add to the exposure with the cold IV drugs, the prep material and the cold procedure rooms (as they are kept cold for the convenience of staff and the machines) then many patients may be put at risk. Certainly nothing I can see is done with the safety of the patient in mind.
I had read articles where medical providers don't think they should be punished for mistakes. But again, what is their definition of a mistake? Is it you can do unlimited amount "mistakes" that may or may not kill another human being? Why does this only apply to the medical community? Radonda said what she done was common. So is it common to make medication mistakes and does that make it alright for a patient to die? Seems so in their world because after all we are just objects. What if I were a hair stylist with a new rule and I gave my client ( prep nurse) a little something to relax them in the chair and stripped them because I didn't want the hair to get on their clothing? Would that nurse cry foul bc first she wasn't informed what would be happening or would she accept that I was the professional and had the right to do the appt the way I wanted? What if I had others in while she was stripped naked in the chair before I would put the protective sheet on her? Would she be okay with that because they too are professionals? Would she be okay if the door/curtain to the booth was not closed? It would be NO to all those questions because they would have bodily dignity and safety concerns so why are they so bent on doing the same to defenseless patients? I would bet many nurses would say that wouldn't be necessary to do all that for a haircut.
Really where else in life can a service provider get away with "mistakes" that can kill you along with sexual abuse of their choice? Even cops have to answer for their overuse of authority so why are medical providers having to answer for theirs?
I have noticed something on Quora about "weve seen it all a thousand times". The men are telling the nurses its dismissive and not comforting AT ALL. The ones that answer and argue with them are female nurses saying it IS comforting. That there is nothing to be embarrassed about. We are comfortable seeing you naked. These are the same ones that tell men they have no clue how painful child birth is and get all pissy, whenever a female problem comes up. So if men dont understand women problems, then why is it that ALL female nurses absolutely know that by saying weve seen it all, should be a comfort to men? How do they know mens problems, if men dont know a female problem? If they truly were the geniuses they claim to be, dont you think they would take the many mens opinions on that phrase and maybe not use it and actually show empathy for that patient? What is so hard for them to understand? Cat
by identifying as a member of a protected class, one is given additional considerations in care. two of the best classes that anyone can identify as, but especially a white male is as a trauma survivor and/or a member of the lgbt+.
trauma informed is becoming the standard of care. being a trauma survivor give one the right to be granted accommodations under the americans with disabilities act. this is basically allowing anyone (especially men) to be afforded the protections that women enjoy.
-- banterings
Banterings and all my visitors and contributors here, I think that it is time to provide you the link to my blog posting the written by my former medical student and expressing his view in 2018 titled "Difficult Patient vs Difficult Doctor" with 45 reader comments including Banterings and PT and others and, of course, myself.
I think we are still faced with the riddle "whose at fault". Who should we all point our fingers as illustrated in the picture for that blog presentation? Here is the direct link:
https://bioethicsdiscussion.blogspot.com/2018/01/difficult-patient-vs-difficult-doctor.html
At this point of our current discussion, it is worth looking back to this 2018 discussion and perhaps by now
there is an answer ..Maurice.
Biker, I forgot to mention your contribution to the blog thread. Has NOTHING changed over the 5 year period..or has the conflict between patient and healthcare physician or nurse only worsened.. perhaps even related to COVID and the United States 21st Century Cures Act? We have to go over and over with what has happened in the recent past to attempt to resolve the conflicts which have been amply detailed and discussed on this blog thread. ..Maurice.
i have undertaken a research project currently...
looking at healthcare providers indicted or convicted of patient sexual abuse there are a many similarities in these cases including:
-- providers claiming that they were following guidelines
-- providers videoing/imaging patients for educational purposes
-- providers saying a treatment/exam was needed
-- patients unconscious when the acts (of abuse occurred)
-- patients suffering PTSD/trauma from the events
my end game is to show a large number of patients suffer ptsd from the guidelines that providers consider appropriate. simply having a magic white coat does not make the encounter benign.
-- banterings
My primary observation of recent year trendlines is that the pressure being put on physicians to process ever more patients results in more referrals to other doctors or for more tests, and also a grasping for a quick diagnosis that is plausible, but w/o confirming follow-up. If you can't take the time to figure out what is going on, you can still meet your throughput metrics for that day by sending the patient on to see someone else.
Not everything lends itself to quick diagnosis or a ready course of action, but such things take time but with private practices almost being a thing of the past, the MBA's in the corporate suite prioritize throughput volume over effective care.
I have a vestibular system disorder that has been with me my entire life but which has gotten worse with age. The onset of severe vertigo-like episodes and worsening balance issues caused me to make a primary care appt. Quick diagnosis of benign paroxysmal positional vertigo and a set of exercises to cure it. Made it worse, not better. Send me for an MRI of the brain. No tumors. Send me to neurologist. Can't quickly diagnose it, sends me to a hematologist (never did figure out what they were looking for). Nothing there. Send me for physical therapy. Made it worse, can't finish the therapy. Send me to audiology. Very abnormal test results but nothing that lends itself to a quick diagnosis. Send me for physical therapy again. Makes it worse, can't finish the therapy. Send me for in-depth audiology testing. Extremely abnormal test results that don't point to a specific diagnosis. Surfaced that I was in a perpetual state of nystagmus. Send me to specialized physical therapist that runs tests using high tech equipment. Results so bad can't even finish the tests. Note to primary care nothing came of all the above. Send me back to specialized physical therapist. Repeats the same tests with the same results. Specialized physical therapist can't diagnose problem & sends me for regular physical therapy again. Makes it worse, and can't finish. I stop seeking care for it altogether.
Surely all of the above cost more than any of the people I saw having been allowed to dig into the issue and figure it out, but throughput metrics don't allow for that. So, no more doctors visits, no more testing, no more physical therapy. I've better learned what the triggers and physical limitations are so that I can somewhat manage the situation on my own.
As an aside, each time I got passed on to someone else, there was never any follow-up to inquire as to the results of who/what they sent me to. I long for the days when primary care physicians oversaw their patient's care, using specialists as needed, but remaining in charge of the overall picture rather than just passing their patients along.
It shouldn't come as a surprise to anyone that the focus of healthcare staff isn't on patient dignity. Both patient and provider are on an assembly line and the pressure is on providers to be efficient.
JR
As a person who has worked at nursing homes and assisted living homes I can tell you that nurses do occasionally get fired. I don't know how often their medical license are taken away though. Sometimes the terminations are so problematic for them they just let their licenses expire. Cops don't have enough accountability either. If you're thinking of Derek Chauvin, he was unconcerned when he learned he killed George Floyd because he fully expected to get away with it. Ratio wise I don't know whether cops get away with murder more or if nurses do. JF
JF,
Yes, sometimes nurses do get fired but that is an exception rather than a rule. Most of the time, they will just go somewhere else bc as far as I know there is no national tracking system if they lose their license in one state. I have reviewed the nursing board cases in several states including Indiana, and rarely do deserving nurses lose their licenses.
Yes, cops don't have enough accountability and no I wasn't talking abt Chauvin but rather Kim Potter. The Chauvin case was different. I believe in both cases the men killed were resisting arrest, had prior criminal records, and at least one was in the act of committing a crime when police were summoned. Having said that, Chauvin had an attitude of superiority which many medical providers also have and who believe they have the right to treat a patient in any manner they please. Also, patients are not being treated bc they have been suspected of committing a crime. Big difference in the situations but both professions share a common thread: they believe they are superior to those they serve and are sworn to protect. Again, not all are bad but my theory is to avoid both by not committing crimes therefore not putting yourself in the orbit of police and just not going to medical providers. Avoiding police is easier but if confronted by one--don't resist, argue. However, a medical provider shouldn't have the same authority except we have allowed them the authority over us.
I believe medical providers get away with more crimes because the medical system protects them. Just do an Internet search of medical killers and harmers and you will find this to be true. Look at how many victims one medical harmer has before they are ever investigated. It literally takes years for medical harm to be outed because victims are afraid, may think harm is the standard of care, or can't remember.
Good afternoon:
With the introduction of MBA's into the executive suites at hospitals, many hospital administrators and boards of directors are now questioning whether the traditional medical model of healthcare is becoming obsolete.
The traditional medical model of healthcare has relied on the expertise and authority of medical doctors and other medical professionals to diagnose and treat patients. With the introduction of MBA's into executive positions at hospitals, the focus has shifted towards a more business-oriented approach to healthcare, with a greater emphasis on financial management, cost control, and profitability.
While MBA's bring a wealth of business knowledge and experience to the healthcare industry, some argue that their training and background may not be well-suited to the complex and unique needs of the healthcare system. On the other hand, others argue that the business acumen of MBA's is essential in ensuring the long-term financial viability of hospitals and the ability to provide high-quality care to patients.
Ultimately, the effectiveness of the combination of the traditional medical model and the business-oriented approach will depend on the ability of hospital administrators and boards of directors to balance the competing demands of cost control, profitability, and quality patient care.
It is this writer’s opinion that with each MBA installed as part of a medical facility’s mgmt. team, that facility loses more and more of its humanity. The human element which allowed the patient/provider and facility personnel relationships to grow is being replaced by the drive for the almighty dollar. When the humanity element is gone, it won’t matter if your male or female. The name of the game will be get them in and out as safe and fast as possible & make that money!
In the not to far future, I see these bean counters replacing some doctors & nurses with AI. Step through the scanner & AI will tell you what’s wrong with you and steps necessary to fix yourself if possible.
That’s where we are headed if we don’t take back our healthcare system. It’s broken. It needs CPR and Do No Harm to fix it. You can’t have one without the other and have a world class healthcare system.
Earlier Cat said "nurses were comfortable seeing you naked." Of course they are. It's a power trip for them.
With this MBA push into the industry, nursing and medical schools are now more than ever desensitizing students to the human element of hospital care. They teach them they know it all and the patient knows NOTHING.
What female healthcare works just don't get is when it comes to modesty concerns & intimate male issues, they just are NOT and NEVER will be qualified to say anything because they haven't spent a lifetime dealing with the intimate parts or issues involved.
The same goes for male nurses and intimate female issues.
The system needs to realize this problem & move people around if necessary to give men male caregivers. Or they could just hire back the orderlies they dumped in the name of feminism.
I've said enough. Hopefully I didn't bore anyone too much.
Best regards,
NTT
Maybe nowadays the issues described here may no longer be "difficult patient versus difficult doctor" but instead "difficult clinical administrator (oh and should we add difficult state and federal governmental officials") vs "the classic patient-doctor relationship". Next in medical guidance and care for disease and dignity the "autometron".
..Maurice
Maurice,
Ultimately as the patient I am the customer and I am in charge. It does not matter how I pay the hospital bill (I work and my employer pays part and I pay part of the premium).
Demanding that I be treated with dignity and respect as a human being does not make me a difficult patient.
I no longer see healthcare providers as human beings, they are objects; no different than boards or chairs. This is not my fault, this is because I have repeatedly abused by providers, the other providers refuse to police their own ranks, and NO PROVIDER EVER has apologized to me for what happened to me and none have ever acknowledged that this is a problem in the profession of medicine.
Biker,
As NTT said, AI will replace them. No more gratuitous naked bodies to look at, no power trips, just get back on the assembly line and do your job.
-- Banterings
They could fix the police problem by equipping them with Versed that way at the first sign of resistance just inject them, problem solved!
Sorry that last post was Jeff
I was just reading on Quora.. what do doctors do with patients questioning their judgment? One doc gave 5 bullet points. Number 4 and 5 were dismissing the patients from their practice by having them sign AMA waivers. As i stated there, that piece of paper is their legal key to their egos. That piece of paper is now part of their medical record, labeling them as difficult patients. So what doctor is now going to want to see them, as they are difficult? Where is the spot on the medical records for the patient to explain themselves and why they were questioning the first doctors " judgement"? Is that doctor being a difficult doctor because she wouldnt listen to her patient, when they know how their body feels? Is the next doctor being a difficult doctor because they are reading what a colleague said and again not wanting to listen? Now the patient dies, because they were labeled diffucult. But, that legal piece of paper doesn't hold any doctors accountable. Never sign those AMA papers, leave on your own. Cat
This comment has been removed by the author.
Thinking about the matter of the matter of the medical profession's acts which may be diminishing patient dignity is the professional's own inadequate training in patient obesity. You should read the following article:
https://www.npr.org/sections/health-shots/2023/01/31/1152491692/scant-obesity-training-in-medical-school-leaves-docs-ill-prepared-to-help-patien
which includes the following:
Patients suffer from physician's ignorance
The impact is deep for patients like Patty Nece, who in her 64 years says she's never been free from the stigma of living in a large body. She gets catcalled, compared to cows or whales — insults that amplify her own savage inner voice.
"I'd sorta become my own worst enemy, my own worst bully," she says. "I won awards as an attorney and I've been active in community and nothing overcame all the weight bias and stigma I'd faced."
But, she says, the biggest clinical damage has come from doctors themselves, including from an orthopedist she consulted several years ago about hip pain.
Almost immediately, without listening to her, examining her or even touching her, she says the doctor launched into a lecture about her excess weight, attributing her pain to obesity.
"He said, 'See, you're even crying because of your weight,' which was so far from the truth; I was crying because of him," Nece says. "I didn't want to see another physician in my life."
When she finally did see someone else for her hip pain, the root cause turned out to be a severe curve in her spine. Nece says health care workers often seem to assume that people with excess weight don't know their bodies, even though it's something she thinks about all the time. She says the orthopedist wasn't alone in dismissing her; she's felt spurned for her weight by others, too — dieticians, mammographers, rheumatologists.
Many aspects of the destruction of patient dignity by the medical profession have been described on this blog thread. Shouldn't this be considered another example? ..Maurice.
By the way, anyone aware of an obese physician or obese nurse and how they describe themselves, if they even do that, to the non-obese patient or what they might say to a grossly obese patient? "I see you enjoy eating and so do I" ..Maurice.
Ya gotta love when an overweight doctor tells you should loose some weight. I see many obese DX codes and I know of one doc who uses it often is on the chunkier side. What he says i don't know, but just that a lot of his patients have that as part of their DX. Cat
Is anyone else bothered when the staff says patients can follow "commands". It totally irks me. It shows complete power hungry individuals, who want control over the patient. To me this is also showing lack of protecting the patients dignity. Treating them like animals and not people. Cat
Cat, what do you think about the medical professional stating "You can follow my professional advise" in place of "commands"? Such use of the critical word "can" and "advice" maintains the patient's dignity which often, finally, must be a patient's own decision.
There is much to teach students and those entering the medical profession of the most frequent source of final decision-making.
It becomes that of the patient (or in special circumstances, that of the patient's surrogate). It is a simple concept though important. That has always been my personal view when I was in medical practice and even today. ..Maurice.
Good morning.
Dr., Bernstein, how about "You can choose to follow my professional advise or not"
Regards,
NTT
Maurice... im finding it the power hungry nurses, usually after a surgery or recovery who use the word command. " once a patient can follow verbal commands....." its not in a doctors office setting. Cat
Do as I say. Not as I do. ( They're still giving it to us straight through ) JF
I know a woman in Ohio, she was a patient in a nursing home I worked at I was friends with her sister who worked at the nursing home as a CNA. This lady didn't like her doctors bedside manner so she refused to follow his commands. She had her feet amputated and was still drinking her 2 litters of soda and eating just the same as before. Maybe she should have just changed doctors. JF
NTT, you suggest for the doctor to say to the patient ""You can choose to follow my professional advise or not". Perfect expression demonstrating patient's final responsibility and inherent dignity.
How would you all feel if during the years I was active in professional medical diagnosis and care of patient, I had this above quote as a sign on my office door or even wore the expression as an easily read badge on my white coat? Professional assumption vs frank professional display regarding patient's understanding of "who is finally in charge" is the point of this suggestion and discussion. Perhaps the medical profession and their organization masters tend to ignore such a declaration. ..Maurice.
"You can choose to follow my professional advise or not" which depending upon the tone in which it is said, and the mindset of the person it is being said to, could be interpreted as "I don't care", though that is clearly not the intent. I'd prefer a simple "my recommendation is .... for this reason....".
Just because a doctor is overweight, shouldn't mean he shouldn't advise an adult patient to lose weight if that's what they need to do. It's true that he/she SHOULDN'T deliberately push anger buttons but we can't logically retaliate by self sabotaging because they aren't going to care anyway. JF
I was talking to a FP one time who was very overweight. I asked him abt how he advises people who are overweight to lose weight while he is overweight. His answer was simple: I tell them being overweight has many health hazards which he himself can attest to and not to follow his example. I thought that was a very good explanation. Of course, his complete answer was much better than my shortened version.
As far as the patient being the boss, they are. However, no medical provider should say follow it or not but rather say I have presented all the reasons I believe this is the best option as well as presenting all the options of alternatives and what could happen by doing nothing. It is of not only vital importance but morally, ethically correct for the patient to have true informed consent rather than what the medical provider deems appropriate for the patient to be told. Sadly, this is the case more often than not. However, this is not true medical care but rather coerced, biased care. I respect doctors who are self-assured enough to present all the facts and know the patient has the right to make their own care decisions. Few doctors I have met are that sure of their own powers to do this.
As I have discussed before, there are certain words, phrases and/or actions the medical community uses to assert its authority over patients. "Commands, orders, must, etc." are just a few of them. There are key words like difficult that are used to communicate that a patient doesn't follow "orders" or questions "orders". I have seen this word used abt me merely bc I questioned the specifics abt various brands of insulin. The doctor wanted to use one brand (probably a kickback involved) and I per my son's instructions wanted to know abt others as my son had tried that one and didn't want it as he had had issues with it.
However, bc of O'bama medicine has become big business and I do not see that changing. If they tick off one patient, there are scores more to take their place. It is a numbers game. They have been taught that money is the driving force. Used to be that male orderlies took care of male patients' intimate needs and females took care of female patients' intimate needs. What happened to those males who were orderlies? I believe the political climate (the teaching of hate) in this country since O'bama has caused the epidemic of abuse of male patients.
Hello,
I recently accompanied my wife during her annual doctor's visit. She expressed to the doc her concern about her deteriorating hip joint. His statement to her was, "What outcome would you desire?" By this he was asking if she wanted just pain reduction, surgery, exercises, etc. He was in effect asking her what course of treatment she's consider. This would be followed by the pros and/or cons of her selected choice of care. She was, essentially, making the decisions regarding her care. The doc has been practicing for over 40 years and has NEVER dictated orders. His procedure is to offer his suggestions, often giving multiple options. This is why my wife and I have been seeing him for over 25 years. He's a doctor in his mid-sixties and, has always had a collaborative manner. There are great doctors out there; albeit, they're getting harder to find.
Reginald
Their was a doctor out there named Joel Sherman that had a site that dealt in dignity issues (I don’t know what happened to him) but he said that orderlies and male physicians did things like catheters on men like JR says. According to him hospitals found orderlies to be to expensive and phased them out and doctors got to busy probably due to managed care (assembly line medicine) this all started in the 70’s so you know what men got left with! I’m sure there are a lot of nurses out there that would rather not expose and touch a man’s genitals but they have no choice and no matter how hard they try I think that takes away the intimacy and sanctity of her relationship with her husband and then you have the one’s that make sport of it.
As a male patient which one are you getting and does it matter?
Jeff
When I got my first nursing home job in 1983, there were two male orderlies working full-time on my shift. I was there for 8 1/2 years and we had other male orderlies besides them. I enjoyed working with the guys because they made work fun. We'd end up doing more of the work because a lot of the female patients wouldn't let them take care of them. But at least a small number of men wanted to be taken care of by these orderlies. JF
I have heard that nursing homes are the only place that still employ male orderlies
Jeff
Jeff. When I was in the hospital about 6 years ago there were some male CNA's and male nurses there. ( In Florida at an Adventist Hospital ) JF
On 2/11,2023, PBS did a short presentation on pelvic and DRE done on patients under anesthesia. This I believe is the first time this has been questioned on a national news program viewed as an evening news broadcast. Unfortunately this could make an entire broadcast, however this matter will now be known by a larger segment of the population.
JF your you are absolutely correct there are some but not nearly enough that is the whole problem for male patients that are trying to preserve their dignity. And when a intimate action is being done on a male they are never asked if they would prefer a male nurse to do it but if you are a female you will be asked. In all of my wife’s procedures she generally had female nurses and in any case that she had a male nurse which was rare she was asked if she would prefer a female for anything done that was intimate. Then compare that to my experiences. One example and there are many, a female nurse came into my room to remove my catheter and brought two female student nurses with her to watch never asking if I minded. There is a huge double standard because most men won’t say anything and they know this. And how many of them smile behind that mask as they watch that poor man turn beet red with embarrassment. Why must they make medical treatment for men so degrading and for me all of my treatment has been life altering. Knowing what you could possibly be doing to an individual emotionally and continue anyway without asking would be criminal in any other circumstance outside the medical world. MORE MEN NEED TO SPEAK UP and make it stop!!!!!
Jeff
mitripopulos, I am surprised that PBS did a segment, even if short, on non-consented pelvic exams and DRE's. Maybe there is hope, though I am surprised that women's groups haven't made a big issue out of this years ago.
I must do this in 2 parts.
I came across this article. I like to think myself a caring and compassionate person. I want to feel sorry for these people, but I cannot; that is because they are not people to me. They are kiosks, scanners, vending machines, just a means to an end.
When others try to reason that they are people, I say they are not. Human beings do not do to other human beings or allow other human beings what providers have done to me and those close to me.
Would anyone expect that survivors of the Holocaust must forgive the Nazis? Would anyone expect that survivors of religious sexual abuse return to church like nothing ever happened?
There are many that transcend their abuse, may forgive and move on. Many do not and it is their right. Even if one has never witnessed it, it happens. How many licenses have you had pulled for abusive behavior? How often do you volunteer to be a warm cadaver for medical students?
If you are not part of the solution, then you are part of the problem.
Is it no wonder that patients are treated this way when US medical education is modeled after the German system? The German medical system that gave rise and validation to the death camps.
Note: I have footnoted these assertions in previous volumes and on my blog.
So in reading this article, one simply reaps what they sow: How India treats its physicians: The patient is dead, let’s beat up the doctor and go home
To even further erode trust in the profession, has anyone actually looked at the Twitter Files: Twitter Files?
I have. It is even worse than I suspected. Unelected public health bureaucrats, government officials, the DOJ, HHS, the healthcare industrial complex, pharmaceutical companies, healthcare providers, politicians, and others colluded to suppress scientific discourse and free speech.
-- Banterings
Part 2
The Nuremberg defendants argued that they were following orders (Superior orders, also known as the Nuremberg defense) when they committed crimes against humanity.
The judges at Nuremberg rejected the “following orders” defense. They said that when an individual follows an order that is illegal under the law, they are responsible for that choice.
Empty threats of having no providers is a grasp at the cancer of paternalism. There will be individuals that will simply do what the patient wants and collect their pay check. Others will learn bedside manners and do what is necessary to earn the patient's trust. They will do very well. That is already happening.
Even though I do not believe in CRT, I will use, and teach others to use it, the allegation of systematic discrimination and white supremacy to get what they want.
To show the arrogance, narcissism, and paternalism of the profession of medicine, has ANYONE heard a provider, facility, pharma company, system come out and apologize for being wrong??? Or are they doubling down on because I am a doctor and you are not?
A proven frame wok isa 12 step program (modifications allowed).
1. We admitted we were powerless over alcohol (power, training, etc.) — that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him. Humble yourself.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. (ask our patients what we did wrong.)
6. Were entirely ready to have God remove all these defects of character. Humble yourself.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others. Make amends to society if we cannot make amends to specific individuals. It is not a 1:1 amendment; we owe those harmed a much greater amend.
10. Continued to take personal inventory and when we were wrong promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these Steps, we tried to carry this message to providers, and to practice these principles in all our affairs. Do not be afraid to destroy careers of abusers who refuse to make amends.
-- Banterings
Hello Banterings,
I'm afraid your 12 points are a bit too nuanced for the medical audience you're trying to influence. A more succinct precis of your thoughts might be "Respect Others' Dignity as You Would Like Others to Respect Your Dignity!" Since we're mere patients, we need to keep things simple for those of superior wisdom.
Reginald
Currently being discussed on a medical ethics listserv to which I subscribe is a topic which may be pertinent on this Volume dealing with preserving patient dignity.
The topic is simply (or maybe not so simple) of how should physicians and nurses think and react when they start diagnosing and treating a patient who when exposed has a swastika tattooed on their arm, chest or other possibly exposed parts of the body.
Does such a tattoo represent an element of this patient's dignity that should not be considered by the medical staff as something to initiate discussion or complaint or orders or should such a tattoo be simply ignored and patient management proceed as if the tattoo was not observed or considered? Would or should the presence of the swastika as a badge or on a shirt cause healthcare providers to order removal while in the presence of themselves or others? Any thoughts on this clinical ethics concern. Oh and yes this subject is not made up but has been reported within the medical system. ..Maurice.
Good afternoon.
Dr. Bernstein, being the consummate professionals they claim to be, they should ignore any tats & get on with the exam.
Regards,
NTT
Why should they consider it as we have been told they leave their personal feelings/biases at the door? We know this is not true. If a nurse or doctor has a personal prejudice against a white person, do they have the right to act on this? As the wife of a victim of personal opinions causing harm, I believe for any medical staff to act on their bias should be a criminal offense. Their harm is not merely name-calling but they can permanently harm or even kill with their hatred/biases. However if it is on the clothing of a visitor or patient, I believe most would have a policy that offensive material cannot be worn in their building. I believe that covers a wide range of material such as the F word, etc. I do not believe the medical community refuses to give medical treatment to convicted killers, rapists, etc. so why would it be acceptable for them to individually decide who can or will receive unbiased medical treatment? While being a Nazi is morally wrong and repulsive, I don't believe non-treatment of them should even be considered an appropriate action by a medical provider. Their job and oath is not to judge.
Hello Dr. Bernstein,
I find your last post rather intriguing. You mentioned "... think or react". Who, or what, gives one individual the authority to tell another what to THINK? I'm sure that many of us would be interested in what your listserv participants have to say about this "think or react". Please follow-up with their and/or your insights.
Reginald
Reginald, my interpretation of what was written on the listserv dealt with the mental behavior or reaction of the physician or nurse themselves: Is their personal response one of keeping their reaction of the swastika display simply to themselves or express their reaction directly to the patient? It is not the matter of "telling another what to think" but challenging themselves whether to "keep quiet" or base the professional's personal words and behavior toward the patient on their interpretation and reaction to what the professional observed. So, the discussion could be how the individual physician or nurse defines and maintains their own professional dignity. Remember,
it is not just patient dignity to consider but that of those attending to the diagnosis and care of that patient. ..Maurice.
Hello again Dr. Bernstein,
Would you agree that, possibly, we’ve arrived at the concept of reciprocal dignity to which I alluded in a previous post. Whereas some patients plead to have their dignity respected, now providers will become “coequal” supplicants in a quest to have their (the health care workers') visual dignity respected (i.e. wishing to not be offended by tattoos, etc.)
Those of us who are patients realize that this supplication will come in the form of “we need to …”; nonetheless, the reciprocal nature of dignity is still present, albeit masked.
A simple resolution might be to ask the patient, “Do you mind if we cover your tattoo? Some of our staff are disconcerted by it.” This would be, of course, the courteous way of asking for one’s visual dignity to be respected. Nevertheless, many posting here realize that what will actually be said is, “We need to cover that tattoo!”, without further explanation. We also realize that, as often occurs, the patient may awaken to find the tattoo covered without his or her consent.
Has the time come for health care to recognize that the patient’s dignity is not left at the front door of the facility; and, that the concept of dignity is reciprocal?
I would guess that some of your listserv colleagues would merely respond, “Just cover it up and get on with your job!” Isn’t this ironic. Those who, in the past, cavalierly left others uncovered will now be covering the patient to protect their (the health care workers') visual dignity. Am I wrong in my assessment of some of your listserv colleagues' comments?
Reginald
Maurice,
The origins of the swastika are that it is an Asian symbol of good luck. It was perverted by a certain regime. Of course, the origins of the US medical system, especially the education come from that same regime.
Tattoos are a very personal thing. I know many people who have tattoos that are of a sexual nature meant for their intimate partners only. I have seen people speak about leaving gangs, hate groups, etc., and having tattoos that they regret, but not having the money to remove them. There are charities that remove tattoos to help people escape the gang life.
There had been a discrimination against indigenous peoples for facial tattoos. The Inuit of Alaska and most famously the Papua New Guinea indigenous peoples.
Society expects that as patients, if we expose our bodies, we are not to be judged or discriminated against.
What if the guy with the swastika on his arm was an undercover FBI agent who spent his career fighting the white supremacy movement, now talks to at risk youth, and keeps the tattoo to show what this movement requires as proof of loyality?
This person may not want to tell his story because he fears reprisal on his family for being undercover law enforcement.
How dare anyone judge any individual? Who do any of us think that we are; God? (...of course that type of thinking plagues physicians.)
The profession of medicine just keeps proving what I have asserted correct and keeps calling for an intervention by society.
-- Banterings
Reginald, on review of the two dozen or more comments by the listserv medical ethicists, I really couldn't find a contrasting clinical behavior discussed regarding accepting the professional's physical "covering" vs patient
unpermitted "uncovering" of a part of the patient's body, the latter, a point of heavy discussion on this blog.
..Maurice.
I just made an appointment with a general surgeon to have a consult. He did my colon surgery a few years ago and is an excellent surgeon. I will be requesting no sedation beyond local anesthesia and no intimate care by female nurses and that includes being present for any intimate exposure which is a given with hernia surgery. It will be interesting to see how this goes
Jeff... there was a nurse on Quora who said how she prepped a coworker for hernia surgery and didnt see his genitals. She says thats how she does all the prep for that type of surgery. If she can do it for a coworker, why can't they do that for everyone? Lapascopic needs to be under general but you shouldn't be exposed, but are. Open can be done under a block, where you are awake. Again, genitals shouldn't be exposed, but are. Either way the genitals are covered for the surgery. IMO... if they are draped anyway, why prep? Neither should need a Foley, yet again routinely done. Look into the covr undergarmets and get them prior to consult or show your surgeon what they are and have him order them. Cat
Jeff and Cat. People on this blog have also talked about wearing boxers on backwards. JF
Yes..hubby wore them as well.
Now this is the interesting part. Since he was not having ANY sedation he gave consent to students. Not a single student was observing. Wouldnt you think his was a case that you'd bring students into? So many people say you want an EXPERIENCED gastro doing an unsedated colonoscopy. So does this mean future doctors arent willing to learn? Surely some students were around.
Sorry last post was Cat
JF the boxers backwards is great for colonoscopy but what I need is left and right hernia surgery in the groin right above the genitals. Cat I don’t know if the COVR garments would allow enough clear access to the area but it is worth checking into. I refuse to be sedated during the surgery because your correct an abdominal block will do the trick but they usually insist on sedating you not for any benefit to the surgery but more to turn you into a blob of puddy with no memory . That is why I am requesting an all male team because I will be stripped naked and as uncomfortable as it is being stripped naked in front of a room full of strangers I don’t have near the amount embarrassment or humiliation that occurs to me when women do that to me. With males it feels a little awkward with women it is traumatizing I found that out first hand and if I were to have to re live that experience I don’t know where I would end up emotionally? I’m already hanging on by a thread because of past experiences . The good thing about all of this is I have time to test the waters with this because except for the pain I have I can push this off if need be and find out if going forward holds any hope for me in the future for other health care needs. I’m anxious to see the results of this. I know that most of the people I know think I’m over the top with this fear I have but for me I not only have personal feelings about this but moral ones also I don’t believe God meant for women to be looking at and handling men’s genitals that their not married to and the same goes for men. As modern medicine has progressed and more and more invasive procedures are developed the need to bend the moral rules became imperative because of staffing issues and expediency (and don’t forget money) but none of this is surprising just look at the rest of our society in moral decline
Wish me luck and I’ll let everyone know how it goes
Jeff
Jeff if hes doing it lap the incisions are by the belly button and right/left 6 inches. Hubby was only shaved from mid chest to pubis (high enough from his penis). Open surgery covr wont get in the way either.
I had that done that way for my colon surgery but that was laparoscopic with open incision the cut is right at the hernia site which is in my groin
Hello Jeff,
Have the doc sign a document indicating the conditions for your surgery. This might include Covr garment will cover genital area, Covr garment will not be removed, All male surgery team will be present, No female personal will view or care for genital area, Etc. Add whatever statements you feel necessary. Don't feel reluctant to have the doc sign your agreement. Tell him that it's to inform the other medical personnel attending to you; and/or, it's a reminder to show him so that he doesn't forget your situation the day of the surgery. After the doc has signed the document, make multiple copies and have them ready for any inquiries. If possible, have a good friend with you in pre-op to notify the personnel of your situation, and to show them the signed document. These people are under tremendous pressure to perform. They need as many reminders as you can supply. I hope all goes well for you.
Reginald
Also to add to Reginald comment. These will be doctors orders. They can not go against their written orders. Cat
I don’t know what my chances are of getting a doctor to sign something like that but it is worth a try thanks Reginald
Jeff
Hello Jeff,
If the doc hesitates, tell him the document will be useful as a reminder for him and to show other personnel that this is his directive and desire. I asked an ortho doc to sign a similar document and he did so without hesitation. I also had the document ready in pre-op when the nurse asked me to take everything off. I said, "I'll be wearing these." (Showing my Covr garment). She said nothing else and walked away. I didn't even need to show her the document. I guess she thought that the doc and the male surgical nurse would deal with it. If I encountered any resistance, my son (who was with me in pre-op) and I were ready to pull the IV and leave. You'd be surprised how fast changes are made when an insurance patient begins (or threatens) to leave. At each doctor visit prior to the surgery, keep reaffirming with the doc your need for an all male team and whatever else you're asking. Sure, you'll be deemed a pest or a neurotic; but, who cares. What's important is that your operation is done while respecting your dignity. If need be, let everyone know that your religious convictions require that your private areas not be viewed by females. Too often people thing that religious beliefs need to be tied to some organized religion. Actually, any deeply held convictions can be interpreted as religious convictions. Use any avenue that you can to have your beliefs respected. Again, I wish you well.
Reginald
I have a question. I recently had a lawyer draw up an advanced directive that states my wishes in great detail. If I had him sign a letter of receipt wouldn’t that suffice?
Hello again Jeff,
I understand advance directives to be useful in the event that you cannot act for yourself due to some incapacity. I'm not sure that they're relevant if you can speak for yourself. Please check me regarding this. Nevertheless, you never know what knowledge medical personnel have regarding advanced directives. A lawyer's signature always sends chills up the spines of medical staff. Bring anything that you feel will help you to get the type of care that you desire. Take care.
Reginald
Cat did your husband have open hernia repair or laparoscopic? Thanks for all your input
Jeff et al...
I have preached this for years. Patients inpatient getting IV antibiotics have used this to walk outside the hospital freely and reenter. A transgender friend uses to get hormones without doing blood work. Another patient told their doctor they are not removing their pants as part of any exams.
All have been respected.
One simply request an accommodation under the Americans with Disabilities Act (ADA).
PTSD is a qualifying condition under the ADA as are other psychological disorders. To rise to the level of a disability, your anxiety must substantially limit one or more of your major life activities such as receiving (avoiding) healthcare.
More on what constitutes a disability here:
The ADA prohibits discrimination by both public
and private entities providing goods and services.
I had a recommendation from someone who was granted an accommodation and allowed to wear a "willy warmer" for his procedure. Although sold as novelties, he found one that did the job without making a mockery of the procedure or his accommodation (no animal faces).
Men and women can also wear a "C-string." A C-string is a garment consisting of a narrow strip of cloth with a spring that covers the genitals (similar to a G-string which is attached to a waistband). It is generally considered erotic lingerie but is also worn as "normal" underwear by some people.
Others and myself have posted numerous links to studies, papers, books, etc. on the lack of necessity of a patient being completely naked for all procedures.
Finally, I am going to through this out again: I am creating a resource (most likely a white paper) for patients to get the dignity and accommodations that they deserve when receiving healthcare along with ways and organizations to report offenses to.
If anyone would like to help me write this, write a portion, share resources, etc., both with accreditation or anonymously, PLEASE feel free to contact me.
I will also need assistance in sharing the finished paper.
Maurice, I give you permission to share my email with people seeking it or one can click the link to my profile.
Thank you one and all for reading.
-- Banterings
Jeff.. he had it done as a lap. This was what the surgeon recommended. Unfortunately, due to time restrictions neither one of us had time or knowledge to look into anything. This surgeon was head of the hernia dept here. In a month he was moving to go work at either the Cleveland or Mayo clinic. I forget which. So he needed to get the surgery in plus have time for postop if he wanted this guy to do it. It wasnt until after the fact thst i really started looking into the procedure. What made me curious is he was shaved mid chest to only the top of the pubis ( they did this in preop, so he was awake and aware. ). Incisions belly button and over both sides 4-6 inches. Nothing even close to the pubis or genitals. BUT... his thighs and balls were tinted orange. So they were prepped. He also had pretty decent bruising on his penis. So of course i started looking up what goes on. Damn... did i get an eyeful. The more research i did the more pissed i got. NOTHING was told to him. Just the same generic pros/cons. He was given the versed as the started to wheel him in, so of course he thought he was out before he got into the OR. He was only told the relax you BS. After i told him no, you were awake just not aware, they need you to identify yourself and surgery etc etc. God forbid if he ever needs another surgery. I think itll go differently. He had 1 colonoscopy 4 yrs ago the "normal" way because again we didnt know any better. This last one he listened to me and my resesrch and had it done unsedated with boxers on. So, the system might not change, but i chsnged his thinking/feeling. Which. is a step in the right direction Cat
Cat I hope your husband appreciates your going to bat for him he is a lucky guy. I on the other hand had my wife tell me if I pushed the modesty issue she would not stay involved with my procedure I guess because she felt that I would be embarrassing her and I should just man up so in my desire to keep my support individual I allowed myself to be led like a sheep to the slaughter. After entering the pre op area I was immediately stripped of my support individual and she was placed in a little waiting room. I was then told to strip naked and was then made aware that a young girl was going to shave my genitals and she was going to stand there and watch. The trauma of what was happening to me caused me to mentally shut down and I have no further memory of the events until sometime later. The damage that occurred from this followed me home and led to PTSD. I know that this is not the only reason but my wife filed for divorce so now I have lost the person that I truly love and needed her the most. Life sure throws us some curve ball’s. Cat I don’t know if you share any of what’s posted on this blog with your husband but this would be a good one to share because it’s a blessing to have someone stand beside you in your time of need and JR this is meant for you also
God bless both of you. Jeff
Jeff et al, I am pleased that, at least, this blog thread can provide a pathway for ventilation of individual concerns and emotional upsets, whether or not the views expressed here are a statistically high representation of what is experienced by individuals within the United States or elsewhere in their interaction with the medical profession. ..Maurice.
This is kinda off topic, but kinda not. I just read an article of a nurse being fired in Long Island for abusing (slamming 2 DAY OLD baby face first into a bassinet). The curtain was left open a bit from the viewing window and dad just happened to be there taping his son, when he taped the nurse doing this. It goes on to say curtains are " standard procedure to keep privacy of their patients. Fortunately this nurse did not up hold that standard." We all know what else gets hidden behind curtains. We all want curtains for our privacy. This is SCREAMING at me why we need someone with us at ALL times. What else did newborns go through behind closed curtains with this nurse? What else is hidden behind closed doors? Everyone here knows that answer. Cat
Jeff,
I was told by a relatively famous urologist (over 15 yrs ago) that he was seeing more and more wives advocating for their husbands and he didn't like it. He said I was more outspoken than most but than I told him I was proud to be labeled as such and he should get used to it. I also told him "too bad" because what I wouldn't allow to happen to me, I won't allow to happen to my husband. We had searched long for a place for my husband to have his prostate cancer surgery. The 2 Indiana hospitals that medically and sexually assaulted my husband were on the list we turned down and we know they held a grudge bc we saw them mention his prior prostate records from 15 yrs earlier in those MRs. We believe that is the main reason the hospital systems decided to harm him as to teach him a lesson. Make no mistake--Medical Retribution is a real thing especially when he was telling them that night what he would and would not accept as treatment or how he would be treated.
My husband has his prostate removed via lap surgery. He agreed only to a 24 hr time to be spent in the hospital. He went in at 7am one morning and left by 8a the next morning and we boarded a plane back to Indiana despite the doctor saying he would have to stay there. I was with him in pre-op and post-op. I saw them drop him from the gurney during transfer to the patient bed. During that time, no nurse ever check his foley cath site at the penis. They merely checked the bag. The dr. did check it early the next morning. I never left his room so I know everything that took place. This was much different than what happened at the Indiana hospitals who didn't want any witnesses to their crimes.
When I was in post-op, I was amazed at how there was no effort to safeguard patient's personal dignity. There were curtains but none of them were used except around my husband. Pre-op was much the same. A male orderly came in to shave him. There was no mention of this beforehand bc this was and still is something the medical community doesn't feel you need to know. You have to wonder if they think if a lay woman is raped by someone using a drug if they really think it is worthy of being called rape bc their attitude that patients do not have the right to know what happens to their body during medical procedure is none of the patient's right or need to know. At that time, he did not request an all male team bc he didn't realize sexual abuse was an acceptable standard/outcome of medical treatment. I guess it also wasn't something we needed to know that prostate removal would also cause heart issues.
We removed the foley ourselves and he has never sought anymore urology care since 2007. He is done with how he was treated all those years of "strip as you go" exams and how he was not given all the info plus now he has medical and sexual assault to forever live with as a consequence of seeking medical care.
I, too, have learned much from what has happened. I will never allow him to be harmed again . We never expected harm like what was done to him but now we know it can and does happen. Although his prostate experience was unpleasant, it did not reek of criminal and malicious intent. He tolerated unpleasant medical experiences all his life as do most men bc they know no difference. I, as a woman, have known them to be different and to advocate for myself.
There are more women like Cat and myself. Cindy and I have talked to some on our radio show. I can't imagine your former wife being okay with you having things done to you that you did not want done or approved of.
I will pick up on one small piece of what JR said about post-op. A few years ago my wife had surgery and I was allowed in for a few minutes while she was there. It was a large roughly square space and I didn't think to count how many patients were there but I'd guess maybe 2 dozen. It was basically two rows of six back to back in the center with an aisle on either side and then a single row of six on the two outer walls with entrances to this room on both ends.
There weren't any curtains separating the patients, and no apparent effort to shield patients from view of anyone in the room when sheets were pulled aside or removed. I did not think it was appropriate that I should see any patient intimately exposed and would turn away. Most patients seemed to be still kind of out of it and may not have known there wasn't any effort to maintain their privacy, but certainly others of us in the room were fully aware, and the staff would have to of known that.
The post-op my husband was in was basically circular with the nursing area in the center. They make no effort for personal dignity respect because they are aware that patients will likely not remember and if they did, they will tell them their memories are incorrect because of the drugs. They also generally do not allow family members in PACU so there are no witnesses. It all goes back to they really don't care. Patients are no different than objects--pieces of meat hung from the ceiling. They don't assign human qualities or rights to patients. You are there for their expertise and they are superior to the patient. However, don't offend them but they are free to offend you. I also believe for those who ask for special considerations (i.e. to be treated with human dignity/respect) once that patient is drugged, they get even (medical retribution). Versed/fentanyl cocktail is the method that gives them total control over the patient with the benefit of erasing that patient's memory. The added bonus is while the torture is happening, the patient is aware, reacts but can't do anything about it. There are some very mentally ill people who work in healthcare. Why aren't there measures to weed out and prohibit those individuals from working in healthcare?
I agree. While I have avoided surgery to this point, I have some comments about treatment at the initial stage. I have seen two doctors over the last year for a urology issue. In both instances I got the distinct impression that he (in both cases) really didn’t care whether or not I got any better or even lived or died, there were full waiting rooms, so the money train would keep coming.
On the topic of modesty, one MA had to do a bladder scan. I half joking opined that it was embarassing and a woman would have had a female MA for the procedure. My wife was in the room at the time. The MA bluntly told me “well there are plenty of other doctors in the area.”. She would only be that blunt if she was confident 1, there would be no consequence if reported and 2, she was used to saying it. After all where can a man go to see a urologist where there isn’t a total female support staff? Certainly not in the Southwest Ohio area. With the backlog of cases due to the Covid mess, they know that any consideration for modesty or respect is not relevant. You have to take what you get or live with it. Frustrating!
Ohio Man
Much like a serial killer is able to go undetected in the general population for years voyeurs and sexual predators in the medical field can go undetected indefinitely when they have access to a completely vulnerable patients that may also be under the influence of drugs.
Exposing and touching patients genitals is a completely excepted part of medical treatment and if that allows them some form of sexual satisfaction or maybe it just satisfies their need for power and dominance over another person that could go on for years undetected “ SCARY “
In most cases only the patient is aware of what happened to them and either doesn’t know that what happened to them was inappropriate or they were to drugged up to remember or not believed when they complained. Once you have come to this knowledge about the potential for being violated you lose all trust and tend to look at everyone with suspicion.
A good example of how bad it is two individuals that worked for the hospital that I have had multiple surgeries were arrested for sexual assault on patients in the past two years. They were doing full body exams on patients in pre op including genitals and were not licensed or authorized. The only reason one of them got caught was the patient mentioned something to one of the other nurses and for once someone spoke up. This person had been employed at that hospital for five years. Makes you wonder how many other genitals had they played with?
JR. Anytime a profession doesn't have enough accountability anything could happen. I saw on a news channel about a patient from Knoxville Tennessee about an elderly woman being discharged from a hospital but she insisted that she needed more care.
She still felt sick and also had a broken ankle. The hospital employee had a different opinion and called hospital security. The hospital security then called the police.
When the police arrived they also didn't believe her about being sick or having a broken ankle and talked to her in a derogatory way. Then she died. The women can't be brought to life by any human power but she possibly could have been KEPT alive except she had two sets of enemies working against her. The Officers are on paid leave but won't be charged for anything criminal. JF
These nurses are to quick to call security, yet when a patient needs security from the nurse nothing is done. Cat
JF,
Yes, I have seen that video of that poor woman. Unfortunately, you're right. Nothing will be done.
Ohio Man,
You hit the nail on the head. They don't have to care bc there are others to take your place. In fact, we were told if my husband didn't like the medical and sexual assault he suffered, then go elsewhere the next time. The medical mafia is so very powerful by having the $$$$ to buy power and control over the years, they know they are untouchable.
Jeff,
It is scary because for everyone who is caught, you know there are so many more who will never be caught. Just think abt how many patient probably were harmed by just two of them. It is mind blowing. Just think abt many saw this happening but never said anything.
Cindy and I have talked abt that generally the textbooks they study from teach them to respect a patient's bodily dignity. It teaches them how to change a gown without exposing a patient. There are facilities that do not routinely strip and/or unnecessarily expose their patients. So the question is why do some have the perverted need to routinely strip/expose while others don't? We know there is not a medical need to do so for every procedure.
I saw an ad for a mammogram on Twitter other day. The patient is gowned and smiling. The tech is standing there smiling too. This differs greatly from many stories I have been told were the woman is naked from the waist up with no gown while some impersonal tech touches her breast. In Europe, many countries have the patient position their breast.
I also read an article in MedPage abt why ORs are so cold. The dr. stated they keep the patient warm. They dr. did not go into the real details that during pre-op and post-op the patient is naked thus not kept warm. This dr. knows the real story as he is an anesthesiologist who is generally in the OR before the patient is draped. He did admit the ORs are cold for the comfort of the staff. Well, at least a little truth there. But going further they are kept cold for the equipment and guess who's comfort is last on the list?
I contend that if they didn't know what they were doing is wrong, they would not be gaslighting us by spreading such false scenarios, misinformation, or disinformation. Guilty people lie and they are guilty of crimes against humanity bc every medical patient is entitled to basic human rights such as bodily dignity.
Most patients will never know how they were abused because the medical community does a better job at keeping their dirty little secrets hidden than delivering medical care that doesn't cause medical harm such as medical PTSD. I am sure that if some female nurse went into a public restroom and some man had a camera to film her, she would feel violated. Wouldn't I love to be the judge that would say to her, "What are you so upset about? He's seen vaginas before. Yours is nothing special. Case dismissed."
JR one thing that is causing the medical institutions a lot of grief is the internet.
They have lost their ability to hide behind their deceit and drugs and are being hit with a much more educated and informed population of patients. The patients are starting to ask questions about things that in the past were never asked because you would never ask about what you don’t know.
I find that to be a ray of hope for people so they don’t have to learn like I did the hard way. Of course they could still say that you either except their gold standard of care or go elsewhere but they still have to explain what they have never had to in the past.
If enough people start asking it could effect change
Ohio Man, welcome to this blog. Dr. Bernstein has done a great service hosting this for these many years.
A bladder scan or ultrasound does not require any intimate exposure. None. They just need access to your abdomen which is accomplished by lifting your shirt and possibly scootching your pants down slightly, depending upon what you are wearing and how high up they ride. Been there several times, including the 1st when I didn't know any better and was fully exposed.
You are right that they all have more patients than they can handle and have no incentive to care about your privacy or dignity. In rural America there often isn't anyone else to go to unless you are willing to drive long distances to get there.
I don't recall if I entered this question in our previous dissection of the preservation of patient dignity: the political differences if present. In the U.S. which political party is more attuned to the dignity concerns as presented here. And, in a more general view, throughout the world is there a conservative vs liberal difference in the medical system behavior? ..Maurice.
Dr. Bernstein the question you ask is one that I have contemplated many times . From my observations the medical community is split in two camps most nurses and tech level people tend to run on the liberal side while doctors lean more conservative. My father in law was a staunch conservative and my brother in law was a staunch liberal and both were orthopedic surgeons my wife’s boss was an OB/GYN and liberal but complained about be out numbered by the other doctors because they were predominantly conservative. When you read a lot of different nursing sites it doesn’t take long to realize they lean mostly left. The final analysis in regards to the patient is it doesn’t matter because the left seems to believe that their truth is all that matters and except for a few the right is completely complacent
Dr. Bernstein, I never thought about the issue in terms of D vs R and having spent my life in New England which is overwhelmingly D, I perhaps can't know the difference any more than someone who has spent their life in an overwhelmingly R region.
That said, at a national level the D's are deeply entrenched in anti-male sentiment. It seems that in the D world, women that insist upon same gender care are deemed empowered and men that want the same are called sexist. D's are never going to advocate for equality of men in healthcare.
At the same time, my perspective on R's at a national level is that they are entrenched in "traditional" thinking and that they likely are OK with the expectation that boys and men simply "man up" rather than be treated as the equals of female patients.
Though their reasoning and perspective might be different, the end result is the same. Male patients are "less than" when it comes to matters of privacy and dignity in healthcare. If that wasn't the case, you wouldn't see the same complaints coming from every corner of the country regardless of that regions D vs R orientation.
Good morning.
Dr. Bernstein, neither side cares about male patient dignity. Don't know about the female side.
For over three years now, I've been working both sides of the isle attempting to get someone to take up the cause of male healthcare. They won't even offer to look into opening an Office on Men's Health.
No matter how much evidence I threw at them, my requests for help fell on deaf ears.
Which is why when my reps came to me looking for my vote last November I asked them what have they done for male healthcare on the federal level.
All I heard was crickets so I told them we need a change in Washington & voted for their opponents.
Offices on Women's Health were established at the federal level back in 1990. To this day, men still have no Offices on Men's Health at the federal level.
According to the National Library of Medicine, there has been very little interest in what is now understood as “men’s health”.
So what do they do to COVER UP their lack of interest in male healthcare is, "They blame men for not taking better care of themselves.
Men & boys in this country are just an afterthought to an American healthcare system that since the mid 60’s has become female centric.
Let’s look at cancer research dollars for the year 2020. Dollars are in the millions.
Breast Cancer: 514.7, Prostate Cancer: 209.4.
As you can plainly see women again get over twice as much research funding then men do.
If men & their mates, moms, & girlfriends want this to change, WE HAVE NO CHOICE but to vote like mined people who will turn a deaf ear to the healthcare industry & big pharma into congress.
Today's congress is toxic to men's healthcare. They've got to go. I for one will keep voting for the other guy or anyone else until something gives.
Thing that really bothers me is there are doctors that have said men are underserved. Why the hell aren't they standing with us & trying to change the system?
I've said enough for today.
Have a great Sunday & stay safe.
Regards,
NTT.
As a whole, the medical community (including the AMA, nursing boards, etc.) is left leaning especially when you get into cities such as New York, Chicago, LA, etc. The university medical center are left leaning. I also think nurses tend to be left leaning thus why they seem to delight in making male patients suffer sexual abuse. I agree with Biker in that women believe they should have same sex medical care and they are called him while male patients asking for the same are called sexist and deserve to be sexually abused.
I also know that neither political party will help with male issues because the medical mafia funds their campaigns (buys their silence). NTT is right in what he said that men's health is not being funded or even taken as seriously as women's health issues. It is not politically correct and also politicians don't have the same worry that we do abt receiving good, non harmful healthcare.
NTT, the mere fact that women on average live 5 years longer than men would seem enough of an incentive to care about men's health. There are people screaming from the rafters over any societal statistic in which women fare worse than men, but a 5 year longevity gap is deemed unimportant, both in the healthcare system and society at large.
One of the last posts in Volume 11 was an excellent presentation of the history of nudity and bodily modesty issues as written by our visitor MER. I thought it would be appropriate to repost the historical presentation on Volume 123 in the following segment postings. ..Maurice.
Saturday, March 21, 2009 2:05:00 PM, MER said... One point I’ve tried to consistently make in my past posts is – how we feel about nakedness is contextual, depends upon the situation. The same person who may frequent nudist events may be embarrassed or even humiliated being naked in other contexts. The same is true for those who are extremely embarrassed being naked in front of a female nurse or doctor. In other contexts, in front of a male doctor or nurse, they may not be embarrassed. I’ve been trying to study the change in attitudes toward nakedness in Western culture, especially the US, within the last 100 years or so. This is a complex subject and I don’t pretend to have “the” answer. But I do have a few suggestions. In the late 19th century, early 20th century, interest in Greek culture with the start of the Olympics, reminded us that these Greek athletes competed in the nude, and often trained in the nude. The Greek perfection of the unity of mind and body became visible in statues of the “perfect” athletic body. I think the early Olympics had some influence on attitude changes. This about the time we begin to see the growth of modern nudism and males swimming nude in public swimming pools.
About the 1890’s, when Boy’s Clubs, YMCA’s, (the scout movement, etc.) became popular, attitudes toward masculinity changed. The notion was that we were becoming weak as a culture, especially males, with the closing of the frontier. These male bonding institutions in connection with exercise and wilderness experiences helped shape our attitudes toward nudity. In UK, as the empire was declining, a similar attitude developed about the decline of masculinity and the traits associated with it. Early indoor swimming pools started being built. They had filtering systems that were sensitive. For that reason among others, males were required to swim naked. It started in the YMCA’s and Boy’s Clubs and later came into some of the college and high school systems. But, and this is a big BUT – it seems to me that there was always an understood, tacit agreement – no females were allowed. This would be strictly for men and men felt safe in these situations. I don’t think naked military induction exams really became standard until WW1. That’s not to say it didn’t occur during the Crimean War, the American Civil War or the Franco-Prussian War. We’d have to research that. But before “modern” warfare, governments were more interested in bodies in any condition to man the front lines. Doctor’s examining naked bodies didn’t really begin seriously until after the French Revolution secularized the hospital system and doctors from all around the world headed to Paris to study and get access to real bodies. Read George Eliot’s “Middlemarch” to see how one of the main characters, a British doctor, brings back modern medicine to England from his Paris studies. There’s a revealing chapter in Tolstoy’s “Anna Karenina” where Kitty is ill and must go through a complete examination with one of the “new” thinking doctors who insists that he examine her entire naked body. Very revealing. It shows the arrogance of that doctor, how the modesty of the patient is completely ignored.
If ever there’s a literary example of Foucault’s medical “gaze” it’s there in Tolstoy. Kitty was simply an object for this doctor to examine. My point in all this is that the modern medical examination of the complete naked body doesn’t start until the mid to late 19th century. We occasionally see photos of naked soldiers from WW1 and WW2 being examined. This was standard. But I would argue that there was a strict, assumed, tacit agreement that there would be no women present. The question is often asked as to why these men felt comfortable swimming nude together, or being examined naked during military inductions. I would argue it was because of this understanding that this was a male ritual that excluded women. Now – something begins to change after WW2 and comes into being in the 1960’s. It has many sources, but I argue that it’s closely connected to what we call the “sexual revolution” and the growing feminist movement. As more women enter male occupations, as this process gets embedded in legal doctrine, that is, giving rights to the same access for women as for men – we see things change. As more women want access to these indoor pools the policy about men swimming naked changes. As gay rights becomes an issue and as more gays come out of the closet, some men show more homophobic tendencies and become less comfortable being naked around other men. As sexual abuse, predation and crimes become more publicized, people become more wary with exposing their bodies in more and more situations. How does this relate to what we’re talking about? Before we get to medicine – we see one example with the military induction during the Vietnam War. With more women becoming doctors and joining the military, we find many anecdotal examples of naked male inductees facing female doctors and nurses. In fact, there are a significant number of anecdotes of female clerks and other non medical personal having access to these naked men. Here’s where we see the old understood, tacit, agreement breaking down. In the past, it was understood that there would be no females present for these nude male rituals. Things now change. I would argue that during WW1 and WW2, as a general rule males in the military (unless seriously wounded – again, I’m not referring to extreme examples) were not subject to intimate examinations by female doctors or nurses. I grant the exception of the USSR and some other European countries. But remember, medicine wasn’t opened to women in the early USSR because the Soviets were concerned with gender equity. I suggested more women became doctors than men because being a doctor didn’t have the social status it did in other countries. It wasn’t considered the highest, most honorable calling for men. Combine all this with the dominance of post modern philosophy – the concept of gender doesn’t exist, it’s only a cultural construct – and we see this attitude enter the medical system. Exempting emergency situations, it wasn’t that long ago that male orderlies or nurses or doctors handled intimate procedures with male patients. Even the “older” retired nurses today will tell you that. As more women entered medicine, it was just expected that gender didn’t matter and that they would have access to males just as the male doctors over the years had had access to females. Although attitudes are changing, this world view is still significantly embedded with the medical culture. These attitudes changes that now claim gender neutrality have come relatively quickly and without an open, honest discussion which includes patients at the table. I don’t claim this is the whole story. I’ve probably missed some important elements and movements. I present this summary, my opinion, for discussion and criticism. I believe it’s relevant to what we’re discussing here.
I hope you all found the dissertation posted above by MER a worthy presentation and reflected a review as posted in March 2009. Does the review meet the status of "nakedness" in the medical practice of 2023?
Has there been a worldly societal change or are we moving along a guided path.. leading to ????. ..Maurice.
What MER had to say was accurate but sadly as far as I can tell the song remains the same.
I had my appointment last week with a surgeon to discuss hernia surgery and express my concerns and needs. I have all the faith in the world in him as far as his skills but there was some serious gaslighting going on when I said that I wasn’t comfortable being in the or with women in there. His comment to me was that there would be women in the or but to remind him on the day of surgery about my modesty concerns and he would make sure that I wouldn’t be exposed. He knows and at this point so do I that the whole region at the incision site will be scrubbed with disinfectant to at least 12” in all directions and considering that the genitals are 1to2 inches from the incision site how is that going to work out?
When I asked him about that he said don’t worry about that they could work it out? And when I said I only wanted local and no sedatives he said he could speak to the anesthesiologist about lite sedation, what do they consider lite just enough to strip my memory? Needless to say I didn’t schedule the surgery and will continue to live in pain. Nothing has changed!
Greetings to Dr. Bernstein and the many contributors to this blog. I am one of those "lurkers" who has been following this blog since 2014 after my own medical adventure. I finally have the courage to relate my experiences and my perspective on topics in the blog. I should have commented in a timely manner but I going to make an attempt to contribute going forward. I feel I owe it to the people who have contributed so much.
I first want to express my most sincere and heartfelt thanks to Dr. Bernstein for moderating this blog for so many years and for the many contributors. Finding and reading this blog literally helped save my life by allowing me to realize that I was not alone in my feelings after several urological procedures that left me with serious depression and while not officially diagnosed as PTSD, it surely is. Over the years I have stepped away for periods of time, but recent kidney discomfort has me thinking that I will be running the urological gauntlet again.
There are too many contributors to mention specifically and no doubt I have missed some, but I wanted to recognize the following individuals for contributing or sharing their very personal stories on a regular basis: JF, Biker, Misty, Banterings, Dr Linda, Jason Kk, Belinda, Don, PT, Ray, NTT, JD, Reginald, Ed T, 58flyer, JR, Rick, Dr. Bernstein.
I did not contribute for several reasons. First, I am not much of a writer and didn’t think I had much to contribute. I have been re-reading the entire blog starting in 2014 in preparation for adding my comments (30 hours of reading so far). The sheer volume, detail, and eloquence of the frequent contributors is astounding. Secondly, after reading the ways people have suffered, I am somewhat ashamed that my misfortune affected me so badly. My situation is trivial compared to what I have read. I have read things that made me so sad and depressed that I wanted to cry as well as some things that made me so violently angry at the perpetrators that I had to step away from the computer to calm down.
Some of the things that I would like to share are personally very embarrassing and while I feel I could safety share them on the blog (anonymously), I would not want my friends or family to read them should they stumble upon the blog. Identifying the places where I have lived and certain details would make it easy to identify me. I know it is strange that I could talk to strangers easier than family. I haven't decided exactly how I will address some issues. I am a male in my 60’s and due to societal norms about maleness I could not talk about this even to male friends of 50+ years.
I am organizing my thoughts in the following ways:
1. I would like to comment on some interesting questions that Dr. Bernstein has asked over the years, even if they are way in the past.
2. Share my experience and the how/why it affected me so much.
3. Relate some anecdotal experiences that have been relayed to me by friends or family pertaining to the idea of medical modesty/dignity.
4. Share some “wins” where I used the suggestions and techniques gained from this blog to better the outcomes on medical encounters that followed the urological experience that caused me so much trouble.
EM - Extremely Modest
more to follow
I begin my contribution by expressing my opinion on the question Dr. Bernstein asked at the beginning of Volume 124.
While there have been some improvements in attitudes of medical personnel concerning medical modesty, I am mostly pessimistic for the future. We have an inept government that cannot secure a border, spend less than we take in, who don’t answer to the people that elected them or care what happens to them, and who seemingly are marching us to World War III (political diatribe). I do not think anything will be done legally or administratively as demonstrated by the lack of interest that NTT has experienced. There are many contributing factors to the current state such as an incredible pressure on medical professionals to do more with less (doesn’t excuse the bad behavior), a critical shortage in the number of medical personnel such that the patient has little choice but to go along or else be canceled as a patient. In general, there is a coarsening of societal values/norms that allows and even rewards bad behavior. A modern feminist movement that no longer is pro-female but anti-male and sometimes I am not sure they are pro-female any more. As I age, I am terrified of the attitudes towards the elderly by some in the medical profession. Should I land in some type of assisted living, I feel like I will be looked at as an old, grey-haired, sexless object that is undeserving of any compassion or respect. On the bright side, at least in the short term, I have found a large urology practice that appears to employ some men. I live in the Ocala, FL area (1.5 years) and go to the Urology Institute. They have locations all over the state and I will travel hundreds of miles if I have to in order to find an office in the practice that can honor my request for male personnel. EM
Im a democratic. Cat
Welcome EM, I look forward to your posts.
MERS summary as posted by Dr. Bernstein is very well stated. I will add that by about 1960 or thereabouts the concept of elementary, middle school, and even high school aged boys being subjected to intimately exposed exams by female nurses and/or with female clerical staff present for school physicals took hold. Whether that was allowed in prior decades or not I don't know but as the women's lib movement took hold in the 60's the stripping away of male privacy accelerated. During the Vietnam War, female clerical staff present during military physicals of young men lined up nude, then by the 70's female reporters in male locker rooms, female guards in male prisons, female staff in boy's corrections facilities etc. As the decades progressed, despite sexual impropriety suits being almost exclusively a female patient phenomena, forcing female chaperones and female scribes on male patients began to proliferate. The trend line has been steady for a couple generations now with no sign of any movement towards male patients being viewed as the equals of female patients in terms of privacy and dignity considerations.
I haven't personally ever been in jail but one of my female coworkers told of taking a shower in the jail and seeing a male guard walking past the shower she was in. My oldest step daughter said it was true ( she's been in jail a couple of times ) JF
Dr. Bernstein
I have picked several questions from past volumes that I thought were interesting and have seen topics referenced from past volumes so I hope this is okay.
In 2016, you asked if the age of the caregiver matters? Would you be more comfortable if your caregiver was older?
In my case, her age makes a huge difference. I would always feel more comfortable with an older woman than a younger woman because of my perceived differences in maturity. Not sure what this says about my psychology, but I would also be less embarrassed if I did not consider her as a potential sexual partner or was in some way not attracted to her physically. Maybe because there is no fear of rejection if there is no interest. EM
Dr. Bernstein
In August 2018, you linked to a discussion (Volume 12 March 2009) about the changes in attitudes toward nudity and later posed this question
have a frank question to ask the males here whether the male issue is not so much visible nudity but of concern that the patient's genitalia may appear to others not "manly" enough or even of the reasonable fear of penile erection or even ejaculation during the exam.
I think the fear of getting an erection is a great concern for many men. When I was younger, two of my biggest fears in this area was the fear of getting an erection and getting taken to an ER and being stripped in front of crowd of strangers. I think the fear of getting an unwanted erection is warranted as evidenced by postings to All Nurses and other sites where some female doctors have stated that they are amused by the humiliation and embarrassment of males they are examining during school physicals. There seems to be a complete lack of empathy on their part as they continue to perform these exams and don't recognize how much mental harm is being done and don’t really want to do anything to help the situation. If Mother Nature caused female breasts or other parts to spontaneous double in size in similar situations, there would be more empathy. Thankfully, as an older man, spontaneous erections are no longer an issue. Ironically, as a younger man, while waiting for the doctor to arrive, I would attempt to gain a partial erection just in case the exam called for exposure, particularly if the room was cold.
On the issue of feeling inadequate, this is precisely my concern. I was the kid who hid and took his shower last in high school gym class. This concern manifested itself purely due to observation/comparisons in the locker room since the internet and porn did not exist at that time. If internet porn had existed, I would surely have developed a far worse sense of inadequacy. I am thankful that I didn't experience mandatory nude swimming or the school physicals that have been described on this blog. This fear has followed me through life and resulted in me not dating in high school or college, refusing to play sports, being too afraid to join a fraternity, being afraid to join the military, being unable to wear a bathing suit and get into the water, and embarrassment being seen wearing cycling shorts, etc. Ultimately, I decided to withdrawal from contact with women in my early 40’s resulting in a really lonely 25 years. I maintained absolute and strict control concerning my exposure and other than a couple of exams with male doctors, I was not required to be exposed to medical personnel until I was in my mid 50’s. My ability to control my exposure is a key to the amount of humiliation and embarrassment I feel. EM
Dr. Bernstein
I thought I would share some experiences that others have related to me.
A female patient in a rehab facility was being helped out of bed by two male nurses. As she frantically tried to arrange her gown to protect her modesty the male nurses started laughing and said "She must think she has something that we have never seen before". Sadly, it appears some behavior is universal.
A young, handsome, fit male was at a youngish female doctor’s office for a physical exam. He was dressed at that point and she had left the room. The door opened and the doctor returned followed by another female (doctor/nurse). She introduced her and said "She needs to complete some training and needs to do a male genital exam. Is that okay?" When the individual first told me the story, he said he surprised and shocked by the appearance of the second woman and didn't really want to allow the exam and would be highly embarrassed. He said that if he didn't agree to the exam, he was afraid that they would think he was inadequate and trying to hide the fact. He agreed and the two women performed the exam. Interestingly, one year later when I asked him about the exam to clarify some points, he stated that it didn't bother him at all. He said, "When I was in high school, I streaked the local What-A-Burger". I asked if he was provided a gown and he said no, it was the basic "drop your pants" approach. I am not sure what changed about his mind about the exam.
An elderly, male patient was having his vitals checked by a mature female nurse. Two very young women appeared dressed in nurse garb. The mature nurse says, “These ladies are here to give you a bath”. He told me that before he knew what happened, the two nurses yanked his gown completely off and proceeded to bath him as if he was an infant.
The same elderly male described his experiences with directed beam radiation treatment for prostate cancer which occurred daily for several weeks. I didn’t question him closely but he made it sound like there was a room of naked men waiting for their turn. When their name was called they would grab a special custom-fit mold and proceed to the machine. A mixture of male and female techs would place them on the machine and position them based on alignment markers that had been drawn on their hips. At this point, they were finally given a small cloth “napkin” to cover their genitals and the short procedure would start. When the treatment was over, the process was reversed and the patients left to get dressed.
EM
Dr. Bernstein,
I have a thought and wonder if the readers of this blog would agree or disagree.
In the 9 years that I have been researching the idea of medical modesty, I have come to the conclusion that the “bad actors” use the patient’s nudity differently depending on their gender/sex to satisfy some need. The activity seems to fall into two categories either sexual desire or control/humiliation.
In most cases, males abuse their patients to satisfy a sexual need. While it sometimes involves physical abuse, it is often the observation/filming/touching of the naked patient when they are sexually attracted to the victim. It is often done is secret or when the victim is incapacitated and the victim has no knowledge of the offence until it is discovered at a later date.
I can’t recall reading of any situations where the man exposes a female patient in order to exert control and cause humiliation and embarrassment though I am sure it happens. This would be akin to a rapist targeting an elderly woman not because he is attracted to her, but rather because he want to inflict pain, humiliation and fear on a helpless victim.
On the other hand, female offenders seem to be interested in control and causing embarrassment, pain, and humiliation. Most often the victim is fully awake and to shocked to react or they are incapacitated in some manner but are aware of what is happening. The forced nudity is often displayed to multiple individuals in order to magnify the feelings of humiliation and embarrassment.
I have read very few instances where the offender shows a sexual interest in the victim. It obviously happens as demonstrated by the “Denver 5” or the instance where a nurse told the patient “I will be getting to know you real well” as he was being put under. I think this was related by Biker.
These are generalizations and not true in every instance and only based on what I have read in this and other blogs.
EM
EM [and NTT]
Your observation is similar to mine that male abuse is sexual and female abuse is control, control. control.
Prison and the delivery of medicine have a common culture in that "they own your body".
BJTNT
EM and BJTNT,
Rape is not a sexual crime but rather it brings gratification through having the power and control over someone. Sex is the means to the end which is how I see the female medical providers (which includes nurses/techs) when they sexually abuse a male patient. Power and control for some give off a sexual pleasure. Do not underestimate that this is indeed a crime of sexual gratification as they are doing to the opposite sex.
Having the right to bodily dignity is not a modesty issue but is a human right. For whatever reason you have for wanting same sex care or no unnecessary exposure, it is a basic human right that over the years the medical mafia has done eliminated. I have said time and time again, unnecessary is sexual abuse. As women have gained more and more the right to bodily dignity and respect, men have lost it. Why this is so is the question we need answered. But like elsewhere in society, in order to give one group more rights, we have take away those very same rights from another group. Society now teaches us we have the right to say "No" to the common person touching us without our explicit permission. We have laws against sexually exposing our bodies so why is in a medical setting the only place where you cannot/do no have the right to limit your bodily exposure and say who sees/touches your body? This is a question that I have never gotten a medical provider to properly answer. Want to try, Dr. B. or any other medical lurkers or those who may help Dr. B. moderate this blog? Why is it when you seek medical treatment you give must give up total control of your body?
JR, I have never experienced, thought of or heard of heard in my entire professional career of physicians, nurses or other medical professionals, who as a group as an integral part of their professional behavior (better: misbehavior) displaying what has been the theme presentation over the years by virtually all writing here. That is why from the beginning, I expressed my impression that those writing about this professional misbehavior and experience here were representing only a small patient population. I have since wondered whether I was underestimating.
Yes, when I started this blog topic, the medical practice population for generations was operating, acting, under the ethical principle of physician paternalism and only beginning to accept practice of patient autonomy.
I strongly urge those medical professionals who may come to this blog thread to express their own views about the subject. ..Maurice.
I have hoped for feedback to this blog thread topic by medical professionals but I have received over the years virtually nothing. What does one make to this??
By the way, I do remember writing a posting similar to above many times to this blog topic but I just wanted to let any new visitors here who haven't systematically gone over the multitude of postings on this subject what represents my current viewpoint.
..Maurice.
Dr. B.,
Yes, I do think you are and many others within the medical community underestimating the attacks made on patient dignity. Why is that? There are many reasons just as there are many types of patient dignity assaults. Let me say the main reason why this is an unknown area to medical providers (until for many, they become the patient) is they never ask a patient about the "exposure" experience and also that the large majority of patients will never vocalize to a medical provider how they feel about the experience.
I have talked with many, many people over the years since my husband was criminally assaulted. I ask direct questions. I have seen surveys such as the Press-Ganey and nowhere on these surveys do they ask questions pertaining to bodily dignity issues, if patients feel they were given true informed consent or all the needed information, or a place where a patient can write in extra comments. It is as if they don't want to know.
What happens when I talk to men is they don't realize the "strip as you go" exam doesn't need to be done in that manner. When asked abt the female onlooker, most don't like it but didn't know they had options. Most will also say they had no idea (i.e. informed or asked permission) an onlooker or in some cases, "students" would be present. The difference I have found between female and male patients in the arena of intimate exams is that I have found no female patient that has had a male onlooker present or a male doctor with a male onlooker in the exam room. Interesting? It should be. Shouldn't the medical community be reviewing this as does the medical community as a whole believe that women are sexless which goes against science? Just this week there was a news article abt a lunch lady sending nude pics of herself to young male students. Sexless in actions indeed! To paraphrase Banterings we know that absolute power corrupts and that in these types of circumstances where there is such an imbalance of power, bad things happens but why has the medical community turned a blind eye on female abuse of male patients?
I would say if you went back through your blog history, you would find the overwhelming majority of posts were written by men who have been abused by female healthcare providers which is just the opposite of what happens in the media. In the media, there are only stories of female patients being sexually abused by male healthcare providers. Why is this so should be the question of the day.
My husband was brutally sexually assaulted by female healthcare providers but crickets from the media. The man from Washington state had a little coverage but again crickets. Sexual abuse/assault is happening but when it happens to a man, there is silence. Even when it happens to female patients, it takes 100s of victims but like in Utah, the medical mafia is able to manipulate and play games.
Again, my question is why does the medical community believe they are entitled to sexually abuse or assault medical patients? It is because it is a silent crime? It is because the general population has been brainwashed to accept medical sexual abuse which unnecessary expose is? Or is it because many do not know they have been unnecessarily exposed which can occur in an exam room but the more severe cases of sexual abuse happen when the patient is drugged and defenseless?
I would like to be able to politely and openly talk to medical providers about this issue. Again, I am asking if you would arrange for me and some others to have a conversation about this issue so both sides can learn and perhaps start to make changes. You have access to a teaching university. This would be a great place to start.
Dr. Bernstein, I think much of the disconnect comes down to a vast definitional difference between staff and patients as to what constitutes maintaining privacy and respecting dignity. Certainly today's corporate medicine run by MBA's in the C-Suite is part of the problem but the definitional differences long pre-date today's corporate medicine.
Convenient is not synonymous with necessary nor is polite synonymous with respectful. The definitional disconnect between staff and patients is that staff thinks these things are synonymous and as a result think they are doing everything right. Just to make my point by one example:
Shaving a patient's groin for a cardiac cath or hernia surgery is necessary. Exposing his genitals while doing so is convenient but not necessary. Being polite while doing so is nice, but it does not make the unnecessary exposure respectful. It may subsequently be necessary to expose him for application of disinfectant or as part of the draping or post-procedure process but the fact that he will be subsequently exposed does not mean needlessly exposing him during the shaving process is OK. Necessary means minimizing the extent, duration, and/or audience. "Convenient" says he'll be exposed eventually anyway so it doesn't matter if I save a few seconds by exposing him now too.
Biker,
I totally agree with all you said except it is not necessary to expose the genitals at all for cardiac cath as the COVR garment is made to provide the necessary protection and access for cardiac cath. The COVR garment is sterile. Donning the garment can also be done without the patient being exposed. Also, most patients are not prepared as they are not informed about the exposure as to why, who, and how. Medical providers do not feel patients have the right to this information which some may want while some may not. Some patients who go in for a radial cath are very shocked to learn their groin will be exposed per shave and sterilization just as someone who is going in for ankle is surprised to find out they were stripped entirely nude when access was only needed to the approx. the knee.
I have read that for many procedures in Europe, the patient is told to shave their groin area just as many women in Europe position their own for mammograms. Why is the US so different?
Call me prude but to have a woman expose me and touch me intimately like that is more than I can bear and goes against everything I believe. And when I requested an all male team for a hernia surgery consultation I had last week I was told in a matter of fact tone there will be women in the OR but we will protect your modesty. How do they propose to do that?
Felt like gaslighting to me!
Good afternoon:
Dr. Bernstein you said;
"I have hoped for feedback to this blog thread topic by medical professionals but I have received over the years virtually nothing. What does one make to this?"
Sir, if medical personnel came here & posted, that to them would mean they are acknowledging they haven't treated male patients with the same level of dignity & respect they treat female patients which in turn would force them to acknowledge in the real world they've done men wrong.
For the medical community, that would be a huge NO NO.
Until a male patient finds the courage to take the system to task or someone on the inside finds the courage to break the glass ceiling, they will stay quiet.
Regards,
NTT
I have no doubt, as myself, the are many in the healthcare profession who could "speak up" their own views and perhaps also "break the glass ceiling". I am upset if there are still healthcare providers who operate under the old "paternalism" and fail to keep "patient autonomy" in mind as they do their daily profession. ..Maurice.
Good evening:
Dr. Bernstein, I agree with you there are doctors out there that "know" the struggles men & boys are going thru but because their peers like things they way they are, they just keep quiet when asked by men to say something.
Also, old habits die hard & nowhere is that more evident then in the American Healthcare system.
Regards to all.
NTT
Why couldn't the patient be informed so he/she could shave themselves? Most genitalia gets washed everyday in the shower or bath. JF
EM. What are your thoughts about the doctors, male or female who just allow their staff to freely stroll in and out when patient examinations are occuring? Where the staff person to knock on the door would that doctor just say "Come in.". ? What is that doctor's motive? Or maybe they're justified because it's not their fault that they have no regard for the nobody important patient. JF
Jeff,
I think you are right on the gaslighting. As stated many times before on this blog, "protecting your modesty" is just talk and probably means they will be respectful while they are exposing you. Or that if they only expose you for a minimum amount of time, it is somehow okay. You are in a difficult position because your surgery is not elective and you need to have your injury repaired. If business was slow, I think they might be more concerned with patients taking their business elsewhere.
I have been thinking that if I am unable to secure an all-male team or mostly male team for future procedures, I may insist that I stay awake until the draping is completely done and ask to be woken before the process is reversed. I will be staring right at the nurses, watching every little move they make. They probably won't like it since it won't be convenient. This means I will know if something is done wrong instead of wondering if something went wrong.
EM
JF
I am not really sure if it is subterfuge and they pretend to have no control so they don't have to deal with it. I don't understand an intentional act and would like to think they are just clueless because after all it isn't them. For example, During an appointment prior to surgery my surgeon was saying something like "It isn't that bad" or "It shouldn't hurt that much" or "Is is really that embarrassing". I finally said, "Doctor x, you haven't had that done to you, have you?". He said, "Um no". I said that's what I thought. In 15 or 20 years when you are on this side of the desk, I want you to remember our conversation.
I am fortunate in that I have never been walked in on after an appointment started. I have however, been ambushed by observers/scribes, etc.
I think everyone on this blog is starting to be much more pro-active. It seems odd but maybe before each exam, we need to say something to the effect that "Doctor x, I am sure you have made provisions that we will not be disturbed during my exam, right?" to make people aware.
EM
Dr. Bernstein,
I want to relate my story now but would like to add some preliminary information that might add some context to my interaction with the nurse that treated me so badly. The only possible reason for her behavior I can come up with is that she thought I was being crude and giving her a “come-on”. Even if that was true, she should have called me on it and I would have been profusely apologizing and explaining that would be the furthest thing on my mind. I will let the readers of the blog decide.
I could never be a profession poker player. My facial expression immediately conveys my feelings. Someone looking at my face will know if I am happy, sad, mad, nervous, or embarrassed. To illustrate, during a work physical in my 20’s I was dressed in only my underwear doing all sorts of bending, sitting, squatting and performing “duck-walks” across the floor for the female nurse. At the end of the exam, she says “I need to do a hernia check”. When I heard that I thought to myself “no problem” and attempted to act like I was not troubled. She takes one look at me and says: “Oh, I am so so sorry. I can run down the hall and get a male provider to do the exam”. I allowed her to proceed.
Another example is just prior to spine surgery, I was sitting with a female intake coordinator. She was discussing the process and said, “They will place a urinary catheter before your surgery”. She looks up at me and with a pained look on her face quickly says, “I am sorry, it is hospital policy”.
Part 1 of 3
In my late 50’s while working in Washington, DC, I started experiencing pain in my lower right abdomen and it was discovered that not only did I have a horseshoe kidney, but I had (3) 9 to 12mm kidney stones and my renal pelvis was enlarged (Hydronephrosis). I did my research and selected a male urologist with impressive credentials who was the head of robotic surgery at George Washington University Hospital. After reviewing imagery, the solution was that I would undergo an Ureteroscopy with laser lithotripsy to break up the stones. I nervously explained that I am embarrassed to be seen naked, especially if women are present on the surgical team and his response was: “Are you afraid you don’t have a big enough shl@ng”. Not a great start, but I was not deterred because of the level of discomfort.
The surgery was scheduled at George Washington University Hospital and I went through the normal pre-op process where I was naked under my gown and was asked to quickly sign the various consent forms. At this point in my journey, I knew nothing about Versed, observers, photography during the surgery, prepping or positioning of the patient. I felt somewhat relieved because I had a male anesthesiologist but quickly discovered that the Scrub nurse and Circulator were female. While I was waiting to be taken to surgery, I noticed a young woman standing at the foot of my bed who had not participated in any discussions. I finally said “Hello” and asked what her role in the procedure was. She indicated that she was a Resident and would be observing my surgery. My face must have given away my feelings because she quickly said “Oh, is that okay? If not, I will go watch a different surgery”. Being surprised, I was too embarrassed to refuse. I tried to act cool and be “manly” and said no problem. “My case should be interesting because my horseshoe kidney is placed higher than normal and slightly rotated from the norm”. Had I been asked in advance, I would have said no to an observer.
The anesthesiologist came back in and said it was time to go and he would give me something to relax me. I don’t really remember much until I woke up in my room around 7pm that night. My urethra was on fire from “nose to tail” and I wondered what had happened. I had no recollection of meeting with my surgeon after the surgery and had no idea of whether the surgery was successful or not. I felt good except for the penis-on-fire and needed to urinate. I went to the bathroom and was not successful.
EM
Part 2 of 3
This scenario repeated itself several more times and I started to realize that I couldn’t pee and would probably need a catheter. The mere thought of that caused an immediate panic and I decided I would force myself to pee no matter what in order to spare myself the embarrassment. I went back into the bathroom for an extended period of time. I strained so hard and for so long that my body was shaking and I was dripping sweat off my face into a puddle on the floor. In the midst of this I realized that I had given myself an erection. My penis was bright red and was very painful to the touch. I got frightened and thought that I had torn a vein or artery and caused myself major penile damage. After a 20 minute pep-talk I decided I had to call the nurse.
I rationalized that it was no big deal, she was a trained medical person and had the knowledge and experience to deal with it. I pressed the call button and explained I had an issue and needed to see her. When she came in, I took a deep breath and while probably red-faced with humiliation, I meekly explained that I strained so hard trying to urinate that I gave myself an erection, which was right red and very painful, and I was afraid that I caused a serious injury and could she assess the situation. Without saying a word, she turned and abruptly left my room. (Mistaken for a come-on???). It took a lot for me to ask and I decided that I was not about to ask a nurse about it again. Fortunately, over a period of time the situation resolved itself and no apparent harm was done.
I was once again left with a burning urethra and the need to urinate. I continued to try and urinate (much less forcefully) until around 9pm when I decided that I was going to need the catheter because by now I was really uncomfortable. I hit the call button and told my nurse that the last thing I wanted was a catheter but I was hurting and didn’t see any alternative. She said to wait another hour. I waited until 10pm and called again. She said she would confer with a doctor and called back and said wait an hour. At 11pm, I was hurting real bad from the bladder pressure and called the nurse station. She said for me to wait another hour. By this time, I was in 8-9 level pain and I curled up in the fetal position and stared at the clock counting down every minute until 12 midnight. I once again called and told her that it was critical and that I needed help “NOW!”. She said she would be in to see me. At 12:30AM see walks into the room with the cath kit. I am the kind of person that hates surprises and wants to know exactly how things are done. Prior to the surgery, I had watched numerous medical training videos on how to perform a catheterization. I knew about maintaining the sterile field, how to cleanse the penis, how to advance the catheter until urine flows, etc. and felt that I could probably have done it myself. I also knew that it is common to utilize lidocaine jelly to numb the urethra before inserting the catheter. To help alleviate my nervousness and embarrassment I decided to engage in small-talk. I said, “I sure hope you brought a load of lidocaine jelly”. In a not pleasant tone she says “No”. I was shocked and said “You’re kidding, right?”. She angrily says, “No. This is not an incision!”. I thought, She is the nurse and must know best. I laid back and was preparing to match the sensations with the steps in the process that I had studied.
EM
(Part 3 of 3)
Without any warning, without sensing the cleansing process, without saying, “Take a deep breath and relax, I am advancing past the prostate”, she abruptly rammed the catheter in one forceful movement. The white-hot flash of pain was so intense that I couldn’t even catch my breath enough to scream. Mercifully, the short-term pain was tempered with the reduction of pain in my bladder as the urine flowed. I didn’t move immediately and was still white-knuckling the rails with my back arched off the bed when she says, “Awww, did that hurt much?” and walks out of the room.
The remainder of the night was uneventful and I had the catheter removed by a female nurse the next morning and seemingly I was none for the worse as the urethral pain had subsided.
I had no idea that this was the very beginning of my severe emotional trauma (PTSD?) that in the next couple of months led to uncontrollable fits of crying, counseling for the remaining 9 months of the year, the loss of 60 lbs of weight in less than 3 months, and several instances where I sat on the edge of my bed with a gun pointed at my head with my finger on the trigger. I purposely did not drink or do any drugs that would reduce my inhibitions, otherwise, I probably would not be writing this story.
I wrote the hospital to complain about the nurse and received a boiler-plated apology and doubt that anything was done to punish the nurse.
I am ashamed that my situation caused me so much grief because it is minor compared to what others have endured, but I appreciate the chance to get this off my chest and I will continue the story later since I have been writing for some time now and need a break. Eventually I will get to the things I have learned from this blog and how they helped.
EM
My husband was only shaved to the upper pubis. There was no need to expose him whatsoever. I asked about clipping themselves. One arrogant nurse said they do it better and youd have no clue as to where to shave ONLY they do. I said ok how about a diagram in the pre admissions paperwork highlighting the area necessary. Crickets. Is this another way of unnecessarily exposing the patient? They think people are absolutely stupid. More control/power issues with the staff. Cat
EM WOW that is horrifying what happened to you. Like I said in previous post I had a nurse rip a catheter out of me with the balloon still inflated all because she wanted to get even with me for asking two female nursing students not to stand there and watch. I know that a lot of people think that we are exaggerating our experiences but I can tell you they are real, and if a woman has a sadistic streak in her she may find no better way as a woman to retaliate against a man than to cause injury and pain to a man’s penis. Considering it is the single most prominent feature that symbolizes his manhood. I know it sounds unbelievably sick but we live in a sick and fallen world and if you think those scrubs turn a persons Stoney heart to a heart of flesh you would be sadly mistaken. We as a patient have no way of knowing what is in a person’s heart and to submit ourselves while totally vulnerable has become for me something that terrifies me. It is sad that the very institutions that have the ability to heal are also adept at breaking a person emotionally. They have deceived me and caused me so much emotional trauma at this point what ever comes my way health wise is going to be what takes me out of this world because what earthly good is it to have them fix you biologically and send you home to broken person?
Jeff... there versions of protecting your bodily dignity only means waiting for you to be asleep. As if it goes out the window because we are unconscious. I still eant to keep.my dignity awake but especially while im asleep. Cat
NTT...on Quora the ONLY ones that come forward with the true facts are the RETIRED ones. The ones that are now powerless to put forth change. One i talk with regularly is a retired OR nurse. She saw it first hand, but was a single working mother who says she couldn't speak up as the repercussions towards HER would be vast and career breaking. Its so clear that the ones that say they would report such behaviors are liars. They know damn well NOTHING would be done, except their life would turn to hell. That only leaves us protecting ourselves any means necessary. I for one will refuse preop meds, insists on being awake for prepping and draping and make sure i am awake with no lingering amnesia prior to going to recovery. You want my $$$ work WITH me not AGAINST me. Cat
Good morning:
JR, you said you had read that for many procedures in Europe, the patient is told to shave their groin area just as many women in Europe position their own for mammograms.
And asked "Why is the US so different"?
The answer is that the United States healthcare system dis on a power/control trip.
People need to be in the know, before you go for any medical visits. It's the only way to protect yourself.
Putting new blood in Washington is the only way we will break this vicious cycle.
Cat you are right. Only those retired will speak up. Retribution would be swift & harsh to anyone currently working that spoke out.
That's it for now.
Take care all.
NTT
NTT, you just made me feel GREAT with the concept that all the acts in the medical profession to degrade patient dignity is POLITICAL. In the United States, we all should be able to, through voting, reestablish that dignity that has been degraded. Correct?
By the way, "putting new blood in Washington" is centered about which political party? ..Maurice.
Dr. Bernstein:
The only way we will be able to effect any type of change on the healthcare system is thru legislation in Washington.
The system refuses to work with patients.
As far as political party goes I don't care what party they are from. e need like minded people who can turn a deaf ear to the medical community & do right by the patients.
I'm tired of wasting time & effort trying to work with medical people & gov't employees.
EM.
I read your nightmare scenario at George Washington University Hospital.
Two questions.
When she did your catheter, are you saying she did NOT lubricate the urethra at all before inserting the catheter?
Did she use a lubricated catheter or at least lubricate the catheter before insertion?
If she did neither, that's a HUGE problem.
Every video I have seen & book I have read on the procedure states the urethra is always lubricated BEFORE any insertion.
Most kits come with a syringe filled with lubricating gel that is released into the urethra then a clamp is applied to the head of the penis to keep the gel from leaking out & you wait 5 minutes for the gel to take effect. Next, you remove the clamp & slowly insert the catheter.
If the patient feels any pain, you stop, back off a bit then try moving forward again. It's a slow gradual process in case the patient has BPH & to avoid causing any damage to the urethra. There have been cases where the catheter is pushed thru su hard that the urethra is torn.
Ramming the catheter through in one forceful movement is pure agony without the gel in place.
I'm sorry you were put thru this. You were in the hands of an amateur NOT a professional.
That's all I have for now.
Regards,
NTT
Dr. Bernstein, across my adult life we have gone back and forth as to which party is in control. Neither party has ever done anything as regards the issues we discuss here. My guess is that the privacy of the political elite is respected and that they are treated with the utmost dignity. Not experiencing life as us unwashed masses do, they simply don't know and/or don't care.
EM, NTT, having had a couple dozen cystoscopies, lidocaine is always inserted and then allowed to sit for a few minutes before insertion, and for me at least it feels a bit odd going in but it doesn't hurt. Of course in urology offices I am the only patient that the nurse is tending at that moment and as such he/she is not under any time pressure.
Here is a 2018 article from the American Medical Association which provides the AMA Code of Ethics and discussion regarding the role of the medical profession regarding PATIENTS AND POLITICS which I think may be pertinent to what we are discussing here. To read the brief article
go to:
https://www.ama-assn.org/delivering-care/ethics/patients-and-politics-what-ama-code-medical-ethics-says
Does anyone here see a political motive and behavior in your interaction with physician or nurses? ..Maurice.
NTT
I don't know if the catheter was lubricated or not but there was almost no delay from the time I felt my penis being manipulated until the insertion. I did not sense any cleansing and there was definitely no numbing gel applied which I specifically asked about. I was probably lucky that I didn't get physically injured like what happened to Jeff.
After reading the surgery report I learned that the surgeon tried multiple different ways to advance the equipment but due to my unusual anatomy, he was not successful. He even wrote that pain and inflammation was expected due to the amount of manipulation. I think it is quite possible that the insertion would have been extremely painful even with the most compassionate and gentle care. It really was a combination of my lifelong insecurities, the nurse's refusal to address my concern that I injured myself, being made to suffer for several hours, and the forced insertion followed by the snarky comment that set up the emotional upheaval that was to come.
Dr. Bernstein
As the medical “representative” on the blog, I am sure it is difficult and uncomfortable for you to read about the truly horrendous things that have happened to people. It is unfortunate that it only takes one bad experience to overshadow many good experiences. There have been a number of times over the last 9 years when I have felt you have unfairly received the brunt of redirected anger and I appreciate the fact that you continue to moderate this blog.
I am hopeful that the major of the situations are not the purposeful infliction of pain and embarrassment but rather due to the mistaken belief (stereotype) that men have no modesty, that patients shouldn’t mind if they are asleep, or that the pressure to get things do quickly overshadows the patient’s dignity. I would like to think that it will be possible to rekindle empathy through education or mandate better behavior through legislation.
Unlike many on this blog, I only had a single bad experience and most of the time my contact with medical care has been of a non-intimate nature. Several times I have been treated with such care and compassion that I was “crushing” on my caregivers and came back with cards and treats to show my appreciation. A reassuring pat on the hand or shoulder felt wonderful.
To All
Thanks to all for letting me vent and I would like to finish my story (in a more abbreviated fashion) and relate how this blog helped me as well as other coping techniques that might help those currently in distress or even future readers. I look forward to participating in ways to change the system such as educating medical personnel and seeking legislative changes. I have a theory about why it seems difficult for men to achieve the success that women have had and will offer that up at a later date.
EM
Dr. Bernstein,
Politics is a tricky subject. There is such polarization these days that I personally would be very hesitant to air my political beliefs. I would be afraid that that my treatment could be compromised should my beliefs differ from my caregiver. If my caregiver shared beliefs that differed from my own, I would not challenge them and remain quiet. If the topics were very superficial and remained unemotional, I might engage in debate.
EM
NTT,
I agree that the only way to change the delivery of medicine is thru federal legislation. We need to have a leader, a bill of particulars, and then inform first time legislators of these patient needs. The AMA donates too much money to existing legislators to waste time with them.
Even MDs don't feel that they need to advocate for patients. Although one MD made the news on KevinMD by advocating for patients.
BJTNT
EM
Quote "came back with cards and treats to show my appreciation." Unquote.
How many other times have you shown appreciation to a person that provided good service otherside of the delivery of medicine? Possibly never because we expect good service everywhere except in the delivery of medicine.
Poor servce is the exception in the real world.
Good service is the exception in the delivery of medicine.
BJTNT
I started to read the article you posted but got stuck on physicians enjoy the same freedom of speech that everyone else does and it immediately made me think of the bogus surveys that some of the posters here have talked about.. The guys posting here have mentioned the questions/requests that they needed to make were absent and no space for other comments to be made. That isn't freedom of speech. Certain patients here have even written letters that possibly never made it to administration. Is that a coincidence?
Just a thought. JF
I do not want my doctor or anyone else in healthcare talking anything political with me. This has never occurred but if they did I will simply tell them what they want to hear so as to not get on their bad list. To even just tell them you don't want to talk politics would signal them that you don't agree with them, which risks retaliation on their part.
Hello,
I was saddened to read Biker's last post. It's deplorable to think that we cannot view doctors and nurses as friends and companions on our health journey. To be reluctant to speak for fear of retaliation is what one would expect in a totalitarian country. Has healthcare become that uncaring?
Reginald
Good evening:
Reginald, the Florence Nightingale's are gone.
Most people today go into the field for the paycheck. The power & control trip happens after they've been accepted into the cult.
You give a nurse what SHE perceives as a problem or pis* her off, she WILL at some point, retaliate against you & you won't like it. It can be anything that might set her off.
It shouldn't be this way but unfortunately they don't weed the bad ones out before they get in.
Regards to all.
NTT.
the fact that Maurice is the only (high level) medical professional provider on this blog says everything. you would think that at least one association, med school, facility, etc. would have someone to handle social media to promote their profession. we need to "take the gloves off."
a friend had filed a complaint with a facility about an incident similar to those talked about here. the administrator was giving her the usual run around; medical professionals, the way we do things, etc. sensing that she was getting no where, she said that she will be organizing an antifa protest at the facility. she identifies as a socially protected class (minority).
the issue was addressed the next day.
one of my strategies for patients to protect themselves is to identify their protected class and/or request an accommodation under the americans with disabilities act. in both instances, the patient is under NO OBLIGATION to prove that they have a disability or are a member of that class.
-- banterings
Banterings et al, if you want to see a blog topic on this blog in which I was knocked down by a whole series of physicians who identified themselves as pathologists please go to:
https://bioethicsdiscussion.blogspot.com/2013/01/should-pathologists-be-physicians.html
Oh..they will come to this blog and write when what is written by me truly offends them. And if you go to the above link you and read what was written will document my statement about medical professionals and responding to what is written here.
Of course at the time of the publication of that post in 2013, my words really set them off. This clearly gave me awareness that professionals in medicine are around looking and speaking up but it seems what is written on "patient dignity" issues are not as stimulating as my suggestion to pathologists that starting their career with the whole process of medical school and internship and residency is unnecessary and that a PhD medical professional degree rather than MD should be acceptable.
What do you think about their response to the blog and their viewpoint?
Again the link: https://bioethicsdiscussion.blogspot.com/2013/01/should-pathologists-be-physicians.html
..Maurice.
Reginald, my comments aren't so much an indictment of people who work in healthcare but rather of the political environment as a whole. It is just that in healthcare there is a huge power imbalance that potentially has ramifications. I identify as a moderate in the middle of the political spectrum, agreeing and disagreeing with both parties. I vote R and I vote D or I vote for neither if they are equally bad, depending upon the candidates and the issues. The problem in the current environment is that the far left and the far right won't tolerate anything less than total agreement. Neither party has room for moderates anymore. They want our vote but not our opinions. People such as myself thus tend to be wary of engaging in political discussion with anyone other than our closest friends. So as to avoid confrontation and potential retaliation, the path of least resistance with anyone else is to lie and just tell them what they want to hear. I'd be glad to discuss my thoughts if they were willing to listen but the hard core on both sides want to proselytize rather than discuss.
This is of course theoretical as such a discussion has yet to come up in a healthcare setting in my experience.
FAMILIES Have become that uncaring and fragile. Marriages broke up over the 2016 election. I've been guilty myself. I'm trying not to be now. I do have friends and family of the opposite political side but we have to limit what we discuss. JF
I think it is a certain immaturity if people cannot discuss and accept different political viewpoints. If different viewpoints cannot be tolerated, what do we have? I believe countries like Russia and North Korea don't tolerate different viewpoints and that is what many woke individuals are trying to turn this country into.
I do believe politics are something that should not be discussed with a health worker or really anyone giving you service. Although my husband didn't discuss his political views (as he was harmed probably bc the area where we live is known for its politics), he was harmed by an entitled, MeToo Bernie supporter. I also believe that in the cases of Jeff and EM, they suffered medical retribution and make no mistake, it can happen to you just as it did to my husband and them without ever knowing you have "set" them off. I completely agree what NTT said in his last post. It is an unspoken hazard of seeking healthcare--intentional medical harm which medical retribution is. It leaves the majority of those who have suffered it with a lifetime of PTSD.
I also think that during the time of O'bama/Biden, they signaled that "entitled" harm was okay against certain groups. Since many of them could not accept a President of the other party, "entitled" harm was grown and grown. Because of media, we now know how bad this issue is. I didn't like either Bushes or O'bama but I sucked it up but to see how unhinged some are over Trump or even DeSantis is unreal. "Suck it up, Buttercup" because it can change every 4 years. I believe people are entitled to their political views no matter how wrong I think it is. I practice that until their attacks turn personal than I am done with stupidity and sadly I have found most who are the opposite of my views can only spout out personal attacks because the facts just aren't there to support their viewpoint(s).
To answer Dr. B., I believe you are less likely to be intentionally injured by a R medical provider than a D especially if the D provider is female. I believe the brainwashing fed to woke individuals justifies harm if they feel entitled. However, I believe both political sides do nothing because all have been bought and paid for by the medical lobby. Harm generally doesn't happen to them because they have VIP medicine (except in today's climate woke ppl may feel entitled to harm even them). We saw in the NY riots, medical providers rioting and being violent with police. Wouldn't you like to be that cop having to receive medical attention from a rioter in scrubs screaming they wish you were dead?
BJTNT
I do tip the my waitresses/waiter when dining and do so more heavily if I like them on a personal basis.
I also give flight attendants a bag of candy every time I fly.
Unlike many people on this blog who have had repeated negative experiences, I have been fortunate in that my worst experience is limited to my urological surgery. However, I have stopped several potential exposures because of what I have learned here. As I age, the potential for unfavorable outcomes will no doubt increase.
I totally agree that patients should not have to bribe their health care workers for the treatment they deserve. That said, I admit that I brought candy to surgery in the hopes that it would lead to a more favorable treatment where I would not treated poorly while exposed. Most of the cards and letters etc, were given to floor staff where I was awake during our interactions.
EM
Dr. Bernstein and readers/contributors
My story continues:
Receiving Versed in combination with the experience with the “nurse from hell” resulted in my mind going into overdrive. I visualized every possible humiliating scenario from being wheeled through the lobby naked to having groups of people standing at the end of bed while I was naked in the stirrups. I envisioned them laughing, pointing, making jokes and taking cellphones pictures. Nothing was too outlandish. As a method of coping, I tried to convince myself that it didn’t happen that way and only the Scrub and Circulator saw me naked and the other members of the team were busy at their respective work stations (C-Arm, Laser Tech, Anesthesiologist) and not staring at me. I decided that at the follow-up appointment I would ask the urologist about the positioning of personnel and complain about the observer and general discomfort over having so many women involved in my procedure.
Not only was my urologist impatient and dismissive of my concerns, I found out that the surgery was not successful and would have to be repeated. Before I underwent another Ureteroscopy, I tried Extracorporeal shock wave lithotripsy (ESWL) to break up the stones. It also failed.
By this time, I had found this and Misty’s blog and started therapy. I was slowly starting to communicate my desires. While not in writing yet, I told my urologist that there was to be no observers, no photography of external genitalia, and that I would refuse any drug that actively caused amnesia such as Versed. I wanted to be introduced to each member of the team and observe them for a minute or two before being put under.
My next surgery was scheduled at a local surgical center in which the urologist had an ownership interest. My second attempt at coping was to write funny inscriptions on my body thinking that if they were laughing at the jokes, they might treat me better. Afterwards, I decided that was a bad idea and only focused more attention to my body.
I had a female Scrub and female Circulator but a male anesthesiologist. Just prior to going into surgery he walked away and was replaced by a female nurse anesthetist (CRNA). I got to the OR and the C-Arm tech and the Laser Tech were women. As I was being put under, I noticed 3 women hovering in the background which brought the total to 8 women.
The inclusion of 3 observers infuriated me and I wrote both the surgical center and the urologist asking for an explanation. They denied that they were there and they did not show up on the surgical report.
to be cont'd
EM
EM story continues
During my follow-up, I tore into my urologist and essentially accused him of staffing the OR with women to punish me for being a pest and asking about the positioning after my first surgery. He claimed it was coincidence about the 5 women and he did not see the 3 observers. Perhaps they left after the prep and draping and before he entered the OR. He said he would never do that do me. This procedure failed as well.
Perhaps I made him think about my concerns because for the next three procedures, I always had a male Scrub, male Circulator, and male Anesthesiologist for two of three procedures. I felt that a mixed sex team might help moderate potential bad behavior. This become part of my strategy for coping. Addressing photography, observers, male personnel on team, refusing Versed, and getting introduced to the surgical team allowed me to get through the 3 procedures with minimal mental anguish.
In addition to the male personnel (coincidence?), I got the urologist to perform a cystoscopy to pull my kidney stent with no nurses in attendance. He also removed an ad for a scalpel-free vasectomy from his website because it featured a woman’s voice saying “Oh, it’s so small” followed by a nervous sounding man saying “What?” to which she laughed and said “I mean the scar”. I told him it was very offensive and not funny.
My urological story ends here and I will soon share some "Wins" that occurred during subsequent umbilical hernia, shoulder, and lumbar spine surgery.
I would not have thought to ask for the accommodations I received without reading the contributions and suggestions on this blog. I was also much more aware of the potential for unnecessary exposure and was able to prevent it from happening.
EM
Dr. Bernstein,
I thought you made a compelling argument concerning whether a pathologist should receive patient-facing training. I don't believe that I have ever met a pathologist that analyzed my tissue samples. I have never met any radiologist that read my MRIs, X-rays, Cat Scans or other diagnostic imagery. However, ER doctors and specialists I sought out (podiatry) have discussed x-rays of broken bones and they routinely had patient contact.
It seemed to me that the concern was focused on either an issue of pride or the thought that it would be less prestigious to hold a PHD rather than MD. AGG made some good points about performing biopsies and I would want that procedure done by someone who had patient-facing training. There was an anonymous contributor that indicated he was very introverted and would be concentrating on lab diagnostics. Patient-facing training would not be particularly useful for him/her.
EM
EM,
We are products [victims?] of our society [culture?] in that I also thanked my anesthesiologist when she changed to a spinal tap when I requested it. She was from Africa - maybe a different culture?
At the same operation, I included a second thanks [one letter to the medical institution] to express appreciation for the young lady who delivered the food when she made a second trip to get me more coffee. Coffee [I'm normally not a coffee drinker] is a diuretic for me and I needed to pee before I could be released.
BJTNT
Hello,
The attached URL is from a post in 2015. I hope you find it useful.
Reginald
https://participatorymedicine.org/epatients/2015/06/guest-post-by-duncan-cross-i-sent-this-letter-to-a-doctor-who-pissed-me-off.html
Hello again,
Another interesting dignity read from Brazil is attached. You may wish to scroll down to the conclusion. Maybe the word is getting out to medical personnel regarding dignity. However, will any changes be made?
Reginald
https://bmjopen.bmj.com/content/12/5/e059129
Hastings Center logo
March 16, 2023
Should Clinicians Ever Deceive Patients?
Sometimes, Yes.
“I don’t know if it’s ethical, but . . .” said a nurse before she proposed giving a placebo to a patient who had asked for his opioid dose to be increased—and who could not comprehend the harms he would suffer if his request was met. This is one of several situations in which doctors and nurses wondered whether it would be ethical to deceive or even lie to patients or their family members, discussed in the latest Hastings Center Report. The lead article proposes a framework to help clinicians figure out the degree to which a deception could be ethically justified: Read more.
Reactions to the framework:
The Problem of Clinical Deception and Why We Cannot Begin in the Middle, Justifying Clinical Deception, and Deception, Pain, and Placebo.
BJTNT
Reginald,
Excellent article from Brazil but again, it is another country doing the study and publishing the results. The US just will not accept that patients have rights especially bodily dignity rights for males. This article also failed to mention male patients but rather talked abt pregnant women needing more bodily respect but it was a start. If you don't mind, I think Cindy and I will discuss this article in an upcoming broadcast. It is worth sharing. We are always looking for articles to discuss on our show. Thanks, Jeane
Hello Jeane,
The statement I most liked about the Brazilian article was,
"The investment in training and education of health professionals is the best solution to improve the quality of care, bringing patients to a more active position in their treatment, promoting information and autonomy, aiding in a timely manner, respecting rights, maintaining vigilance in cases of disrespect and violations of dignity, encouraging the acceptance of differences, reducing all types of prejudice and stigma, and allowing professionals and patients to act together."
This appears to be a very collaborative approach to healthcare. If this training took place, I believe we'd see much greater respect for the dignity of both men and women.
Sadly, US health care personnel, apparently, don't seem to see a need for such training. Maybe your broadcast team can enlighten them.
Take care.
Reginald
Dr B
Do you remember anything about college being free? I remember seeing something about that in a Devotional an older family member had but don't know what time period that would have been and I can't find the book. Also some of the bloggers here have talked about legistration being the key to getting our issues resolved.but I think maybe they may be wrong. I think a much larger number of doctors would be the key. But the cost of College insures that that will never happen. If the doctors had to compete for patients or lose hours there might be an incentive for them to want to take care of us in a way that works for us also. I know that it's not always the doctors who create the di to respect patient gnity violations but they often let female staff freely come and go when patients are exposed
They could require their staff to protect the patients modesty. Just preach it to the staff at the staff meetings. An occasional write up or job termination would give it a little leverage also. I wonder also how many family relationshipsnare permanently harmed because staff exposes patients to whoever happens to be around. JF
JF, if what you are suggesting that the world of patients (and we are all part of that world) truly needs more physicians and more nurses. And I am certain most every doctor and most every nurse would agree with that suggestion. Much of any behavior or misbehavior performed by doctor or nurse has somewhere in its origin the fact that there are too many patients for doctors or nurses to manage and medically be responsible as part of their individual professional work and the doctors and nurses own personal life management. The fact must be considered that there are too many patients and inadequate numbers of medical professionals for the patient "load" (if that is a worthy term).
Beyond, moaning and groaning about the medical care status 2023, perhaps we should all participate in getting more and more young people to go into the profession of medicine and patient care. Is there anything illogical or unwanted in this need and action. ..Maurice.
In the case of colonoscopies anyone can and does enter the procedure room while its being done. Case in point my husband had the receptionist walk in to ask the doctor a question. Why exactly was this necessary at that time? Why couldnt it have waited until it was finshed? Someone said they had theirs done awake and the nurse put a note on the door saying patient is conscious. Why shouls that matter? Oh i know.... what the patient doesnt know wont bother them. My husband's gastro had no problem with awake or pants on. This was hus 2nd colonoscopy. Why was this never suggested at his first one? Why did he have to be the one to ask? People avoid colonoscopies because of the embarrassment. This avoids it. All this doctor needs to do is rewrite his about procedure paperwork. He doesnt even need to spend extra time explaining to every patient. We must have options. Since he was going to be awake he OKd students. Not a single one was there. Dont you think hes would have been a great one to observe ( since the nurses kept saying being awake is highly unusual). There is a skill to be learned doing it awake, yet nobody wants to take the time to be taught, why is that? I feel its up to us not politicians. The more people who ask for options to their doctor, the more they will be willing to accommodate. Cat
My limited understanding is that the nursing shortage is largely driven by a lack of qualified nurse educators to teach in nursing schools. That in turn limits how many students schools can accommodate. For nurses with Masters degrees & PHD's, there is more money to be had becoming NP's rather than professors.
My limited understanding is that the doctor shortage is primarily due to the number of Residencies being funded not keeping pace with population increases and the aging of the population adding to the demand. The cost of obtaining such an education is an insurmountable barrier for many but there remains more qualified applicants than available slots nonetheless, so cost is not the primary reason. Cost barriers instead more serve to deter socio-economic diversity amongst the applicant pool.
Cat, that a nurse put a note on the door saying that the patient was conscious affirms that staff is free to come and go from the room when patients are unconscious. I've had 4 done while awake and for one of them a Resident did just walk into the room to ask the doctor a question.
I think the worst "just walking in" abuses are in ER's. That has happened in each of my ER experiences, and in each case it was a young woman from Registration who literally just walked in without first seeking permission to enter, and always for something that could have waited. Fortunately none were at a moment that might have been embarrassing.
Dr. Bernstein,
I just read an article stating that many new doctors are opting out of ER specialties and instead picking specialties like plastic surgery and orthopedics. Not sure this bodes well for the future.
https://thepostmillennial.com/med-students-skip-er-residencies-opt-for-specialties-over-much-needed-basics
EM
Probably if they would have knocked they would have been invited in anyway. Even if you would have been exposed. JF
EM says Greetings,
A couple of forgotten thoughts before I share some wins.
I also had a testicular ultrasound where the technician was a young female. The procedure went like a text-book operation. I was left alone to change and cover my penis with a towel and place a towel under my scrotum. She knocked, waited, and then entered. The lights were turned down low and she stared at her equipment for almost the whole exam except for when I stood to do a “Valsalva maneuver” and she was sitting directly in front of me. She left and I cleaned up and dressed. However, as I left, the grins on the two young female staff was unsettling.
My first major surgery was for a cervical fusion but I wasn’t as worried because I thought they won’t have to move the gown since they are working on my neck. I found out in pre-surgery meeting that hospital policy was to place a Foley catheter. Years later, I got the surgical record and found that I was prepped by a woman and that there were also student observers. If that happened today, I would try to get a male to place the catheter in pre-op and ask to wear some type of procedure shorts. Even without the catheter, I was no-doubt exposed while they placed grounding pads and various sensors.
During the heated discussion with my urologist where he exclaimed that he did not arrange for an all-female surgical team and denied the existence of the 3 observers, he also mentioned that he had even told the nurses “To make sure and keep this guy covered as much as possible”. I don’t know if they really changed their routine but it immediately made me think of two questions.
1. If he knew I was modest and concerned about the exposure, why not tell me of the special instructions before the surgery to help ease my mind. He also could have said something like “I know you are concerned but I have worked with these nurses for years and they have always behaved in a professional manner. And If I ever heard of any nurse disparaging my patient, they would never work my on team again”. A white lie then would not have hurt.
2. If he had to give the nurses special instructions to cover me, what in the heck is the normal procedure.
Wins:
Getting the urologist to perform a cystoscopy without his nurses present
Asked and was able to keep my underwear on for an umbilical hernia operation.
When I was needed a rotator cuff procedure, I chose a female surgeon who seemed to have good online reviews and whose credentials seemed impressive. I also researched or asked questions about how the positioning was performed. I eventually found out that you start on your back and when knocked out, the gown comes off, you are exposed to the room, and then several team members roll you onto your stomach.
When I called the surgical center in Ocala, FL, I was going to ask about keeping my underwear on or whether I could wear a COVR garment. I barely got the word “underwear” out of my mouth when woman abruptly said, ‘NO! , everything must come off”. I didn’t argue and politely said that she can cancel my surgery because I will find somewhere else. My big regret is that I didn’t write or call the female surgeon and let her know why I changed my mind.
I was actually able to negotiate an all-male team and wear the COVR shorts at another facility in Tampa, FL. My surgery was delayed for hours and they were short a nurse. The scheduling nurse that I talked to asked if it was okay for her to join the team. Because she was so compassionate and understanding I agreed to her presence. It really didn’t matter anyway because I was wearing the COVR shorts. The incision was above the waist band and at most they only needed to move it down a bit. I purposely did not get the surgical report to see if it mentioned removing the shorts so I would like to believe they didn’t.
EM
EM continues
Just because two surgical centers verbally agreed the wearing of my underwear, I was no longer that trusting. I found a water-based, body adhesive called “JOMI Compression” that glues clothing to the skin. I think it is often used by women wearing slinky dresses without bras. Once dry, this adhesive forms a very strong bond between skin and material and it is readily apparent when the seal is broken. I used a liberal amount of glue and secured the underwear. When I got home after the procedure, I got a warm, wet washcloth and easily removed the underwear. I was not “painted” nor were my genitals shaved in either case.
I decided to start my hormone replacement therapy (HRT) again and made an appointment with a urology practice nearby. The male doctor walks in followed by a young woman who was introduced as a medical student. The doctor wants to do a DRE, so I calmly explained that I understand she is trying to learn but I am not comfortable with her participating in my intimate exam. She says, “It’s okay, I have already seen this” and leaves the room.
It was then the typical drop your pants, turn and bend over which I find extremely degrading and humiliating. Ironically, if I have been given a gown and if the DRE would have been performed while I was laying on my side, I probably would have let her stay. I was somewhat miffed that he didn’t ask ahead of time and sprang her on me. The old me would have meekly complied. Later when I had the testosterone pellets implanted in my hip, the doctor brought two nurses and the medical student for a max two-person job. I am not that sensitive about a butt cheek so I let it slide. I get my HRT elsewhere now.
I am determined to give my Dermatology office some corrective criticism when I go in for either my next skin check or a blue-lite treatment on my scalp (I am bald). The male dermatologist walks in with two women, one of whom is a scribe. I do not get a complete skin check and am dressed in my boxers. I was mildly annoyed at the lurkers, but as long as I am covered I am okay. I also had an infected skin follicle due to bicycle riding located at the bottom of my butt. He suddenly says, “Well, lets see it!”. He really had some attitude. I would have had a real problem if it was in an intimate area, but I only had to lift the leg of my shorts a little. There wasn’t much concern about modesty about patients in underwear because as they opened the door to leave, I exchanged glances with another patient walking by. When I left, I was walking down the hall and a nurse opened the door to the room next to mine. I too exchanged looks with the woman in her underwear. I am planning on asking for a different doctor next time and will explain why I want to change. I think this practice could use some education.
EM
Dr. Bernstein,
As others have mentioned, I agree that the purchase of medical practices by corporate interests is detrimental to the patients and that there is a tremendous emphasis on profit.
When I was having my rotator cuff repaired, I was third in line and while waiting I could hear the pre-op nurse quietly talking to the anesthesiologist. She asked if he was administering nerve blocks and he replied no. He said that the doctors were complaining that it slowed down their schedule too much. After a while, it was my turn and the nurse (to whom I brought candy) leans down by my ear and whispers "Don't worry, we are going to take care of you". The anesthesiologist came in and had me tilt my neck to one side. I felt the needle go in but then it was lights out. As much as it hurt the first 24 hours, I am really glad I got the nerve block. I can't imagine that the nerve block took 5 minutes to administer.
EM
EM
When I was 14 and being examined by our PCP, the female "medical assistant" just walked in with an inane comment for the doctor. The MD moved to cover me which made me aware of caregivers just walking in unannounced.
In decades seeing MDs, the doctor has always knocked [although rarely waiting for an acknowledgement] and never has anyone else ever knocked - never.
Not being Mr. America, I'm always amused when the "medical assistant" enters at an inapropriate time.
For example, why did the young female MA walk into my exam room as soon as the dermatologist left, only to rearrange the things on the counter - the most was a quick peek?
Although not a consenses on this blog thread, I think it's all about control, control, control.
BJTNT
EM... how/when did you put the Covr on and keep them sterile. I would like to explain to the staff how these work when we are abruptly told NO. Thanks Cat
You definitely would have missing hair and skin if they tried to move those shorts, not knowing the glue was there. Many actress use double sided tape on their nipples to keep the dress in place. I remember an interview once where one said it felt like she was going to pull her nipple off trying to remove it. Cat
BJTNT, I think the women who work in medical practices on account of the access it gives them have refined the art of knowing exactly when to walk in for some non-essential task. I had shared the story before but a few years ago at the dermatologist, I established upon arrival and again when I was roomed that it was only to be the doctor in the room. I'm given a gown to change into and literally the moment I had completely undressed and was reaching for the gown, a woman (don't know who or what she was) knocking asking if it is OK to enter and as I shout "No, I'm not dressed. She opens the door anyway on account she started to as she asked the question; her not waiting for an answer. I yelled loud enough for anyone in that practice to have heard me "I said no. Which part of no didn't you understand!" She left immediately and when the doctor came in he was clearly walking on eggshells on account he knew what had happened.
Interestingly I have a female PA for my primary care provider. I didn't choose her but rather went with her as it was my only alternative I could find within a 1.5 hour radius of where I live. The lack of primary care providers in rural America is that acute. Fortunately she is brilliant & thorough in her analysis and has addressed issues that doctors haven't. She has brought in a PA student a couple times, but not without asking me first, and when another staff member wants to see her, they knock and wait for her to crack the door open and slip out into the hallway. She never lets them into the room, nor does she open the door enough for anyone to see in. She takes my privacy very seriously despite me never having said anything to her in this regard.
Some of what EM describes are the small differences that doctors, nurses, and others could do if minimizing patient exposure was a priority. But it isn't a priority and patients get exposed more than is necessary. Why? Some combination of convenience, control, and/or voyeurism in most cases. Yet I suspect most of them want their privacy respected when they are the patient.
Biker,
Thanks again. I remember your story from an earlier post.
I had a female PCP for years [only one, all others male] until she returned to FL. She did complete [intimate] exams that male PCPs haven't done for me the last decades [just lab panels].
No one ever tried to walk in with the female MD [her policy?].
BJTNT
I would have put on the hospital gown first, before taking off my pants.
I assume this was in reference to my comment:
"I would have put on the hospital gown first, before taking off my pants."
Now I put the gown on before taking off my underwear but back then I didn't realize such a defensive action was required. It is sad that we even have to think in these terms. One would think patient privacy would be a core value for people who work in healthcare.
Cat
I left the Covr garment sealed until I could show the nurse. She was not familiar with them, but after examining them said ok. I swapped my underwear with the Covr garment, put on the gown and got into the bed as normal.
EM
I reached out to the people from COVR and had a back and forth exchange about the use of the COVR garment for hernia surgery they were very helpful with all my questions but I know that the entire area where the incision will be made which is only inches from the genitals will need to be sanitized and although the COVR garments are sterile my skin isn’t. They said that the garment could be removed for skin prep and then put back on?
Sounds to me like that totally negated the whole reason for wearing the garment?
The bigger question is how many unsuspecting people have had their garment removed for skin prep after being sedated and then waking up in recovery never knowing the truth of what happened?
And if you think that the medical establishment is going to reveal this to you I have a bridge I would like to sell you
What is more sanitary? A person with a disposable adult diaper on? Or a person who has an incontinent accident while they are unconscious? I always assumed incontinent accidents were the reason why patients were required to get nude in the first place. We take showers or baths everyday anyway. Why do we need to be more sterile than that? JF
Jeff. What kind of surgery and hernia? My husband had lapascopic inguinal hernia surgery and his incisions where in the belly button and 6 inches to the right and left of the belly button. Nowhere even near the top of the pubis. Nor was he clipped any lower. Are you having open surgery? Cat
Jeff it is very obvious where the skin prep was. You still have an orange tint. Why cant you use the antiseptic wipes on yourself before putting on the covr? Cat
Cat it is open because the lap is done under general anesthesia and open is done with local and sedation. I can’t go under general because of the effects it has had on me in regards to memory and cognitive issues and I was requesting no sedation either because I don’t want them stripping my memory and turning me into a compliant lump of play-Doh . As far as me prepping my own skin I know with the protocols they have in place and the very strict guidelines they adhere to in regards to skin prep they would never agree to that. There is one simple way all of this could be resolved for me! An all male team! Under those conditions it may feel a little uncomfortable to me but to have a strange woman becoming intimately involved with my genitals is more than I can handle. I don’t know why I have such a extreme adversion to this scenario, my psychologist thinks that it goes back to traumatic events from my childhood that are being suppressed and I also have personal convictions about the morality of it all. As far as they are concerned once they put on the magical scrubs they are afforded full access to your genitals to do as they will and then to make sure that the take over of your body is complete they pump you full of Versed
The road block that I keep hitting is their insistence of having females in the OR and for some reason the only individuals that know how to clean a Man’s genitals is a woman because that is who always does it .
Enough said!
EM
When my grandfather went to get dentures made up ( many years ago ) he was made to completely undress also and he seriously didn't want to do it. It was female staff attending to him also. Being sterile was the reason given to him also.
JF
Naked for dentures???
Maybe 20 years ago, my wife wore only a glown for cataract surgery - total of a half day in a hospital in the greater LA area. Approximately five years later, she wore a glown and underpants for the second cataract surgery in a LA eye surgery center - again for just a few hours.
BJTNT
That's what my grandmother said about it afterwards.JF
Hello Jeff,
Call other local hospitals and doctors (or not so local) to determine if an all-male team can be obtained for you. Let your doctor know that you're looking for an alternative hospital and/or doctor. Maybe they'll try harder to accommodate you. I wish you well.
Reginald
Reginald the way people are dropping like flies in the medical community your lucky if they don’t have the janitor helping out with your surgery. The hospital system that I have been using is the largest hospital system in the Washington DC area with 5 major hospitals in the area and more hospitals operating under a different name. They are in the best position to accommodate me and my surgeon of choice now works for them they have systematically bought up all the areas private practices and created something of a monopoly. Because of the shortages that exist in their ranks it is harder than ever to limit who you will except in the OR and the smaller the facility the harder it would be for them to accommodate. And when you try to talk to them about trauma informed care and dignity concerns the response I get although I can’t see them over the phone is like a deer in the headlights.
And when I thought I had crossed my t’s and dotted my i’s for a pacemaker and was reassured I would be accommodated once I was in the OR there were 2 women that I could see and one was there to clean my genitals. I guess she thought she was doing me a favor by waiting until they hit me with the propofol before cleaning me up down there, which I still say was completely unnecessary. Their claim is in the event of an emergency. My attitude is let’s cross that bridge when we get to it.
And their protocols trump you’re wishes every time
Jeff,
You just shattered my illusion. I always assumed that anyone in the medical institution could see my genitals - including receptionists, traveling salesmen, and accompanied friends, but not the janitor. Since janitors are working class I wanted to think of then as the last bastion in medical institutions of our societal values - not that accidental views might not happen.
Remember my story when my urologist appeared with a middle aged woman and the MD said she was a resident - no title, no name, no request to stay. I assumed she was his neighbor [fellow resident] in their vacation condos in HI who just happened to be in town.
BJTNT
Thanks for that you made me laugh
Good afternoon:
From our conversations here, my talks with other men in prostate cancer support groups, and stories being told on Quora, the conclusion I keep coming to is the american healthcare system has abandon their core principles of compassion, empathy, patient advocacy, & integrity.
Today, these principles have been replaced by the chase for the almighty dollar.
Patient dignity & privacy be damned. Get them in & out as quick as possible & keep those dollars flowing.
They keep employees in line with fear & intimidation tactics so the outside world doesn't hear & get Washington involved. If someone gets caught doing something they shouldn't & the cops aren't involved, they just move that person to another area until things cool down then they go back to where they were & pick up where they left off.
To keep patients from making waves, if the infraction is serious, they buy them off & get them to sign a non-disclosure agreement. If they want to sue, they just throw lawyer after lawyer at you until you tire out & just give up.
As far as compassion, empathy, patient advocacy, & integrity go, there was this well endowed gentleman that was going in for surgery. While being prepped his privates began to rise to the occasion & of course ALL the women in the OR smiled & giggled.
The female surgeon in the room covered his privates to lower the temperature in the room & get everyone refocused on their duties. As prep continued, he continued to rise to the occasion. At that point, the female surgeon said what the hell. I'm gonna free Willy & proceeded to pull the towel off of him & everybody had a great chuckle at the patient's expense.
Compassion, empathy, patient advocacy, & integrity all out the window. One of the females in the room didn't think it was funny but didn't advocate for the patient & speak up about what was done in there out of fear of losing her job. The facility fear factor kicking in.
They may teach compassion, empathy, patient advocacy, & integrity in nursing & medical school but once they start working behind those brick & mortar walls, it all goes out the window due to pressure & the culture that has invaded our healthcare system.
Until enough people that have been abused by the system to the point, they are ALL willing to come forth & speak out against the system so Washington has NO CHOICE but to listen & ACT, NOTHING will change & things will be bad for the patient.
All we can do right now is to continue to warn people of the hazards they may face when seeking medical help. They must go in eyes wide open.
I'm tired of men walking away from needed care because some dumb female healthcare worker & her colleagues thought it would be fun & funny to embarrass & humiliate a prostate cancer patient who's just trying to stay alive.
Best regards to all & have a great week.
NTT
NTT Well said
NTT, You write "Until enough people that have been abused by the system to the point, they are ALL willing to come forth & speak out against the system so Washington has NO CHOICE but to listen & ACT, NOTHING will change & things will be bad for the patient." If this can be the mechanism for change, how can this "ALL willing to come forth and speak out against the system" be facilitated without judicial or some further physical or psychic harm to the patient? ..Maurice.
We need a leader. There are at least five posters here who can fill that role. Who will step forward?
BJTNT
Dr B. I tried to wait until NTT answered first but I'm not sure he's going to answer anytime soon. I hope I'm not doing anything wrong because sometimes I get upset when I ask one person a question and somebody else answers. My though isn't that MORE people are victimized but maybe a CERTAIN empowered person be victimized. Or maybe an empowered persons family member who complains to the empowered person. " I won't seek medical help because of this is what happens when I've sought help before!"
Also I wonder if the empowered people and the lawmakers are automatically treated with dignity. I have sometimes wondered if one mistake is addressing the system directly by writing letters that get thrown away before the person who needs to read the letters sees them One person once commented that hiring a lawyer would be extremely expensive.
I'm wondering if a more effective approach might be to confront and discipline the person (s) directly. Maybe punish first and explain shortly afterwards. In employment people are OFTEN terminated for reasons completely different from the reason given on paper. It's just a thought. JF
I think what should be considered regarding the interaction between the medical professionals and their patient can be dissected into two biases operative in the behavior of the behavior of the professionals. One bias is "explicit" which can be easily distinguished by the professionals overt behavior. The other bias in "implicit" is the one which may remain hidden and "can surreptitiously influence judgment and can, without intent, contribute to discriminatory behavior." I have a feeling these biases have become the cause of what has been described by patients here all these years.
Here is the link to the New England Journal of Medicine July 14 2022 issue where you can read the article and see if it clarifies the pathophysiology of the profession behavior or misbehavior described on this blog topic:
https://www.nejm.org/doi/full/10.1056/NEJMp2201180
You should be able to access the article even though you may not be a subscriber but let me know otherwise.
..Maurice.
Dr. Bernstein, in the current DEI environment with all of the gnashing of teeth over implicit biases (which has grown a substantial industry.... follow the money as they say), they still can't see the forest for the trees. I have seen endless articles about how we must act because women are under represented in certain specialties, including urology, but never an article about how men are under represented in just about every healthcare role below the physician level. Were told doctors need to look like the populations they serve, but below the doctor level, not looking like the populations they serve is a non-issue for the DEI gurus.
Men on average die 7 or so years before women, yet there is not a word as to whether there are any implicit biases at work that under fund and under prioritize men's health. No federal office of men's health, no men's health centers, no research into why men die younger on average, nor what can be done about it. The overwhelming societal implicit bias that men have no modesty & don't need the same degree of privacy as women does not warrant even a mention in all of the equity and implicit bias healthcare discussions.
Routing out implicit biases from society is a good thing, but what is happening currently is a selective picking and choosing of which biases matter.
Hello Biker,
Your analysis of bias should be printed in every medical journal in the country. Please consider offering it to them.
Reginald
Hello Dr. Bernstein,
Do you think that the NEJM article would be as well-read if "black" were changed to "men"?
Reginald
Biker. I agree with what Reginald said. JF
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I had my vasectomy a dozen or so years ago at a male urologist office. When I walked in I noticed he had an all female staff. During the initial consultation he said that it would be only me and him during the procedure. That set my mind at easy because I was apprehensive. After I was naked and spread eagle he walked out and left the door open and left me like that for five or ten minutes as people walked by. I have never trusted doctors ever since then.
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Edgar60, "people walking by, as in medical staff, clerical staff, or other patients?
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