REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.
TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com
IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice
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Preserving Patient Dignity (Formerly Patient Modesty) Volume 125
TO ALL THOSE WHO HAVE BEEN READING AND CONTRIBUTING YOUR COMMENTS TO VOLUME 124, BLOGGER.COM HAS SHUT DOWN THAT VOLUME (PRESUMABLY RELATED TO THE NUMBER OF COMMENTS EXCEEDING A LIMIT. )
PLEASE CONTINUE YOUR DISCUSSIONS NOW ON THIS VOLUME 125
I LAST POSTED THERE THE FOLLOWING:
I feel from a legal point of view of an ethics blog which this blog is an example, it would be legal, ethical and fair for this blog contributors to AVOID naming specific names of those individuals or institutions regarding their misbehavior or potential criminality unless you can provide publicly available news publications as reference that has been the resource for already having publicized that particular misbehavior or criminality. Specifically naming names of individuals or institutions which has not been already written in the news media should be avoided. We have to be fair. ..Maurice.
182 Comments:
I have been unable to obtain and reproduce here the text of the postings which had been written today to Volume 124, the attempted recovery of those texts have been prevented by the current behavior of the Blogspot.Com system. If the writers want them posted in this current Volume 125, write the text to this Volume 125. Thanks for your patience. ..Maurice.
HOORAY! Maybe soon you will all have available colo-rectal cancer blood tests which will permit less routine colonoscopies and less embarrassment for screen testing.
https://www.medscape.com/viewarticle/990465
Let me know if you have trouble accessing the above article link.
Is this an example of progress in the solution of one of the concerns repeatedly noted on this blog thread. ..Maurice.
Is the absence of communication amongst those with an interest in PATIENT DIGNITY simply a result of the current holidays or is there some problem of visiting or entering comments to this Volume 125 since Blogspot.com shut down posting to 124? Those who have read this posting now, please write me e-mail about any ideas as to the lack of posting on 125:
DOKTORMO@AOL.COM
..Maurice.
Does anyone have any concerns about completing the Sexual Health Inventory for Men (SHIM)? So far I haven’t been asked to complete it but it seems inevitable I will. My concern is about the security and confidentiality of the information, for example, who will see it? where will it be stored? is it contained in my electronic health record? I looked over an example of the form online and frankly don’t see how any man would put that type of information in writing. A friend of mine told me when he was asked to complete it, he refused, the doctor never asked him why but he also told me the nurse gave him a hard time about not filling it out.
It seems to me that with the ease electronic records are hacked this form and the information requested would be more of a face to face discussion with the doctor rather than a record that will live fore ever, outside your control. I myself have had a “leak” of my EHR, a specific type of surgery was indicated and recorded on it. Within 10 days I got several robo type calls from law firms asking if I was interested in joining in a suit concerning a specific medical device. I never had the surgery, so I can only guess someone in the surgeons office is on the look out and getting a finders fee. When I contacted the hospital group responsible for the records they basically told me no harm no foul, questions like “did you say anything to the law firms,” no real “breach” since no ID data referred to, etc.
From what I have been told by a nurse, there is no female equivalent. I doubt many women would fill it out if there were.
Thanks, Ohio Catholic, for the challenging content of your post and also that it provided evidence that 125 is accepting text not just written by me.
I am amazed and discouraged about our medical system reading in your post about Sexual Inventory inequality. ..Maurice.
TCT wrote the following to Volume 124 but
can't be published there anymore. So here on Volume 125 is what TCT wrote today:
Update: At the pain clinic at a famous SoCal teaching institution (scandalized w/more than 6,000 Student Health Clinic victims) I made preemptive attempts to preserve dignity by making the following demands via "Patient Experience" as a liaison: no more people than what is actively necessary for an intimate exam or procedure; no exposure of intimate body parts for non-intimate procedures. Not asking too much! I made my plea as a repeated victim of medical sexual abuse. The result of my pre. Price attempts?
Being preemptively banned as my appointment was cancelled. I have found that claiming victimhood sends a red flag to them
Also they told me that I would have to be naked for a cortisone shot to the back, as in the context of a "teaching institution" strict sterilization rules must be followed
Teaching institutions take my first prize for perversity.
TCT
..Maurice.
Maurice, my involvement here seems to have dampened the dignity activities. I should name the institution because there's no doubt of a culture of sexual abuse, a conviction & nearly a billion paid out in suits. Also regents & administrators covering up. But they can't accimidate my dignity. They want it all. With this pain & inability to get respectful treatment it won't be prudent to telegraph what I'm contemplating.
My 74 year old dentist went to this institutions, where dental students made the rounds to hospital beds learning breast exams. (What sort of woman allows a dentist to grope her breasts? That kind of blind compliance opened the door for the mistreatment we endure ) He claims that one of his classmates later lost his dental license for making breast exams a part of his dental treatment.
TCT
greetings all.
so i have been away working on my trauma with a shaman. i have made more progress with a shaman in 4 months than a therapist in 6 months.
i want to comment on the er staffing shortage issue from volume 124:
i do not want to get political, but with all these people entering our country it is putting a strain on services everywhere.
the public school system is collapsing in texas,
nyc shelters have no room for the homeless, but the city is opening migrant shelters with x-boxes or putting them up in upscale hotels.
the current administration is giving them "transportation, healthcare and mental health services as well as legal, career and educational services, with no costs being passed down to families".
that is just the people that surrender to border patrol and get processed. we all know what the others utilize: the emergency room. i would hate to be within 200 miles of the southern border and have a heart attack.
the healthcare system is only going to get worse for us average people. the elites have their concierge care or walter reed.
i believe that people are fed up with where the country is headed. the change coming is going to address some healthcare issues (but not the ones that we want). this is going to be a good start to rebuild our healthcare system. i see the issues as being covid (vaccine mandates and safety, outright lies by healthcare providers and public health officials, lockdowns) and the current migrant crisis.
i believe that the new system will be built by americans for americans. along with those issues (of putting control in the patient's hands), people are going to want to be treated with dignity.
-- banterings
This comment has been removed by the author.
What follows is a series of current postings but all attempted by the writers to Volume 124 which is no longer active. I hope they finally will come to this Volume 125 and write directly here. ..Maurice.
EM. You haven't said anything for awhile. I thought it was interesting that you live in Ocala Florida. I was living there in May June and half of July of this year. I'm going back in a few days. My granddaughter was in a bad breakup and has disappeared. ( She isn't dead different family members have heard from her occasionally ) I seriously hate leaving my family that I live with now but they won't let my granddaughter stay here if she needs a place to stay.. My sister in Ocala will.
I'm sorry Dr B. I got off of our issues a bit .
JF
and now from Reginald:
Hello TC Tomaselli,
You seem to be in the same neck of the woods as Biker. You may wish to connect with him re medical personnel in your area. Car pooling may even be possible.
Welcome to the blog. We try to encourage each other to SPEAK UP re our desires for dignity and modesty. Misty at Medical Patient Modesty also has a blog with similar concerns. Don't be afraid to vent and/or to tell us of minor dignity successes. We're all in this together.
Take care.
I'm logged in why can't I edit the mistakes from my last post
TC Tomaselli, to edit be sure to review what you wrote, click on PREVIEW but BEFORE you click on "Publish Your Comment") ..Maurice.
:
I find it extremely discouraging to know that the healthcare industry will turn you away if you don’t except their established protocols for how they deliver medical services, regardless of your beliefs or feelings about intimate exposure to the opposite gender. For some of us, that kind of exposure can have extreme and lasting affects on our emotional well-being. And I can’t help but wonder why they think that correcting in your physical issues must come at a price of suffering, shame and humiliation, because they decided that their professional status has eliminated any type of human response on their part to the viewing of naked bodies. Too much documentation is out there that says otherwise. Even when let’s say a woman exposes, a man intimately, with no idealization of a sexual encounter, but ends up with a shit, eating grin on her face at the reaction of that man’s embarrassment, and she feels a sense of power and control over that man and derive some sense of pleasure from that. How many people around her can read her heart and know what she is thinking, and that very act is sexual. Can anyone show me the statistics of how many times this occurs? I can tell you this much, my wife that worked on a medical campus at a hospital for years and conveyed to me some of the sexually charged conversations they had said that the nurses were the crudest of all.
It is what comes out of a man (or woman) that defiles them
As a man speaks ((or woman) so does he think
CAT wrote the following a few hours ago but to Volume 124 and could not be published there. However, here is what was written:
Unfortunately i can not link it. But, has anyone read the NYTimes article from 3/25/2017 titled Going Under the Knife with eyes and ears wide open? Its about awake surgery. You can read the article without a subscription, but only some of the comments. Of course many of the noway is this going to be done are from the anesthesiologists. The article mentions how there is a growing mistrust of the medical profession. Someone else said that the medical community has to get over their power plays ( not exact words but close) and they need to adapt. 6 years later and the power struggle still remains. Which i feel is a testimony to their lack of concern over the patients comfort. Cat
..Maurice.
i see some new people on here. i like the discussions that are occurring. for those of you who do not know me, i have some really good research that was borne of this blog. you can see it here: Banterings of a Mad Man
i want to follow up my previous comment with this issue that has been brought up in previous volumes: providers putting negative patient notes.
sure it is ok for patients to endure this abuse, but when it happens to providers, then, and only then there is outrage.
-- banterings
i often talk about the problems with the medical industrial complex being greed (money). here is an article that describes what is wrong with healthcare.
They All Laughed When I Spoke of Greedy Doctors
i am all for tearing healthcare down to the ground and creating something different and new.
-- banterings
Maurice, both my parents had colon cancer, & their GIs advised me to get routine Colonoscopies, not necessarily just for early cancer detection, but because removing precancerous polyps can prevent cancer (so they say).
In my case I opted out because I'm not a family guy, I don't want to live as long as Carl Reiner or Betty White, & because cancer is preferable to life's slings & arrows of outrageous fortune.
However if I was committed to longevity & quantity of life, over quality -- I'd put my male pride in my pocket & go.
TCT, please revise your this evening posting and all future postings to avoid naming the names of medical institutions themselves where you are describing upsetting events. Upsetting events, personal or otherwise which have been already published in the news mediacan be referenced with the institution's name and news source. Avoid using healthcare providers full name but if initials are important to include to identify several individuals (such as Radiologist A vs Radiologist B) that type of presentation would be satisfactory.
I am sure you can provide a useful personal story without any specific names of institutions or individuals unless they have been previously named in the news media regarding the issue.
Thanks for your cooperation is this matter and all those who are posting here their experiences. ..Maurice.
Reginald wrote the following to Volume 124 and postings are no longer posted there.
Here is what Reginald wrote today: ..Mauricee
Hello,
Below is the URL for an interesting article on dignity, incontinence and dementia. The key notes at the bottom could apply to many bloggers if reference to dementia patients is changed to male patients.
Reginald
PS Maybe male patients will get equal consideration after dementia patients' needs are addressed.
https://www.nursingtimes.net/clinical-archive/continence/dementia-incontinence-and-the-loss-of-dignity-in-acute-hospitals-13-03-2023/
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 at this time to
publish it on Volume 125 ..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.
Thanks MER. ..Maurice.
By the way, you all may find reading the postings by the various participants in the Volume 11 (year 2009) and maybe you can compare what was written then and what we all have been writing now in 2023. Here is the link:
http://bioethicsdiscussion.blogspot.com/2009/03/patient-modesty-volume-11.html#comments
Have times changed or are we still in a period of inertia?? ..Maurice.
Dr. B
I just read all of volume 11 from 2009 and realized that very little has changed. The clear message from then is the need for trauma informed care and that need is as great today as ever.I had open heart surgery at the end of 2019 and although 10 years had passed since volume 11 the amount of deception that was utilized on me to prevent me from knowing what they had planned for me was astounding. Going forward on the day of the procedure I was being treated like a lamb to the slaughter it wasn’t until it was over and I was able to look back at what had been done to me that I could clearly see how much effort was put into the deception which would have required the concerted effort of the entire establishment to pull this off.
Having been through 4 previous surgeries with my wife at my side for pre op the moment I entered the pre op area my wife was requested to wait in a waiting room and would be called back later. We both protested to no avail . I went from scared to death of the pending surgery to terrified at losing my support individual with no explanation. I have read over and over again how important it is to assure a patient and keep them as calm as possible for better surgical outcomes. Obviously they blew it on that one and I can honestly say at 65 years old I had never been so scared in my life. I know that some of what I’m saying has been said before on this site but it needs repeating. I was instructed to strip naked and put on the gown and was asked a series of questions in the process because I knew something was off I told the nurse that I had very strong moral convictions and I didn’t want to be exposed intimately to a female her response was to leave my modesty at the door and then immediately declare to me that they were going to shave my chest and genitals! At that the curtain opened up and a young girl is standing there with barber clippers in her hand. I was told at the surgeons office weeks before not to shave my own chest which was the perfect opportunity to make me aware of genital shaving but nothing was mentioned but my chest? This is why I say this was a concerted effort by everyone involved to keep me in the blind. They know that a patient at the very least would be embarrassed by this being done to them and it could go as far as it did for me and drive me to a level of emotional trauma that caused me to suffer dissociative amnesia at the moment she started shaving my genitals.there are those that will say they were just doing their job but from my vantage point the immediacy and surprise ambushing felt like sexual assault and I now live with PTSD because of what was done to me. This was done at a facility that is not only nationally recognized but has patients come from all over the world.
The waiting room they put my wife in should have a sign above it that says genital shaving waiting room at least that would give you some warning!
And if all of this is so pure and proper why do they feel the need to prevent a wife from watching a young girl shave her husband’s genitals????
My point in all of this for expeditious purposes they hide the details of humiliation that you are going to suffer because time is money and this way they eliminate the laborious time consuming questions and maybe protests that might arise from a patient that has dignity concerns . If there is a trust problem in the medical industry they have no one to blame but themselves.
All the issues that people were struggling with in 2009 are still there
This comment has been removed by the author.
Did the other visitors here take a look at the Volume 11 discussion and agree with the conclusion that Jeff wrote today?
..Maurice.
Hello Dr. Bernstein,
I didn't see a referral at the bottom of vol 124 indicating that a new vol had been started. Fortunately, I found vol 125. Maybe Biker and some of the others need a notification for this vol. I'm happy to be back.
Reginald
Reginald, Biker is aware of this Volume 125 and Bantering wrote here 8 days ago.
If you have any direct contact with our other commentators, I certainly be p;leased if you could inform them. All they need to do is go to:
https://bioethicsdiscussion.blogspot.com/ and Volume 125 will start the display.
..Maurice.
Hello Dr. Bernstein,
Your statement from volume 11 follows: "So the patient should say to the doctor "I want someone of the opposite gender to perform the exam and this Doctor is the reason why I am making request..." Then the doctor will be aware that the patient is not satisfied with accepting any gender and will also have an understanding of why the patient made the request. That is all that I am requesting of the patient. A good doctor will then use that information to try to provide the best outcome for the patient ..Maurice."
You asked, in the present volume, regarding Jeff's analysis of the present modesty/dignity situation. I'd suggest that the situation has changed. In addition to Jeff's laments, many posters have indicated that doctors are NOT interested in providing the best outcome for the patient vis a vis modesty/dignity. The prevailing attitude seems to be, "I can't provide that kind of treatment. Find another doctor." Presently the situation seems to place protocol before patient needs. It would be refreshing if your volume 11 statements could actually take place in the present medical milieu.
Reginald
PS I don't have access to other posters' email addresses. I hadn't seen any postings from Biker and, I thought that he might be unaware of this new vol.
Sorry for being AWOL. Dr. Bernstein had told me volume 125 was out but I misread that message and had been wondering what had happened when I wasn't seeing any activity on volume 124. My fault for reading his 1st message too quickly.
MERS comments in volume 11 that Dr. Bernstein reproduced are an excellent synopsis of what the history. Without waiting by first going back to read volume 11 again, I would say that the trend line of being dismissive of anything male-focused within healthcare has accelerated over the past decade. We're now supposed to celebrate women making rapid inroads into Urology despite urology being a male-patient dominated specialty, and at the same time celebrate that male doctors are rapidly disappearing from OB/GYN specialties on account the patients are female. It is as if current day feminism wants female doctors to dominate all medical specialties.
TC yes the door was open for patients and nurses to look in on me. I vowed to never go back to the doctor unless I was in so much pain that I couldn't stand it. Well, that happened to me back in February 2023. Surgery, full anesthetic, my worst nightmare.
After I was back in my room and trying to pee in that plastic thingy a female in a lab coat snuck up behind me and said "I'm not looking". The one time I couldn't get up and go to the can and there she was. Fortunately I made the sheets go all the way around my groin before doing that because I KNEW someone would do that. The floor nurses were all nice, they never tried to get a peek. I swear that lab coat woman was in there just to try to get a look. Maybe one of the girls in surgery said something about me to her and she just had to have a look for herself.
I did take a look at Volume 11. Didn't have time to read every entry but it was a great discussion.
Having thought more about what has changed over the ensuing years, I would say it has been the demand that women be represented in equal numbers in every specialty, except for those specialties that are dominated by women already, in which case no changes are needed. There are similar demands that racial minorities be represented in proportion to their overall societal numbers. With both women and racial minorities, it is posed as a statement of fact that doctors must look like the populations that they serve. In response to such demands I have agreed that those are laudable goals but given the gender discrepancy "vs the patients they serve" is vastly greater below the physician level, shouldn't rectifying that imbalance be an even higher priority than rectifying it at the physician level. No one has ever responded to that.
If anything, as a society we have continued down a path of de-prioritizing the interests of male patients.
Maurice Bernstein, M.D. said...
HOORAY! Maybe soon you will all have available colo-rectal cancer blood tests which will permit less routine colonoscopies and less embarrassment for screen testing...
That is good news. My wife made an appointment with her (female) doctor for me. I went and she was so quick to put a glove on without me even seeing her do it, and walked really close and held up a gloved hand six inches from my face with two fingers extended. (Sprung it on me for maximum effect.) Time for your prostate exam she said. (I'm absolutely certain that I would have been ambushed by her two female nurses who I saw sitting at the nurses' station mere feet outside the door had I submitted to the exam.) One way or another I felt that doctor would expose me to her nurses, either by inviting them in, or by opening the door to exit before I was dressed. Then would come the nurses station giggles as I walked out on the walk of shame. I assumed a defensive posture, and said I just had one less than a year ago. I didn't tell her this but I will do my own DREs from now on thank you very much my male urologist is a straight up sadist when he isn't exposing private parts to the world. She didn't even ask if I wanted a DRE or if I had ever had one.
She had me do a cologuard which came back positive but I don't believe it. Then she referred me to get a colonoscopy. I will never get on that assembly line of indignity. I read where people say tell your GI your concerns about modesty.
They don't care! They are so busy that anyone who even talks to them before the procedure just comes off as an annoyance. Let's be honest, once the procedure begins they are going to do whatever they want, inside and out. It is their way, or the highway.
ps: I cancelled my next appointment with that female pcp. I went decades without a pcp, hopefully I can go another decade without one.
As some of you may know from much earlier Volumes that I have had an indwelling Foley Catheter for several years authorized by a male urologist but every month it is removed and promptly replaced with a fresh new catheter but always done by a female nurse practitioner and there has never been any behavior shown which is anything beyond the appropriate clinical behavior or communication. Yes, they know that I am a retired physician if that should make any difference in their behavior and talk during the procedure. ..Maurice.
Dr. B you are saying that you have no problem with a woman exposing or touching you intimately as long as she has a professional demeanor. That is not necessarily the only problem that many of us have with that kind of an encounter. The very act of that being done to you by a woman can be very degrading and humiliating which is borne out by the sheer volume of people that have expressed those feelings on this blog. So I don’t know if you are insinuating that what you describe makes it acceptable to all or are you just stating what makes you personally comfortable
edgar60, my take on that gloved hand maneuver is that she thinks it is funny to do that to her male patients. Very unprofessional. Sort of a passive aggressive feminist power move. As for a colonoscopy, you could consider doing it w/o sedation. I have had it done that way several times and it is not a big deal. In fact I find it fascinating to watch the whole procedure on the screen. Not being sedated, the staff will be careful to keep you covered, except your backside of course where the doctor must have access.
Dr. Bernstein, I think most female healthcare staff maintain appropriate clinical behavior when performing their duties, but that does not preclude it still being uncomfortable or embarrassing for many men. This is the part that many women in healthcare don't seem to understand. They think that if they aren't doing anything wrong that their male patients should be OK with it, yet as patients themselves they often only want female staff for certain matters. They are generally blind to their personal double standard.
For a year following bladder cancer surgery I had BCG & Interferon treatments administered by a female NP. This required I lay on a table fully exposed while she inserted the BCG /Interferon via my penis. She was totally clinical in her mannerisms, and a nice person, but that didn't mean it wasn't a bit embarrassing nonetheless. I know it shouldn't matter but I appreciated that she was about my age vs a 20 something. I also appreciated that I had her for every one of my treatments vs my cystoscopies where I had a different female RN prep me each time. That lack of consistency as concerns who did my cystoscopy prep made it feel like every women in that large practice wanted to get her turn. I realize that's not the case but it is what it made it feel like. Had I any say in the matter, I'd of preferred to have the same RN prep me each and every time.
Just as the physician community is on this big "must look like the patient population they serve" kick while ignoring the vast gender imbalance below the physician level, it is as if the MD/NP/PA community thinks the only people that matter in the patient experience are themselves. They don't think it matters who is doing all of the intimate prep and care of patients.
I couldn't pee last year and went to the er at 3 a.m.. A tall thin woman was the attending. I was horrified but in so much pain I couldn't leave. As it turns out a man put in the foley while another man observed. It was dignified and quiet and professional. I couldn't believe how lucky I was. When I went back to have it removed it was a quiet woman resident at the same er at about 8:00 a.m.. She *asked* if a male student could observe and I agreed. In hindsight I would have removed the foley myself not because of a bad experience (because it wasn't that bad) but because it would have saved money. I agree, it doesn't have to be brutally awful if done in a respectful manner.
Hello Dr. Bernstein,
Do you think that, if you request it, a male nurse would be provided for your catheter change. I know that you're comfortable with a female; however, I wondered if a request for a male would be honored, especially since a monthly visit would not require much of a scheduling problem.
I wish you continued good health.
Reginald
Thank you Biker. My Dad is encouraging me to go as well. I especially don't want anything to do with the office that she referred me to. I had one bad experience with one of the doctors there already (not related to modesty). The other doctors are just guilty by association in my mind. Plus if I do have modesty issues at a hospital 50 miles away somehow I don't think that would bother me as much as if it happened in my home town. My pcp said she could refer me to someone else but she needed a name. I had a wonderful experience with an upper gi guy in the city but I'm not sure he does colonoscopies. The guy is truly gifted. I need to work up my nerve to get another referral at some point. Frankly I just got out of surgery a couple of months ago and am recuperating well and feeling much better. I need some me time before getting poked and prodded again.
IMO some giggly nursing station nurses (or some immature doctor's office receptionists) with not enough to do are the worst. I had some doing that giggling bit at the hospital er after I got my catheter out and was leaving. They weren't even in the room but they sure all snooped into why I was there. I think overworked floor nurses in inpatient wouldn't bother me as much somehow. Those lab coat power women with the white coats and perfect makeup can just get out of my room forever. Those with nothing to do but tittle all day with their work girlfriends or else just troll the rooms looking for amusement with an attitude of superiority do not have my respect in the least. Grow up ladies. Am I wrong for feeling this way?
Volume 123 signed Jeff at the bottom
At Thursday, December 15, 2022 5:02:00 AM, Anonymous Anonymous said...
That is a story about a purposeful assault by a medical worker. It would have been no different had she stabbed him with a scalpel. All because he stood up for his modesty? How horrible.
I was lucky that my urologist didn't mess me up on purpose. That man is pure evil. He had (9) 1 star reviews out of 18 reviews on one website. I sincerely pity his patients. I could hear one lady loudly wailing inside a room as I walked out. I'm almost certain that she said something about being worse after his treatment. Be careful out there people.
Biker. Often we have heard that we teach other people how to treat us. Unfortunately when it's said YOU teach people how to treat you YOU is plural. Too many male patients pretend to get a sexual thrill out of intimate care performed by female staff even if they are secretly embarrassed. That isn't something a lot of female patients do. If a female patient acts like she's enjoying it? She probably is. A humiliated female often cries and doesn't have the same abilities to hide her feelings. JF
Jf you are absolutely right about men not all men act as if they are enjoying what is being done to them but I would venture to say a lot do. It’s the only way that some men know how to hide the shame and humiliation they are feeling . I personally have reached the point that I would tell them to stop but in the past my reaction was one of becoming frozen which is the most damaging out of the flight/fight/or freeze response to trauma. What is sad is most of the medical personnel act oblivious to the feelings that a patient may be having and that way there is no accountability on their part as they proceed to break the spirit of another soul
JF, you are correct. One of the ways that men deal with their embarrassment is "manning up" during the event itself, making believe that they aren't embarrassed. Most of us could do it convincingly by time we emerge from our teens. That just serves to reinforce the healthcare world meme that men have no modesty. Those same men often carry it a step further afterwards by joking about it with their friends in a bravado kind of way. I did it following my 1st bladder cancer surgery (via the penis) in which 5 medical students appeared (4 female) telling me (not asking) that they'd be observing and then the OR nurse mere seconds before putting me under tells me in a decidedly sexual manner that she "was going to get to know me real well". I was very embarrassed by all of that and so what did I do afterwards? I joked with my buddies that there was a fierce competition by the women in Boston to get a spot in that OR on account word had spread that there was a real man from the countryside having surgery vs the city boys they usually have. This is how men often protect themselves emotionally and it serves to reinforce the manning up socialization.
Regretfully, another way is by acting as if they enjoy it at the time, and making inappropriate comments or jokes to the female staff. Some men are pigs and are in fact enjoying it, but for others it is a defensive mechanism. By joking they think they are hiding their embarrassment. In either case the rest of us suffer for it given the poor image it gives male patients.
Nurses in the UK to wear body cams in the guise of stopping sexual assaults:
https://www.firstpost.com/world/uk-healthcare-horror-after-over-6500-rapes-sexual-assaults-in-hospitals-since-2019-nurses-to-wear-body-cams-12503342.html
Patient privacy takes another hit. The patient abuse that will go on when this is initiated will be epic.
I sit here at present nursing a painful hernia that after meeting the surgeon to discuss my ad version to having women in the OR for this kind of surgery that would leave me completely exposed he told me that women would be in the OR but he would make sure my modesty and dignity would be preserved. How is that going to happen when they will have a woman prepping my penis and scrotum which is all in the surgical field of an open inguinal hernia repair? The gaslighting out there is astounding and because I’m a veteran of what they do it only served to piss me off but how many people are deceived by them on a daily basis? And it’s completely legal. With that kind of mentality they should have exonerated Bill Cosby the way I see it there’s no difference
So coming to porn sites soon, body cam videos of UK nurses bathing or showering patients, cathing patients, shaving patients etc. Perhaps even viewings within the hospital by voyeurs on staff.
Good afternoon:
I agree with Biker on the body cam footage. I can also see thousands of lawsuits coming. Cameras in hospitals is a no go even though here in the US they are trying very hard to introduce them into the OR.
Best regards,
NTT
Jeff, what the urologist may mean is he'll make sure that the women in the OR are polite as they prep you. Not much consolation in that. Or maybe he won't let female medical students observe? Patients and healthcare staff operate on different definitions of privacy, dignity, and necessary.
Well as long as they are polite while they play with my junk what more could I ask for
Actually as long as everyone is polite they could set me up on the 50 yard line in a packed stadium
"Polite", really? Jeff et al: a question. Would those doctors or nurses by having been "polite" prevented all of the terrible misbehavior sensed by those who have been writing here and would, therefore, support the dignity of the patient?
How is being "polite" defined in the year 2023?
..Maurice.
Biker and I were both being facetious. polite has nothing to do with it
Every once in awhile I visit this site. Nothing will ever change, however, my only concern is about Maurice. I’d like to see Maurice take a nice vacation. Stroll along some amazing beach, the cool breeze of the ocean, a nice little cup of espresso. I know Maurice, you don’t drink coffee, Ok. This time let’s make it an iced tea. You’ve listened to all this drama, the complaints and the negative experiences etc. I know you know the medical system is a double standard, we all know and many examples have been made. Maurice, you deserve time for you!
PT
Jeff. I read somewhere on Quora that a guy glued the covr underwear on for an inguinal hernia repair. He would have had skin missing if they tried to remove them. They make different styles of pants. Buy them show them to the surgeon and have him decide which style you can wear. Ask him about a foley. My husband got it done lapascopically and wasnt aware a foley is required. If he did i would have talked him into open. Cat
How is being "polite" defined in the year 2023?
Polite means they wait until I am unconscious or out of earshot before they laugh at me.
I define polite as being pleasant and cordial; essentially allowing for an "I'm OK, you're OK" kind of interaction. In my experience, healthcare staff are almost always polite. Maintaining a proper gameface is integral to the interaction, again something healthcare staff almost always does.
Regretfully it all too often seems that those who work in healthcare think being polite is synonymous with being respectful. It is an important part of being respectful, but being polite and being respectful are two different things.
Being polite as you needlessly expose patients or as you are dismissive of their concerns is disrespectful. That is where the disconnect comes in. Somewhere along the line healthcare staff that have "seen it all 1000 times" come to view their convenience in exposing patients as synonymous with necessary exposure. This is where all of those "In my 30 years as an RN I have never...." type statements come from. They become blind to their own actions. They also come to think that their comfort with seeing exposed patients equates to the patient also being comfortable, and don't really hear the patient's concerns anymore, hence the "I've never had a patient express discomfort with me doing...." statements.
In a nutshell, polite is nice but it is not enough.
Good morning:
I hope everyone is doing well.
Biker has yet again, hit the nail squarely on the head when he said "Patients and healthcare staff operate on different definitions of privacy, dignity, and necessary."
The medical community working WITH patients, needs to get on the same page and soon.
Being polite, will NOT stop medical community misbehavior. It's up to the doctors & nurses to show they have morals & are willing to advocate for their patients by speaking up against the abuses. The system we have today seems to have lost its morals.
The healthcare system needs to dump the term "Patient Centered Healthcare" because it in reality doesn't exist today at least for men it doesn't.
In Patient Centered Healthcare, the PATIENT is the quarterback.
So, if you tell me the male patient, I need a catheter & nurse Suzy will do the procedure. As I am the quarterback of this "team", I should be able to reply no, I want a male to do it. If the system truly is Patient Centered, at this point they'd find a male even if they have to pull in a hospitalist to do it. Instead, they tell the quarterback no males are available. Therefore, the system isn't really patient centered because the "needs" of the patient, are NOT being met.
They use BIG words to try & impress the public. The public isn't impressed & should just tell them to come back when they can show us, they mean what they say.
Best regards to all
NTT
So if a girl goes to a sex orgy party knowing there will be drugs a the party and the guy (who is an expert at knowing what drugs do) using a date rape drug is polite, (i.e. saying please just lay still and don't fight. I will only allow those I know to have sex with you or to watch.) then I assume everything is okay? Or would this fall under My Body, My Choice and would be seen as a criminal act although she willingly went to this type of party, was going to use some type of drug, and was going to have sex with him anyhow.
No, polite is not enough. I am polite but that doesn't I give them permission to take advantage of me. Politeness while being abused/assaulted doesn't make it better. It is about respect and knowing the true definition of respect. Not the phony definition of respect that medical providers find acceptable. We know their definition of respect is for the patient to allow them to do their job (the patient) in the manner the medical provider selects instead of doing their job to best comply with the patient's right to bodily respect. Why is it that war enemies immediately strip their captives and ask questions while the captive is naked? It is mental warfare. They may be polite but they know that puts most humans in a vulnerable position.
I had some idiot on Quora saying if you are unconscious it doesn't offend your dignity. So again is it not still rape if a woman is unconscious. When someone is unconscious, you would thing those in charge of protecting that patient would be more vigilant in protecting that patient?
I even read an article saying a female army commander faced "wild" accusations she groped, kissed males under her command. I think this says a lot that the public believes a female can be abused, assaulted but when it is the reverse than the accusations are "wild". This is why the medical community can get away labeling abuse of male patients as "polite". When there is an imbalance of power in a relationship, extra due diligence should be used to avoid any type of sexual abuse/assault but in the medical field it is acceptable behavior especially when it is a male patient/female provider. It is reverse discrimination. It is also retribution for all the perceived harm done by males in the past to females. It is a perfect storm every time a female provider decides to harm a male patient by their inappropriate actions.
So no, polite doesn't work while I am being abused/assaulted. Define polite however you want as it still does not work.
Cat if i glue the Covr garment to me how will they clean my genitals? And I can tell you if they don’t sanitize my genitals the surgery will not proceed because the region around the incision site must be cleaned and the genitals are within that region. I was even told by the people at Covr that the garment could be removed for cleaning and then put back on. If that’s the case what is the point?
That’s a big amen to everyone that responded to this polite topic. No woman possesses enough politeness to compensate for my adversion to her exposing and touching my genitals. In my mind and heart nothing is more pleasurable to me then sharing intimacy with a woman I care for when the vulnerability is mutual but in a medical setting it is totally emasculating to me
PT, I have been fully and completely retired from professionally diagnosing and treating patients since January of 2000. My personal relationship to the medical profession is that as a patient. So, in a way I may be now more objective in my evaluation of my prior occupation than prior to 2000. Well, I am not completely divorced from the medical profession as I continue to be a participating member of a hospital ethics committee.
My goal for this entire Bioethics Discussion Blog including all these 125 Volumes has been and still is a place for learning, discussion and ventilation. I am pleased with my blog and its results.
..Maurice.
Hello Jeff,
Do you really think that if your garment can't be removed, the surgery will be cancelled? Let's see. Everyone is ready in the OR and, they can't scrub your genital area because of the garment. Will the surgeon say, "Ok. Get rid of this one and lets have a smoke until the next one arrives."? Too much is invested in the schedule and the income stream. I'd guess that they'll splash on the scrub paint and proceed. Remember, it's a business and, you provide the income for this business.
I shaved my thigh before a hip replacement and, botched the job rather well. When the surgeon saw it he was concerned but, did the job anyway. They didn't get up at 5 AM to have a surgery cancelled. I've had no problems with the hip after 5 years.
My guess is that they'll say, "What an idiot!" and proceed. Of course, it's your call. I wish you well.
Reginald
PS Dr. Bernstein, I'm sure that I speak for everyone when I say that we too are pleased with your blog and its results. Thank you for providing us with this forum.
Covr are sterile. You prep the genitals yourself with tbe wipes they give you, then put them on. Youve showered 3x with the soap they give you. You are already clean. You can water proof glue them just low enough to not be in the way but still on in the surgical field. Have you talked to the surgeon ? Cat
Dr B. Has any of your fellow ethics committee members read this blog? Has anything written here been discussed at your meetings? Have any committee members agreed about the unnecessary exposure all hospital patients endure? Cat
I have been following a story on Misty’s site about a guy that went in for venous ablation in his leg and was provided with a pair of surgical underwear and then had them removed after he was sedated and had his genitals shaved and cleaned without his consent or prior knowledge . The problem I have with all of this is the fact that once you surrender your body to them you lose all control and the fact that this surgery could be performed with local only but they refuse to do the surgery without me being sedated with their special little help you relax juice that will prevent me from controlling the situation. If you don’t make your request known and clear before the surgery you will lose your ability to advocate for yourself. I already spoke to the surgeon about sedation and he said I need to discuss that with the anesthesiologist which you don’t meet until moments before the surgery. If I don’t make my demands known and clear before surgery date they reserve the right to do whatever they feel is appropriate and as far as them canceling the surgery in the Washington DC area they stack up surgeries so deep a cancellation would only serve to put them a little closer to being on schedule. Going in for surgery is a little like going into a house of horror you never know what is waiting around the next corner and that is by design.if you start making requests/demands they don’t need to worry about a cancellation because you will never get on schedule.so I’m my case I have to be thankful for the amount of years I’ve lived and what ever comes my way will be what takes me out weather it’s surgically correctable or not because I would rather die with dignity
Jeff, You are right, they are busy, and they have all the power in modern assembly line medical misery and humiliation. They do whatever they want, and after that they don't want to hear from you but once, if that. A single person boycott due to modesty or dignity doesn't hurt them one little bit. Many urologists and g.i. doctors around here are booked out six months or more.
I wanted to share something that wasn't absolutely horrible for me inside an otherwise life-long dreaded nightmare of ending up in abdominal surgery, which I was.
I sincerely bless the older CNA and RN women that treat their patients with dignity. An older woman walked into my room minutes before my surgery and said this is so and so a student she will be helping. I was horrified at the prospect of this cute young thing seeing me naked but also terrified of making a fuss so close to life saving surgery. I already hadn't eaten in four days and had weeks of sleepless pain leading up to going to the hospital. I NEEDED that operation.
Then the older lady pointed to the bed and barked at her: MAKE THE BED!! The student then turned her back to us and did as she was told.
The older lady, maybe my age give or take, (I'm 60) then wiped my entire backside with some kind of huge swab while I still had my gown on. She then gave me one to go use on my front side in the bathroom. Neither of them saw my privates. Thank you older nurses who treat us powerless patients with respect. Thank you so much. I hope she knows how much that meant to me.
Hello again Jeff,
Johns Hopkins is near DC. You may wish to call them to state your case. Work your way "up the line". Concentrate on the fact that they like to be in the forefront of innovation. Let them know that this is an opportunity for them and for you. Dr. Marty "Makary is an advocate for disruptive innovation in medicine and physician-led initiatives ..." (Wikipedia) at Johns Hopkins. Try to contact him. Some other avenues at JH are Patient Relations (410-955-2273), Pastoral Care (410-955-5842) and Social Work (410-955-5885). It may take some effort and much perseverance. I wish you well.
Reginald
Jeff,
I encourage you to read the blog of the man who had his pubic / groin area shaved for the ablation procedure. You should email him and connect with him. Go to medicalmetoo.wordpress.com/
You may have to drive farther for hernia surgery, but it is worth finding a surgeon who is willing to accommodate your wishes. One man flew all way to Utah for an urological procedure. You can find his story at this link.
Misty
Jeff
Have you looked outside of DC? A few have gone to different states to find a surgeon that will work with them. Cat
Dr. Bernstein and contributors,
I thought it was unusual that there was no activity on #124 past April 6th. I have been preoccupied with the constant bad news out of Washington and thought the same for others. I decided to look for #125 and will get caught up and rejoin soon.
Edgar60
What you mentioned about the older nurse is so refreshing to hear.as patients we have the right to pick our own surgeon but after that all bets are off and we get what we are given which in my case was only pleasant about 50% of the time which all I need is 1% to do me severe emotional harm
Reginald
Thanks for the info. Are all of those numbers affiliated with John Hopkins?
Misty
I have read both of those stories . The battle that that guy has fought with the venous ablation is horrendous, and his arguments are so valid yet the medical institution has totally blown him off, and refuses to acknowledge that anything they did to him was inappropriate. If you have modesty concerns going into a medical setting you have to go in with eyes wide open because once you’re in there, they tape your eyes shut no pun intended. I’ve had a difficult time trying to communicate with anybody in the medical field to discuss my concerns Even locally I can’t imagine how laborious it would be to try and search the entire nation
I’ve read everything on your site probably at least twice and I’m thankful you’re out there along with Dr. Bernstein to at least try and bring these issues to light
Cat
Like I was saying to Misty it’s very difficult to search for a facility that will even talk to you about these details. They usually want to set you up to come in for a consultation because they can charge for that and the person you’re talking to doesn’t have a clue what to tell you, and then when you get there all they do is gaslight you and it seems that that’s a national problem not local
If you go to the gym you will find a men’s locker room and a women’s locker room of course nowadays, you can’t be too sure what you’re going to find in there, but generally speaking, that’s done for the comfort of the individual because of the uneasiness of being naked around the opposite sex. Why is that so difficult to get across to the medical professionals because the reality is they know better, they live in the same world that I live in and if they haven’t learned life‘s early lessons about respect they’re merely hiding behind a system that’s unfair, and in my opinion immoral
Thanks to all for your helpful advice and concerns it means a lot to me
Dr. Bernstein,
Before I address some of the new topics, I wanted to mention how I am trying to find my voice and address dignity/modesty violations before they occur. I had kidney surgery at a large university hospital in Washington, DC about 9 years ago which was the culmination of my kidney stone ordeal. I ended up with a urinary catheter and an abdominal drain located on my abdomen about 2 inches lower than my navel. Due to this blog, I was aware of the potential for exposure when the residents made their rounds and would want to examine the drain. I removed my arms from my gown and folded the top under the edge of my blanket/sheet and waited. Soon enough, a group of people filed into my room consisting of a male and female resident and 2-3 students. The female resident introduced everyone and said she wanted to check the drain and stepped towards me. I was tempted to wait and see if she would protect my dignity but instead I quickly folded everything down to several inches below my naval but insuring no genital exposure. She seemed surprised but quickly composed herself. I am not shy about anything but genital exposure and even invited the students to step forward and take a close look. They must have been really new because they did not step forward. Everyone but the male resident left the room and he removed my catheter. I repeated this maneuver when it was time to remove the drain two days later. Mission accomplished!
EM
Ohio Catholic,
I share you concern over the security and privacy of Electronic Medical Records (EMR). I have never been given the SHIM you described but have completed a similar survey at the urologist concerning symptoms of Benign Prostatic Hyperplasia (BPH). The questions are not nearly as personal and only concern issues of urination but I still would not want it made available to all office staff.
I apologize for the length of the following story, but will get to the gist of the issue eventually.
After my experience with an abusive nurse and embarrassing exposure during urological procedures, my second worst experience with the medical field involves what I consider to be a complete breach of trust and concerns EMR. This experience (revelation) destroyed my faith in my doctors and emotionally hurt me worse than the physical pain the “evil” nurse caused.
For convenience of travel, I had changed doctors in a large practice. My previously doctor was male and I selected a female doctor as part of my “immersive therapy” to see if I could get over my discomfort with being naked with an opposite sex provider. As I have stated in earlier posts, if I have time to develop a sufficient level of trust and emotionally connect with a doctor, I am completely open and will be able discuss incredibly personal information. While still uncomfortable, I might even allow intimate exams with a female doctor (no observers).
From the second I met my female doctor, her personality was such that I immediately bonded at a level I have never experienced with any other person in my life. The feelings of trust was so incredible that during the initial patient interview, I broke down, was crying, and out spilled my deepest secret concerning my lifelong feelings of sexual inadequacy. Eventually I composed myself and we finished the interview. We even hugged (a first) at the end of the appointment. Over several following appointments, I was even able to submit to a testicular and rectal exam without any mental issues due to the level of trust I had with her.
Fast forward a couple of months and I decided to request my medical records since I was leaving the state. The office staff (females) printed out numerous pages and when I reviewed them I was devastated to see that she had included several lines describing my feelings of inadequacy concerning genital size/shape. This text appeared prominently at the top of multiple pages and was visible to anyone reviewing my records (office staff, nurses, etc.). That information was private and only meant for her ears only. The level of betrayal I felt caused a relapse of my PTSD symptoms including intermittent crying and suicidal feelings. I met with her to convey the hurt she caused. I also met with the records manager in an attempt to get the records expunged. It was explained to me that once the records were entered, they had to be maintained for 10 years by law.
To be cont’d
EM
Continuation of response to Ohio Catholic
This caused me to wonder what was in my records while I was a patient of the male doctor since my distressing urological adventures occurred when I was seeing him. The results were equally upsetting and embarrassing! He had also included conversations we had that I thought were in held in strictest confidence and referenced my body image issues. There was even verbatim quotes of what I had said included in the record. All of this information was clearly available to anyone in the practice and was probably reviewed whenever I came in for a visit that didn’t involve the doctor directly. It was not uncommon for me to see a female PA’s/nurses for pre-surgery tests, shots, etc. The thought of the female personnel reading this is a source of embarrassment to this day.
I even found copies of letters from my urologist/surgeon sent to my primary care doctor and copied to a female PA who had done a couple of the pre-surgery checkups. He also included references to my body image discussions and volunteered that physically I was actually slightly towards the upward end of normal body dimensions. After all the discussions we had concerning my feelings of embarrassment with exposure particularly with an all-female surgical team why would he think that I would want that shared with a female PA. Neither the urologist nor my primary care physician had the human decency to try and reassure me while I was expressing my discomfort with intimate exposure. I guess they just didn’t care.
I now refuse to answer questions or supply information that I am not willing to share with the entire practice. I will likely have to visit the urologist again soon due to reoccurrence of kidney stones and BPH symptoms. I will make a point of asking the doctor if we can have an off-the-record discussion in private where I can ask about using male personnel in surgery and office procedures.
I don’t even want to think about the likely chance than our private medical information has been hacked and is freely available in the wild.
EM
TCT
I am distressed to hear about your experiences while attempting to get an accommodation for personnel preferences during intimate procedures. I think Jeff has related the same experience of being canceled when he requested male personnel. As Bantering and others have pointed out, the shortage of medical personnel is allowing facilities to dictate how things will be done instead of what the patient desires. Since the majority of nurses are currently female, it is going to be difficult for a man to get an accommodation. My attitude has become somewhat sour and I think women might have a hard time getting female-only staff simply out of spite when it should be relatively easy to provide an all-female team. I was hoping that attitudes might be changing but during my research of new BPH treatments I read several articles discussing women in urology and the challenges women urologist face. The attitude seemed to be that men need to get over their childish insecurities and embrace female urologists. I think it is great that women who need urology treatments have an increasing chance of finding a female provider but that doesn’t mean I want to embrace the same.
I have even heard of medical schools stating that patients should be given the choice of same race or same gender providers but I don’t think it will translate into men getting male providers.
I have a colonoscopy in a few weeks and will be discussing a no-sedation option and/or the wearing of procedure shorts or backwards boxers. I am somewhat nervous since the practice I was referred to has Indian providers. There are many videos on youtube concerning procedures and medical treatment and I was shocked to see the casual manner in which patients were exposed in other countries especially as depicted in Indian videos. I watched one on hernias and the male patient was exposed as the doctor was presenting the material. The guy had a “deer-in-the-headlight” look about him and as the camera panned back, there must have been a mixed-sex audience of 50-60 people. Fortunately, a colonoscopy is elective and if I don’t like what they say, I will go somewhere else.
A bigger concern is the potential I will need both BPH and kidney stone treatments. I am hoping that my urology practice in central Florida is progressive enough to have male staff below the doctor level for office procedures. The prospect of hospitals and medical practices simply canceling people who even ask for accommodation is extremely upsetting.
I think it is clear that hospitals purposely omit any details on the level of exposure that occurs during various procedures where a normal person would reasonably assume they would not be exposed. They don’t want people to realize that while eventually only the body part to be worked on is exposed but to get to that point, there is a great deal of total exposure. In many training videos, there is often no attempt to cover the genitals when it could easily be done.
As a man undergoing urological procedures, there is a disadvantage to having external genitalia since the opening in the draping is often pushed flush with the skin which totally exposes the penis and scrotum. I have seen training videos of women draped in the lithotomy position and the draping is left several inches in front of the vulva. Nothing is exposed except to a person standing directly at the foot of the operating table. A man could be draped in the same manner but never is and is exposed during the entire procedure to the whole room. This ruined my attempt to rationalize/minimize my feelings of being exposed by thinking if I could at least negotiate to get a male scrub and circulating nurse to do the prep and draping and that I could minimize my exposure to other personnel such as female laser and c-arm techs.
EM
‘‘Em good job!
Why must we do all these things to protect ourselves against people that are so callous in their care to protect your dignity.
I had something similar happen to me after colon surgery. After I had the pleasure of having a nurse retaliate against me for asking 2 female students to leave the room for my catheter removal. I managed to get out of my bed to retrieve a pair of shorts I had brought. A short time later two nurses entered my room to do a bladder scan. They folded my blanket down to my knees and pulled my gown up to my chest. The surprised look on their faces when they revealed my shorts was priceless actually it was disgusting they almost looked disappointed but they were able to complete the scan with the shorts in place which proved the genital exposure they were planning to do was completely unnecessary. how about this, you fold the blanket down to the waist and pull the gown out from under the blanket there by never exposing the genitals.when someone can explain to me why they choose to expose me when it was totally unnecessary then maybe I would stop accusing them of doing these things for some sense of amusement because the way I suggested would have taken the same amount of time as the path that they choose the only thing missing is the peep show. No patient should ever have to be so vigilant to protect themselves from this kind of abuse
Jeff, your bladder scan story is a classic example of (attempted) needless exposure. It certainly appears to have been purposeful and the result of a discussion with the 1st nurse that had the students with her. And if they had gotten away with it, no doubt they'd of denied that there was any needless exposure; that they followed standard protocols.
Last year when I had my cardiac ablation as an inpatient, a young RN with a 2nd young RN being oriented to the unit came into my room and without saying that she needed to check the groin wound site for bleeding, grabbed the sheet to start lifting it, but I grabbed it myself a split second later and just pulled it over exposing the bandaged groin site. I was sure she would have needlessly exposed me had I not stopped her. She then needed to ultrasound my bladder to see how full it was as I hadn't urinated yet, but I pulled the sheet down and my gown up just enough to give her the access she needed. She didn't say anything but seemed a bit irritated that I controlled what access she had. Upon leaving the room she said she'd be back to catheterize me if I didn't urinate soon. She came back a 2nd time and we went through the same motions, again with her saying she'd need to catheterize me, though she never said how full my bladder was.
Later just the trainee came in and gave me some privacy to urinate into a bottle to demonstrate that I could. I found it odd that this 20 something RN would want to needlessly expose an older guy like me.
The urolgist watched as the young female medical assistant applied the lidocaine to my penis. This female MA handed the instruments to the urologist during the procedure.
It made me wonder that before the urologist's wife hands him a fork, knife, and spoon at the appropriate time during dinner if she has already cut the meat on his plate.
BJNT
Hello again Jeff,
Yes. The phone numbers are from the Johns Hopkins' website. DC is surrounded by states which may have more caring doctors. I agree that searching other states might be fruitful. You might try calling small surgi-centers or doctors groups. Sometimes these facilities offer "concierge" care. They may be more expensive out-of-pocket; but, they might also be more receptive to your modesty/dignity requests and to local anesthesia. After you've contacted someone who seems accommodating, you may need to pay for an office visit to get everything in writing or (if it's a small practice) obtain a verbal agreement for the local anesthesia.
About 5 years ago, when Covr was just entering the field, I showed an Ortho dr the Covr website and their garments. He was completely unaware of their existence. Since he was young, he was amenable to the use of the garment. He also did the hip replacement without a catheter and with an all male team. This took much emailing to the hospital ortho charge nurse be be certain she obtained an all-male team but, it was successful. Having a typed/signed statement from the doctor regarding what's required for your surgery is a tremendous asset.
All of this takes time and is, sometimes, very frustrating. It will definitely test your patience. I do believe that there are caring individuals who, upon hearing your concerns, would try to help you. Finding them is the problem.
Please know that all of us are hoping and praying for a successful resolution to your situation.
Take care.
Reginald
PS Be advised that Johns Hopkins is a large bureaucracy. Your phone calls may be referred to A, then to B and to C, D .... Keep with it until you get a definitive response. If you're able to meet with someone personally, state your case convincingly citing your emotional welfare and spiritual beliefs (Spiritual beliefs do not necessarily need to be grounded in any particular religious affiliation.) I do believe that perseverance pays.
Being purposely exposed for a bladder scan is a malicious breach of dignity. When I had my bladder scan I was wearing sweat pants and the girl asked me to pull them down a little. I pulled the front down maybe two inches, and she didn't seem interested in getting a peek at my junk as she was a professional who only wanted to image my bladder.
As for the shaving the "area" scam, I have been keeping up with that myself since I was 18. It is the same philosophy as with clean underwear. If I am involved in a car wreck and incapacitated I don't want them having any excuse to mess with my junk for one second longer than is absolutely necessary. That practice has already saved me two mental anguishes.
these reindeer games played by immature women in the medical field have got to stop. They are giving the rest a bad name.
Thanks Reginald I’m very familiar with Johns Hopkins my ex had a procedure there a few years back. I just find it amazing that I’m not trying to have any hospital to flip their procedures upside down I’m not even completely adverse to having conscious sedation if it is an all male team but based on past experiences they will slip women in there after they give you versed. That is what they did to me with my pacemaker. Someone in scheduling didn’t see it was in my records that I’m allergic to versed. I was later put out with propofol but not before I saw two women in there and one was just standing there waiting for me to be put out so that she could prep me which was to include my genitals just in case. I had a phone conversation with a nurse prior to the procedure and badgered her about being able to wear underwear and she finally acknowledged that would be done to me no one is ever made aware of this and why would any patient think they would have a woman clean his genitals for a pacemaker that is put in at your collar bone what a bunch of B.S. my request is very simple NO WOMEN! Why dose that have to be such an insurmountable and unreasonable request when it’s imperative for my mental well-being
Also Doctors have lost the clout they used to have so even if you find a doctor that is willing to work with you the hospital is the entity that drives the surgical protocols.
My surgeon for the pacemaker was a great guy and extremely competent. When I asked him about wearing underwear he said he didn’t have a problem with that but I would have to clear that with the hospital
I have read anonymous comments concerning Ohio Catholic and the security of electronic medical records. The SHIM contains questions such as how often a man gets an erection, is it firm enough to accomplish penetration, etc. As someone might imagine having honest answers (regardless of the answer) would be something the average man would not want the receptionist, office intern, summer help to have access to. Also, I was surprised to find in my own medical record comments, which really don’t bother me but did cause me to wonder. Specifically, I expressed my concerns about same sex technicians for some tests. I believe this lead to my doctor stating “… patient has a general mistrust of medicine…,” not exactly what I thought I conveyed. Another comment “…patient refuses general anesthesia.” I really had to think about that one since the only discussion I had with the doctor was my concern about the effects of GA on elderly patients (I’m a 67 year old male) and my wife an RN had told me about some issues with post GA cognitive declines. I had simply asked about the possibility of a local or regional option for an elective procedure. Finally, my record had a section titled “Patient Release Status: This result not viewable by patient.” I haven’t been able to determine just what that means. I have been a regular at this blog and I have learned a lot about the topic of modesty and how to navigate the medical system by reading the comments. I believe it has enabled me to assert myself as I have only begun to have issues and medical concerns over the last few years. Before that I had little contact with doctors and really had not realized just how vulnerable we as patients are and how we need to get smart.
https://www.heraldtribune.com/story/news/2006/01/09/humiliation-at-the-hospital/28455320007/
Jeff
I just wanted to add my 2 cents to what others have said about finding facilities that will honor your request for accommodations. I don’t know if the nature of the surgery you require would dictate going to a large hospital, if not, perhaps the surgeon has the choice of using a surgical center. I had the following done at surgical centers: 4 of my urological procedures, umbilical hernia, cataracts, lumbar spine, rotator cuff repair, wrist/finger surgery, and foot surgery. Many of the surgical centers are owned by the surgeons themselves and they might be more willing to work with you if they really want the business. The surgeons, as owners, should have some sway with the surgical center.
It doesn’t make sense that you couldn’t use a pair of the bilateral COVR garments which provides plenty of access to the abdomen on one side. I was able to wear a pair of COVR shorts for my lumbar surgery since the incision is above the waist band. I hoped that they simply moved them down if they needed more access and didn’t simply undress/redress me while I was out. I also wore underwear for my umbilical hernia procedure and the incision was only a couple inches above the waist band.
EM
Dr. Bernstein,
I read the NYT article you referenced and am quite interested in the idea of wake-surgery because I hate giving up control and not knowing what was done or said while I was under. I also would like to avoid hiring a nursing service to take me to and from procedures.
With the exception of a trigger-finger release surgery and a skin graft on my nose, all of my surgeries were done under sedation.
All of my surgeons discouraged remaining awake via regional numbing or nerve blocks, but it was my urologist that was the most insistent, stating “You really don’t want to be awake for this”.
I have recently watched a couple of youtube videos as well as tv shows that featured cosmetic surgeries that occurred while the patient was awake. The patients tolerated it very well and were calmly talking to the surgeon during the procedure.
As the article mentions, there are probably a couple of reasons that most surgeons would not like this. 1) Concerns over potential litigation should the patient hear something or misinterpret standard operating room language and 2) concerns that the patient would not be able to remain still or get overwhelmed by the process.
I am considering a specific spine surgery practice in Tampa, FL that allow the patient to be awake. The doctor is continually communicating with the patient to ask if the procedure is alleviating their pain.
EM
Does anyone else see the pure lunacy of our discussion like I do? Why Do you have an organization that has invested millions of dollars for new innovations for new procedures but they can’t put a penny towards preserving a persons dignity and it takes outside individuals like Dr. Levi to invent covr garments outside of the healthcare industry’s purview to try and put some human dignity to the insane amount of personal vulnerability and humiliation. Most of the facilities are more than reluctant to utilize these modesty garments for no clear reason and I have had a lot of back-and-forth communication with the Covr people and they have an ongoing crusade with medical facilities to incorporate these garments in medical procedures and they generally receive very cold reception and then when the patient inquires about the use of these garments they act like they don’t know what you are talking about? I try not to be a conspiracy theorist, but something is off with all of this .Would it be sick or twisted of me to think that the known fact that medical people experience a lot of stress in their day and the ability to view patients genitalia when they know that socially speaking this is taboo somehow offers them the privilege of going somewhere where no man (or woman)has gone before. ( I stole that line from Star Trek) an the outside possibility of observing something impressive enough to share with all the other girls at the nurses station or the break room there by offering a moment in their day of something salacious and a good stress buster I know I sound like I’ve come off the rails and am traveling through the weeds but I’m desperate to understand the rationale for something that seems so irrational and unnecessary?
The fact that I ruminate and think of these things constantly is the consequences of what they did to me and drove me to extreme PTSD . Thanks for the biological repairs you did to me, but in hindsight, no thanks
LOL . BJTNT you never fail to crack me up !
Good afternoon:
The areas the american healthcare system has prided itself in over the years are innovation & technology advancements which then led to medical breakthroughs.
But even with all their innovation, technological marvels, & medical breakthroughs, they still get a failing grade when it comes to the area of patient respect & dignity.
Why is it a healthcare system so advanced can be so far behind when it comes to patient respect & dignity?
One reason is this healthcare system as a whole, does very few if any studies on the subject while OTHER countries actively study the subject so they can better their patient's experience.
America doesn't do these studies because if the results were to show that the american healthcare system has been handling the subject the wrong way since time immemorial, outsiders might step in & force changes on a system that has had things their way far too long.
Because they've been allowed to operate with such little oversight (they often use their huge lobby & tell congress & state legislature to table legislation that might help patients & let them handle the issue internally basically what they're telling everyone is stay out of our business & the governing bodies fall in line), for so many years, the healthcare system has become drunk on power which in turn has allowed them to resist any issues they don't want to deal with or changes they choose not to implement.
So as far as the american healthcare system is concerned patient respect & dignity is a DEAD subject because in their eyes as long as employees use Mr., Miss, or Mrs. when speaking with patients, they are being respectful. Dignity & privacy as far as they are concerned is you can leave them at the door or don't enter our hallowed walls for medical care. WE are in charge behind these walls.
A lot of times when men are seeking same gender care or an all-male medical team in the OR the problem can seem insurmountable. The biggest reason for this there just isn't enough male nurses & technicians in our healthcare system yet. Numbers are growing but the pace is woefully slow. Then to compound the issue a lot of men who graduate with their nursing license don't go into urology where they are desperately needed. Outside pressure needs to be brought to bear on the healthcare system to do more to bring more men into nursing & sonography.
Another area where the system gets a failing grade is the quality of people they allow into nursing and medical school. Up until recently the were more careful on who they let into schools. Many in the system today are there strictly for the paycheck not to advance the human condition
A third area of concern is the culture that's being allowed to grow & permeate in these facilities is very toxic to patients especially men & boys. Rules need changing & protocols put in place when female healthcare workers are dealing with male patients.
This only lightly scratches the surface of issues with a system that is drunk on power.
Until their power is short circuited men & boys are going to have to be on their guard & ready to say stop whenever dealing with the medical community.
When they actually start doing what they preach to the public about being a patient-centered healthcare system, the informed consent form MUST be REDONE with PUBLIC INPUT.
Besides going over the actual surgical procedure in the form, they must ALSO be REQUIRED in the form to go over ALL pre-op procedures in detail.
The ONLY way a patient can be TRULY INFORMED is if they KNOW EVERYTHING that will happen. Hiding information will only breed ill will between parties,
So, there you have it in a nut shell. Absolute power corrupts absolutely as is the case with the american healthcare system.
The system is broken & needs to be fixed & the only way that can happen is if you take their power away.
Best regards,
NTT
NTT, what you write can be valid for a broader population beyond the patient as a non-medical professional but toward the medical professional themselves as patients.
Here..read this detailed story by a physician-himself, Lawrence Mieczkowski, M.D. as published today in Yahoo!News:
https://www.yahoo.com/news/im-doctor-almost-died-because-123012778.html
These days, when the medical profession is super-duper busy, well ..it may be that even a physician him or herself becomes treated like the patients described on our blog thread. So.. the application of VIP (Very Important Person) to a physician and nurse may no longer be applicable.
What do you and the other contributors here think about that possibility? ..Maurice.
i read that article. i KNEW colonoscopy was dangerous! what's more they can kill you and get away with it.
NTT maybe when AI takes over we can receive more empathy because the hearts and minds of people in today’s world has become desperately wicked and the medical world is the scariest. When I go to Walmart I put what I want in my cart . I’m not given drugs to make me more malleable and compliant and I get to keep the clothes on that I came through the door with and that applies to anywhere else I decide to go. Because of the legitimate need to come out of your comfort zone in a medical setting greater care and respect needs to be strictly adhered to because the same A holes that inhabit the rest of our planet also work in the hospitals and we are expected surrender control of our bodies to potential sexual predators and voyeurs or just people that get pleasure out of the ability and power they have to humiliate a fellow human being. And even if none of these apply to the person that is servicing you the embarrassment is still there with the opposite sex.
As for me I’ve suffered my last hose being shoved up my penis by a female that has no respect for me as a man and a human being . I wish all the intense feelings that have been expressed by everyone on this site could be required reading for everyone entering the medical field and anyone that’s in a position that allows them to expose a patient intimately should be scheduled for one day at Walmart with a sign that says please pull my pants down so that I can know how my patients feel when I do this to them thank you in advance for your cooperation
Does anyone get the impression that I like Walmart?
Doctor Bernstein
What you said makes perfect sense. My Father in law was an orthopedic surgeon. He also was very brilliant was one of the first surgeons in the United States to do arthroscopy, and also created the first outpatient surgical center in the Washington area. And was laughed at by the hospitals at the concept of same day surgery interesting to note all hospitals, now have outpatient surgical centers.
He was highly respected, and also feared to a degree and the power that he wielding was very impressive. If he said jump, everyone asked how high. Fast forward to today’s physicians and surgeons and they are treated almost like just another cog in the wheel. They hold very little power in today’s medical corporate structure. so to see their VIP status diminish is not surprising, but they deserve better.
So.. the application of VIP (Very Important Person) to a physician and nurse may no longer be applicable.
What do you and the other contributors here think about that possibility?
I read about a floor nurse who was told her patient was a VIP. It was the CFO of the hospital. The nurse told them: He gets the same treatment as everyone else. I thought that was funny. I think unless you can afford to buy the hospital an extra wing that they aren't too impressed with anyone because they get paid the same either way.
NTT,
Again, well said.
edgar60,
They do have a license to kill.
Jeff,
AI is the solution if we can't elect enough first time legislators to advance our needs.
BJTNT
If there is a better level of care for VIP’s I think that should be continued but expanded to include all patients
Jeff et al: Here is a current medical ethics article dissecting the value of VIP patient designation. Short article but current and informative.
https://journalofethics.ama-assn.org/article/why-vip-services-are-ethically-indefensible-health-care/2023-01
..Maurice.
Doctor Bernstein
The article about the doctor and the colonoscopy had to be one of the scariest things I’ve ever read.if a seasoned doctor with the knowledge he possessed was blown off with his inquiries about his condition by a fellow doctor what chance do us minions have? It actually explains why we struggle so hard with our dignity issues. If they are willing to blow off critical issues in regards to potentially life threatening conditions how much effort do you think they are going to expend to preserve your dignity as a person?
I can answer that 0
EM.. i shared that article. I am very interested in awake surgery as well. More surgeons needyo learn this technique. Its definitely more cost effective for the patient. Which is probably why they dont want to use it often. Less $$$ for them. My hubby had his colonoscopy without sedation. Since he was going to be awake with shorts on, he consented to students. Guess how many where in the room? If you guessed ZERO youd be correct. This was on the schedule for a month. Dont youd think that some student out there would want to learn how to do a colonoscopy while the patient is completely awake and aware? Its not common in the US and needs to be taught as it takes a special technique to do the procedure properly. Cat
Jeff. I have said billions of times. For people who "claim" they dont want to or have no interest in seeing our genitals DO NOT go out of their way to keep us covered. We do not expose you unnecessarily. Well if the sheet goes to our kness to check the abdomen. Guess what you just did. If you expose the penis for a testicular ultrasound. You just did. We are professional, well not of you just did any of the above you arent. Cat
I have mixed feelings about the VIP thing. If I am in a hospital I already know that I am going to be miserable. Having a huge room with an expansive marble lined bathroom and a view would mean little to me in that situation. Somehow though I think I would like to have the option to upgrade to a private room if I or a loved one was doubled up or whatever even though I probably wouldn't pony up to do so out of pocket for myself. However, if they are saying that VIPs would get their private parts dealt with in a more respectful manner or their dignity protected from humiliation and jokes better then yes I have a huge problem with that because it costs nothing to treat everyone with respect.
Good afternoon
Doctor Bernstein in regards to VIP treatment for healthcare workers.
In today's healthcare environment I don't see too many workers getting VIP treatment.
Maybe if you're chief of Staff or head of surgery you might see some but most other healthcare workers I doubt see VIP treatment.
That colonoscopy story was something else.
I've been reading the blog of the gentleman that blew out his great saphenous vein. The real tragedy is the fact that no lawyer would take his case.
His issue is he was never told in advance that the underwear the hospital provided would be taken off in the OR & his privates touched shaved & prepped for his leg surgery by the female surgical resident. He felt violated & betrayed. In the beginning he didn't even tell his fiancé what they did to him.
When he called them out on it, he tried getting satisfaction on his own at first but all the correspondence was done by phone calls and/or emails. He got no remedy from them. The university hospital circled their wagons & the lies they got away with were unreal.
Had he met in person where he could present his proof to their lies in person, he might have had a better outcome. Another problem was he got married while all this was going on & moved 900 miles further away from the hospital.
What irritated me most was he tried to get a lawyer & no damn lawyer would take the case. He could have handed any lawyer a winning case with all the evidence he accumulated.
Pre-op, OR, & PACU = backroom
What I learned from reading his blog was that our medical community uses what's called implied consent as part of the patients informed consent form they use for surgeries.
In healthcare they use implied consent to cover their dirty little backroom secrets they don't want you the patient to know about therefore they don't talk to the patients about those secret items before surgery. To them, implied consent covers things like your exposure, hair removal, surgical site prep. Things they do to your person AFTER they knock you out on the OR table.
So, after the surgeon comes to your bedside in pre-op & explains the surgery to be preformed & the risks involved, they ask you to sign the informed consent form.
What they don't tell you is by signing the informed consent form you are also implying consent to them to do whatever they feel is necessary to get your body ready for the surgical procedure.
I don't know about you but I'm not a big fan of implied consent. Bring it out of the shadows & make it part of the actual informed consent form. A Patient is NOT truly informed when the provider is hiding things via implied consent.
We need to get like-minded people in congress & strip their power away from them.
Best regards,
NTT
NTT. Do you or anyone else here know the process of reaching out to your legislators to express your concerns for the degrading and emotionally damaging treatment that patients receive without their consent or knowledge. And the second question is would it make a difference or even be worth it?
Good morning ALL.
Jeff.
On the federal level
Try this for senators.
https://www.yoursenatorslastname.senate.gov/contact/
This for house members
https://www.house.gov/ in the upper right hand corner you can put your zip code in & it will bring up representatives then you can fine tune it from there to find yours.
FYI. I spent over a year going back & forth from DC talking to many of these clowns & have come to the conclusion they are bought & paid for by healthcare & big pharma.
We need new blood that isn't already bought & paid for by big business.
Until we can find someone with influence that will hear us out we need to stay vigilant.
Personally, I'd love to see a major newspaper do an expose on patient privacy, respect, & dignity within the healthcare system.Something similar to what the Atlanta Journal Constitution did on doctors awhile back.
In my travels, I've been looking for a sight that explains all the pre-op, tests, & procedures that people should expect to go thru. There once was a Canadian site that listed what patients should expect & it didn't hold back anything but the site is gone now. I'll keep looking.
I'm also going to keep telling people about implied consent & how the medical community uses it.
That's it for me for now.
Best regards,
NTT
Just shoot me the day I get so weak or sick that I'm not strong enough to refuse a "head to toe skin check".
https://www.reddit.com/r/nursing/comments/135qc2o/nurses_how_do_you_physically_examine_patients/
Question. Tell me why for male patients a urologist needs a female medical assistant, a dermatologist needs a female scribe, and a podiatrist never needs any assistant?
BJTNT
My guess is it only takes one person to play this little piggy!
And my guess is especially with urology, the wee, wee, wee part could get out-of-control
Good morning:
BJTNT. Male doctors would rather look & admire females & Females tend to trust other females over males in healthcare.
Have a great day all.
Regards,
NTT
edgar60, my guess is that the head to toe skin assessments vary greatly as to what extent they occur. What your specific medical problem is, what your general health is, perhaps your age, how busy the staff are, and specific hospital policy likely all play into what the reality on the ground is. The sicker you are and the older you are likely increases the extent of such exams, and for good reason. Older people with very thin skin are at greater risk of bed sores which is a very serious matter, and keeping close watch is a necessity. Of course, like anything else, you can always refuse, assuming you are in a condition to speak for yourself.
Last year when I had a 3 day/2 night hospital stay in conjunction with a cardiac ablation, basically the only thing they monitored was everything to do with my heart. There wasn't any other kind of assessment, except for bladder scans after the procedure.
Some years back I had a bad bicycling accident (going downhill, over the handlebars & into a tree hard enough to crack my helmet & knock me out). Got a trip to an urban level 1 trauma center and their entire focus was on my head. Got a scan and then they kept me overnight for observation given the concussion and the next day did a battery of cognitive tests. They never looked anywhere else, and it would have been to my benefit if I had a head to toe assessment on account I had several very large & nasty hematomas that nobody at the hospital ever looked at. The day of the accident I was too out of it and the next day I was very sore but didn't know of the hematomas myself until I got home and took a shower.
I guess I am saying it depends on the circumstances as to whether head to toe assessments are appropriate, but as the patient you still have the right to refuse. .
Biker, I have read that if you go to the trauma center unconscious that they will automatically cut all your clothes off and do a head to toe. Maybe because it was a bicycle accident instead of a car wreck they concentrated on your head and neck? You are lucky to be alive from the sound of it.
Jeff, Wee wee wee. Too funny.
BJTNT, I think doctors like having lots of young females around, even female doctors like to have them around. The unnecessary exposure thing is just a bonus. Either for amusement, or to impress the young um, ladies, with their power and prowess. A scribe is just bs in the electronic age, extra women rummaging around the room on some pretext is just plain bogus too.
edgar60, if you are unconscious and the ER people do not know what caused you to be unconscious, their protocol might well require full access to your body to allow them to look for physical injuries, bites, signs of infection etc. In my mountain biking example, I was able to tell them what happened which allowed them to focus on the concussion/head injury. I didn't describe any other injuries because I didn't know I had any other injuries, and they didn't bother looking. Perhaps they were too busy & had patients with greater needs.
In my case, had they stripped me completely for a head to toe exam, though I'd of found it embarrassing, I'd of accepted it as necessary. For my heart issue last year, I'd of refused a head to toe exam had they wanted to do one as I knew my sole issue was my heart and there wasn't anything else for them to look for.
Discussing about preparation of the site in the groin where currently virtually all cardiac catheterization procedures are initiated by the insertion of the catheter via the artery in the groin, it is essential to just prior to insertion, on the procedure table, to prevent local and systemic infection, to thoroughly perform the cleaning of the groin. Once the cleaning has been accomplished, the attempt for catheterization of the groin artery will be initiated. This cleaning is performed by the procedure staff and not a sedated patient. ..Maurice.
Dr. Bernstein, that groin prep includes shaving; the shaving and cleaning of which can be done one side at a time w/o exposing the patient. The shaving part can as well be done before sedation and before being brought into the procedure room. Shaving doesn't have to be done in a room full of people with the patient fully exposed. The problem is people in healthcare don't seem to think patient privacy matters once they are sedated or anesthetized.
The problem is people in healthcare don't seem to think patient privacy matters once they are sedated or anesthetized...
This and only this! There is no earthly reason to do groin shaves in the OR unless everybody in there enjoys the show. This could easily be done hours ahead of time and it would save time in the OR. Unless they do it so they can bill us for them watching a peep show in which case it is for both fun and profit.
Good afternoon:
In the chase of the almighty dollar today, patient dignity & privacy have been thrown in the trash in favor of speed. Get them in & out as fast as you can & move on to the next person. Time is MONEY!
So rather than take the time to do all the shaving & groin prep before going into the cath lab to preserve the patient's dignity & privacy let's bring them in the lab, take the johnny gown away in front of a room full of people getting the lab ready for the test & do the prep in the lab because the bean counters say it saves time.
So much for our patient-centered healthcare & patient dignity & privacy.
Best regards,
NTT
My first cardiac catheterization was done in the groin but I’ve had two subsequent, cardiac catheterizations and they were both done in my wrist. I’d take that any day over the groin. They never removed my gown, but I did read about one guy that had one done in his wrist and they shaved his groin anyway go figure.
Radial access is becoming the preferred method by skilled interventionalists as it is less traumatic for the patient. It also means the the groin prep doesn't need to be done unless you have someone who insists on doing groin prep for access. However, that should be discussed with the patient beforehand and patient consent given. Given the nature of informed consent not being informative to the patient, groin prep may come as a total surprise to them. There are many articles that talk about radial access vs. femoral. It depends on the skill of your doctor so the patient should always know if their interventionalist is skilled in radial access.
While the groin is prepped for the femoral access, it does not mean the genitals should be exposed. The one COVR garment allows for femoral prep and access. Unless the patient is incontinent, there is no need for exposure. It again goes back to it being to the medical team's need/advantage for the patient to be exposed. Prep is faster. Faster means greater turnover and many times in cath lab when they have finished for the day, they can leave.
Since they rarely use a general in the cath lab, you were able to experience all the terror of being stripped naked and prepped in real time but that magical drug, versed, has erased your memories of terror and humiliation (at least in most people). After the prep has dried, they will add the EKG leads and the anti-shock pad generally on your back. You would have laid there for a lengthy amount of time not only before but afterwards. They cleaning crew were probably in there cleaning for the next procedure. Nice to know how they guard a patient's bodily privacy or at least most of their Patient Bill of Rights say they do. Don't worry they will attempt to put a gown on you before your family sees you so they can pretend they were caring and didn't sexually abuse you as the definition of sexual abuse is doing something sexual to someone for your own gratification which is exactly what unnecessary exposure is.
Most people do not know that the cath lab is probably the most common place to have your genitals exposed. They might even tell your spouse to leave if they need to check your groin area because they are "guarding" your privacy. It is really absurd they are so superior they believe this.
However, the lesson is most can have a radial procedure and need never to have their groin prepped bc it they have to abandon radial access, they can quickly still the groin area. However, many who go in for radial access are surprised afterwards that their groin was prepped as they were not told this would happen. Talk abt feeling sexually violated is when you have not been given true informed consent. Out in the real world, not having expressed consent to the genitals is a criminal offense but the medical community operates above and beyond the law and really common decency.
We are there HOURS prior to the start of the procedure. The shaving can absolutely be done beforehand. Why cant covr be worn? They come in different styles so the artery can be accessible with wearing them. With all the hospital inquired infections. Id most likely trust myself to disinfect myself over them anyway. Cat
I'm told that even with radial access, the doctor wants the groin prepped just in case radial access proves insufficient. The patient suffers that unnecessary indignity on the off chance it'll save the doctor those few minutes it takes to prep the groin in those cases.
I will add that checking the groin afterwards does not require exposing the patient's genitals. The staff is just as capable of only pushing the sheet aside enough to see the wound site. they don't need to remove the sheet altogether, yet I suspect they routinely do.
Cat, I was an inpatient for more than a day prior to my cardiac ablation, yet they shaved my groin in the cath lab anyway.
Biker,
The majority of cath labs will do the shave or as they call it, the clipping on the cath lab table. Cath labs are sterile to a point but not like an OR. And yes, according to the creep that molested my husband, after 10 years in the CCU, she just learned that night how not to fully expose a patient but the sheet could shield the genital area. I suspect this is what is done when the patient is alone or unable to defend themselves. It is easier and quicker and what harm does it cause will be the argument.
Cat,
COVR could be worn but the medical mafia doesn't want it worn. I have shown COVR to the department head of cardiology of a local hospital system. I have given him all the brochures from Misty. I have told him of how much long lasting harm unnecessary exposure is doing to patients even to the point of avoiding medical intervention but still they continue to go on as before. Why would they change as there are plenty of patients to fill the beds of the ones staying away or going elsewhere?
When it comes down to it, it is the staff and the anesthesiologist who are guilty are unnecessarily exposing patients in the OR setting both pre, in, and post procedure. Most cardiologists/interventionalists come in after the prep and leave after the procedure leaving the staff to suture and clean the patient up in the cath lab. The cleaning crew will also come in during post. By the time the patient is released to the cath lab post op room, they have been covered so the family will not know about their ordeal. Most patients will not even remember their ordeal. It is really sickening when they tell a spouse to leave the room so they may examine the groin wound as if they are suddenly protecting the patient's bodily dignity.
This may sound like a "non-sensical" nonsense, but shouldn't all patients enter the doctor/nurse-patient relationship with interest in the diagnosis and treatment and the procedure risks and clinical value and not with assumption of clinical or patient-directed misbehavior of one sort or another. Is such misbehavior is so so frequent and so emotionally debilitating that this concern is a "number one" thought and consideration which overtakes the underlying personal clinical concerns about the illness itself? My own personal concern would be directed to my illness.
I would consider concern regarding the issues related directly to the treatment and outcome of the illness. Or, based on the presentations here, it seems like the
attention is to the professional person and not the treatment.
Just tossed in a possibility of orientation of patient concern. ..Maurice.
Dr. Bernstein,
I believe the medical establish often purposely makes people take off all their clothes for their own amusement. Otherwise why would they insist that I take off my underwear for an upper g.i. scope? They do it because they think it is funny. The first g.i. scope they let me keep them on. They use any and every procedure they can to get people naked. If a patient is naked and wearing a gown and goes under general anesthesia I would be willing to bet that they are needlessly and maybe "accidentally" exposed by medical personnel over 90% of the time. They want to look. They are all going to look. It is human nature. It wouldn't surprise me if they do that sometimes for a toe operation. Unnecessary exposure is traumatic for many years afterward for some. I still think about what happened to me at the urologist's office thirty years ago. Wondering what happened while we are under is in many ways worse. Should this mental trauma not be given weight by the patient when balancing the possible benefit of any medical procedure?
Bottom line, I do not trust anyone in the medical establishment when it comes to modesty. Patients, men especially, should expect indignity when it comes to their privacy and they will seldom be incorrect. When that rare instance happens when someone protects your modesty in a medical setting cherish it, because it doesn't happen very often, and it certainly doesn't ever happen when you are asleep.
For the naïve patient the central thought would be diagnosis and outcomes but when you become aware of their total disregard for your embarrassment and dignity your focus begins to shift to a situation that feels sick and twisted.
I have tried to come up with an analogy so let’s try this one. If you are trying to be fitted with a new pair of pants and the Taylor that is doing the fitting wants you to try the new pants on but asks you to remove your underwear first with no clear reason for the necessity of this your focus quickly shifts from the new pants to the unnecessary request that has been made of you that would require you reveal your most sacred and intimate parts to a complete stranger. I would find this request and so would many others to be unreasonable and suspicious
I could be wrong but I don’t remember hearing of Taylor’s having versed in their toolbox
Are you confident that your privacy and other demands toward physicians actions including specific behaviors is not contributing to the highly increased "physician burnout" as described in the following current AMA article?:
https://www.ama-assn.org/practice-management/physician-health/pandemic-s-wake-over-40-doctors-regret-career-choice
There is obviously emotional upset on both ends of the medical stethoscope (doctor's ears-patient's chest).
..Maurice.
Hello Dr. Bernstein,
When one presents for medical treatment, that person comes with concomitant expectations. One of these expectations is privacy. As you are well aware, the federal government protects a portion of this privacy via HIPAA. The AMA Code of Medical Ethics 1.1.3 Patients Rights (a) states "[The right]To courtesy, respect, dignity and timely, responsive attention to his or her needs." One could reasonably expect that "his or her needs" applies to emotional and psychological needs, as well as, physical needs. Weren't these the buzzwords we heard about treating THE WHOLE PATIENT/PERSON? Furthermore, 1.1.3 (e) states "To have the physician and other staff respect the patient's privacy and confidentiality." In the medical setting, one could, again, reasonably expect this privacy to include physical as well as data privacy. Yes. The patient presents with a physical malady. However, that malady does not present in isolation. There's a person attached, with emotional, psychological and spiritual characteristics. Without concern for these characteristics, medicine becomes the meat-market that many bloggers here lament.
Reginald
I think the burnout that is occurring in the medical profession at all levels is being caused by management of these institutions not the patients
Good afternoon:
Doctor. Bernstein, people generally begin the doctor/nurse-patient relationship with interest in the diagnosis, treatment, and the procedure.
Where the disconnect comes in, is after the diagnosis, treatment, and the procedure information is given, the healthcare side goes quiet as a mouse as to what the patient will be put thru to get to the end result. They just expect the patient will cooperate & do as they're told.
Healthcare is falling back on their implied consent model at this point.
Some people are okay not knowing what's to come & that's fine but at the same time it's NOT healthcare place to say it's NOBODY'S business to know what they do to the patient once in pre-op all the way thru to PACU.
What's happening is the healthcare system is creating a "deer in the headlights" situation with new patients that don't expect to be treated disrespectfully & have their physical privacy ignored.
They are destroying any trust that was there very quickly.
If healthcare personnel are too scared to tell patients this is the procedure, this is how it's done, & this is who will be doing it & who will be in attendance then it's time to put it on paper as part of the intake paperwork or pre-admission packet they send out to patients to look over if they choose to. It's UP TO THE PATIENT NOT THE MEDICAL COMMUNITY.
The patient MUST be FULLY informed at ALL times so they can make the best decision for themselves. It's called patient-centered healthcare. The patient is the quarterback oof the healthcare team NOT the doctors or nurses.
Making enemies out of patients is NOT good for business. Word will spread how personnel at the facility treat people & they will avoid the place & the people.
Once they have that foul taste in their mouth from a bad visit it's extremely hard to repair the relationship & going forward all trust will be gone as far as future visits are concerned.
The medical community can make this work but only IF they open up & start treating people like human beings first, patients second. I'm sure that's how they'd want it if they were in the bed.
Best regards,
NTT
Dr. Bernstein, my default approach is to trust that the doctor/nurse/tech will competently address my health issue, unless they give me reason not to trust them.
My default approach for privacy and dignity matters is the opposite. I don't trust the doctor/nurse/tech to respect my privacy and dignity until they earn my trust. Why? My privacy and dignity has been violated enough times that I go into encounters assuming it will happen again. Sometimes they earn my trust, sometimes not.
Of course my primary concern is to have my health issue addressed, but I refuse to accept that healthcare staff can't both be competent and respectful.
Yes Biker..it is all about trust expressed by both the patient and physician. Here is an excellent description of this necessary trust on both sides:
TRUST: THE KEYSTONE OF THE PHYSICIAN-PATIENTRELATIONSHIP from the Bulletin of the American College of Surgeons:
https://bulletin.facs.org/2017/01/trust-the-keystone-of-the-physician-patient-relationship/
..Maurice.
p.s.-It could be that because of the time limitations available for communication and actions, along with medical and personal systems time limitations, ideal trusting relationship between physician and patient may be limited.
Something that is not discussed here very often but I believe is one of the biggest drivers in physician/nurse/tech burnout and patient dissatisfaction needs to be laid at the feet of the insurance companies. With the advent of managed care when healthcare facilities had to start excepting the negotiated amount set by the insurance companies and if you look at your EOB’s the billed amount and the negotiated amount aren’t even close.
This is what created assembly line medicine. Doctor visits became shorter. Patients are stacked up in pre op waiting for the next OR to become available and management trying to figure out how to keep the revenue up. Like we have all said it’s all about the money and the ones that suffer in all of this is the patient. Sure all the things that cause us to feel like we are treated like a slab of meat are real and many of the people that tend to us have become insensitive and yes they do play genital games at times because they feel powerless except for the power they have over the patient. The dynamics of what is going on in the medical world is multi faceted and quite honestly it is an industry in failure. Doctors today can’t be what they want to be they have to be what they are told to be.
Let me give you a small example of how powerless doctors have become. When I was told I needed a pacemaker my only request was to be able to wear my underwear in the OR the doctor said he was fine with that but I would have to clear that with the hospital? There was a day when that doctor had the authority to allow me to wear my underwear and cowboy boots into the OR if I so choose as long as he approved it. That ship has sailed!!!
Any wonder there is burnout in their ranks?
Well said, Jeff.
Reginald
And thoroughly supporting what Jeff wrote is this article from 2019 in "The Hill":
https://thehill.com/opinion/healthcare/460377-are-insurance-companies-driving-doctors-out-of-the-profession/
Well, I am sure this "takeover" by insurance companies has not diminished in the interval 3 years or so since the publication.
With regard to the United States, would "takeover" of payment management by the advances initiated by the Democratic political party instead of insurance companies supported currently by Republicans return a better patient-doctor relationship? Oh, yes, party politics and their actions, I am sure, have much involvement in this issue of the doctor-patient relationship. Or do you think, within the United States, politics is not and never will be a factor? ..Maurice.
JF speaking
Insurance companies aren't our friends. They generally try to get out the big bills. Then there's the out of network. Why can't there just be a routine bill payment made and the bills covered that way? Somebody is being overpaid and it causes other people to be overcharged. I saw a video on Facebook recently a Cancer pill costed $523 in 2005 for one pill. The cost went up significantly a couple of years later without any changes in the pill Finally in 2023 the cost has tripled from what it was in 2005 without any changes in the pill. The lady interviewing the person doing the price gouging couldn't tell the woman how much money he had made off of the pill so she told him that he had received half a million dollars in a two year period.
Biker's point is the crux of it as far as I am concerned. Being treated like a piece of meat on an assembly line is a result of supply and demand. More people are getting older and right or wrong obamacare has made the demand very, very long because it basically costs many people nothing to use up resources. The rest of us get to pay for everyone's care and get treated like crap anyway. That high volume of patients contributes to burnout, as Maurice has pointed out.
However...
The focus of this blog is patient dignity. That costs mere pennies. Instead all the medical establishment hears is wawawa when concerns are voiced. You become just another whining patient that they love to mock. You can see it in their faces as you head into OR. It is clear they plan to mock you when you are asleep. That is why I have no sympathy for medical people who end up on the other end of such ridicule. They fear it as much as we do. It is dehumanizing.
I don't remember if it was on this blog or somewhere else but one time a male patient was gonna get surgery so he recorded everything his doctor had to say so he could remember her instructions for him. He forgot to turn his cellphone off and it was in his shirt pocket still in the same room. His doctor said derogatory things about him. Saying she wanted to shoot a gun up his rectum and also she wanted to slap him around to man him up a little. He ended up suing her which is exactly what needed to happen. I would have liked to have seen her face when she realized she'd been caught.
JF.
JF et al: I am in total agreement for the patient to record the entire session with the patient's doctor and even the nurse. This will serve important purposes: carry away back home the specific personal medical information provided by the doctor which is necessary for best self-care but also to document the physician's or nurses attitudes and behavior toward the recording patient.
Patients do have the legal right to record medical visits, although it is easier in some states than in others. Eleven states have wiretapping or eavesdropping laws that require all parties being recorded to consent: California, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, New Hampshire, Oregon, Pennsylvania and Washington.
And here is a 2017 article on this very subject: SHOULD YOU RECORD YOUR DOCTOR'S VISIT?
https://www.aarp.org/health/healthy-living/info-2017/audio-recording-your-doctor-visit-fd.html
Whether the recording be secretive to the doctor or nurse..well, the legal requirements of the US state must be considered.
Full verbal interaction recorded between patient and healthcare can only be therapeutic in the long run.. unless there is something to hide or keep hidden. ..Maurice.
Hello Dr. Bernstein,
Great idea! Could you convince your other colleagues to welcome recording of visits - GP's, specialists, surgeons etc.? At that point questions could be asked about procedures, dignity/modesty, etc. Hopefully, answers would more revealing than "We always keep your exposure to a minimum." (where minimum is defined as exposure for the entire length of the procedure)
Reginald
They give patients the date rape drug for one reason and one reason only, so that they won't remember the abuse that was heaped upon them. I do not want cameras in the OR. That just lets even more people voyeur in. I came to hate my g.i. guy's guts. I felt he was incompetent and a liar who ended up costing me an extra day in the hospital and an extra general anesthesia for zero benefit (except to him). Yet who keeps popping up over and over in my room? Him. Even after my operation there he was to greet me. I'm like wtf? You weren't even in on the operation. He was there in line even before my wife. I guarantee you if there was some way for that so and so to watch my operation he did so, every last minute of it. I do want audio recordings from start to finish so at least they have to wait until they get back to the locker room to mock me out loud but no cameras please.
https://www.actionnewsjax.com/news/local/baptist-health-nurse-arrested-facing-charges-video-voyeurism-sexual-cyber-harassment/LMOKSFPLAZDANGNHRLHMLPYSNY/
Chaperones in the room with patient and physician may be good and wanted by the patient or physician or unwanted, for examples, the doctor-selected chaperone unwanted by the patient or the patient's family member maybe not acceptable by the physician.
Here is an article written by a female physician on this very topic:
"The Patient Case Against Requiring Medical Chaperones":
https://www.medpagetoday.com/opinion/second-opinions/104360
..Maurice
the comments are interesting. One guy voiced the same concerns many of us here have only to have some macho guy immediately chime in saying he doesn't have a problem with it. good for you macho dude, we're all very impressed. another dismissive doctor says get over yourself, my nurse isn't interested in your lady bits. did she say she cared what the nurse was interested in? no. she was talking about her discomfort. nice attitude doc.
the one i liked the best was this:
RVT 5 days ago
The chaperone situation is even worse for men in that there is an approximate 100% chance the chaperone will be a female, and often an unlicensed minimally trained medical asst.
At the dermatology practice I go to, chaperones cause me to forego full skin exams. How does that improve the healthcare I am receiving? I'd gladly have a full exam if there wasn't a female chaperone just staring at me...
That is how i feel. Many male and female doctors get their jollies from exposing male patients to their young female employees. It is despicable treatment.
it occurs to me that we might have natural allies in the fight for male modesty among muslim men:
https://www.islamweb.net/en/fatwa/84257/a-nurse-seeing-the-private-parts-of-men-and-women
edgar60, in the US, nobody can get through medical or nursing school only dealing with same gender patients, nor avoid intimately exposed opposite gender patients during their training, and then afterward, outside an OB-GYN practice, they aren't likely to find employment that restricts them to same gender patients. My guess is that mainstream Islam in the US has reconciled itself with the realities of western society medicine for those amongst them that want to pursue healthcare careers. What would be an interesting question is whether Muslim doctors and nurses are more respectful of their opposite gender patient's privacy.
Biker wrote: What would be an interesting question is whether Muslim doctors and nurses are more respectful of their opposite gender patient's privacy.
Hopefully so because the standard here in the usa is to make a game of exposing male patients to as many female employees as possible. The g.i. clinic called about my colonoscopy referral last week. I told them I didn't want to do it. The privacy thing is just one aspect I can't abide. The other is the assembly line nature of usa medical care these days. If there is a problem after the procedure they probably wouldn't even answer the phone. Dr. Bernstein's article was a real eye opener. I would rather just take my chances than voluntarily enter into another relationship where they have all the power.
this scumbag is still practicing:
https://www.adn.com/alaska-news/2018/03/16/lawsuit-claims-anchorage-neurosurgeon-improperly-took-and-shared-photo-of-patients-genitals/
was not charged with a crime either.
This is why nobody EVER reports anything. Why bother? Denver 5 still have their licenses. Twana Sparks got a slap on the wrist, with dont do that again. When the staff say they report this type of behavior 1st its bull, they dont think anything is wrong. Then when they say its immediate termination, maybe from that facility, but they still have a license to go someplace else. You tell enough lies and you
will start to believe them. And they tell some hum dingers. Cat
Good evening:
Our healthcare system is broken & until the voters are really willing to use the power of their vote to change things, NOTHING will change. If the people in Washington won't listen to th people, it's time the people did their duty & voted them out.
It's THE ONLY WAY to bring about the change that's needed.
Cat, you're right people don't report like they should for two reasons.
1. Lawyers are afraid to take on the big bad bully healthcare system.
2. Before ANYTHING ELSE the healthcare system goes to great lengths to protect their own.
Medical & nursing boards must have civilian oversight to protect the interests of the patients otherwise it will not happen.
People who lose their medical license in one state must NOT be allowed to go to another state & pickup shop again. There needs to be a national blacklist that ALL medical facilities in this country must follow. If they hire someone on the list because they didn't bother checking, there needs to be stiff penalties like lose 6 mths. of medicare/medicaid pmts.
Medical personnel get away with way too much. For example, the neurosurgeon Edgar spoke about, probably will never be charged because, the hospital’s compliance officer ordered Dr.
Kralick to delete the image. Like I said ALWAYS protect their own before ANYTHING else.
He was asked for the pswd. of is Apple Iphone. He refused to give it up.
At that point the state medical board should have stepped in & gave him a choice. His license or his pswd.
The system stinks & until people wake up & put their foot down & force congress to fix it, EVERYONE is at risk.
That's all for now from me.
Best regards to all.
NTT
NTT, tell us what you think is happening or more likely "not-happening" in the United States Congress with regard to the issues you and the other writers here are writing about. Where, in Congress is the site of the "hold-up" of this important issue? Republicans? Democrats? How about our Presidents or the governmental offices? Which part of government can promptly investigate and resolve this issue? The discordance between types of responses to the issue of abortion is, to me, a sign of poor total resolution of important medical behaviors or misbehaviors. What do you think? ..Maurice.
Another aspect which has not been discussed here which is pertinent to the "Preservation of Patient Dignity" is the reaction to and physician and nurse management of the attention and care of a transgender patient.
Here is a worthy read on the subject of this interaction:
https://jamanetwork.com/journals/jama/fullarticle/2805345
Hopefully you will have access to this article. ..Maurice.
The problem here is trying to get any of this on the radar screen is impossible because this topic doesn’t further the causes of the politician or advance their agenda. It is a problem for the masses and in this day and age politicians don’t want to waste their time serving the people
Dr. Bernstein,
I stumbled across so many doctors online that have before after pictures of hidden penis operations, trans operations before/ after surgery pictures. Very, very private images, men and women at their most vulnerable. Yes, I did look at some. All I kept thinking is why oh why did these people submit to having those pictures taken? Were they forced to allow that? i.e. if we can't take pictures and post them online then we won't do whatever surgery? financial incentive? My stomach gets so upset thinking about what if that were me.
Good Day:
There are two distinctly different levels of care being given on a daily basis in today's healthcare system. Healthcare will NOT speak of this difference because then they would have to DEAL with it. Just like they won't talk about the way female healthcare workers treat their male patients because then they'd have to deal with that situation also.
First you have the GOLD standard that healthcare put females on back in the mid 60's. For the most part, their dignity is respected & their privacy protected whenever they require medical care.
Then you have the BRONZE standard where they put the men & boys. Their dignity & privacy was thrown out the window in favor of female care back in the mid 60's & it's been the same ever since.
Over the years, men have chosen to deal with the situation in different manners.
First you have the exhibitionists who could care less who they are exposed to.
Next, you have the alpha males whose egos won't allow them to show weakness in any manor so even though they don't like the unnecessary exposure, their egos make them keep quiet & grin & bear the situation until it's over then, never mention it again to anyone.
And last but not least you have a growing number of men & boys who want their dignity respected & privacy protected to the same level that they protect women & girls.
As of 2022, the U.S. has approximately 4.2 million registered nurses. Of that number, male nurses represent only about 9% of the total.
So, we know, chances are, you're not going to get that male nurse for your intimate medical issues.
Knowing this to be the case, what can be done to get a male patient respectful, dignified, & private care when intimate male medical issues come into play.
The simplest & most effective was would be to create a male patient protocol with input from male patients NOT medical personnel that states exactly how female medical personnel regardless of their job will act when dealing with intimate male medical issues.
They won't do this because;
1. They don't want to alienate their female workforce.
2. Enforcement would be tied to their Medicare/Medicaid reimbursements. Male patient complaints equal less reimbursements & they know they are NOT treating their male patients the way they should so these losses will quickly mount up. Press Ganey should redo their questionnaire & ask specific questions about how male patients were treated by female healthcare workers.
So, since we know they refuse to police themselves they way they should, what can be done?
The ONLY way to force change down their throat is unfortunately through legislation. Health & Human Services is no help. I spent 6 months going back & forth with them.
Unfortunately, with the current polarization in Washington not a lot is getting done.
H.R.5986 - Men’s Health Awareness and Improvement Act has been sitting in limbo for two yrs. now.
This bill would FINALLY establish an Office of Men's Health within the Department of Health and Human Services (HHS) and require other activities to improve men's health in the United States.
We need meaningful legislation that specifies a non-negotiable protocol to be followed by ALL female healthcare works when dealing with male intimate medical issues.
Allowing facilities to do it on their own has shown time & time again it doesn't work because there is NO enforcement.
The only way I see getting what's needed is by voting out who's currently in & voting in like-minded individuals.
It's a struggle but I believe if men stand together, speak with one voice & keep hammering this issue home at them something good will come from it.
Regards,
NTT
NTT, excellent dissection of the United States governmental or other organizations role or abandoned role in this subject. A worthy presentation. Thanks. ..Maurice.
I think ive figured out part of their mindset in requard to advocates. They always say they are the patient advocate. They advocate for us clinically. Going to the doc for more pain meds or this med wont work with this med etc etc. Great please do. The patient doesnt know that stuff. What the patient means by having a family member be an advocate is by making sure they follow our wishes. No students, kept covered, same gender etc etc. We dont know the clinical they certainly dont know the physical/ mental. Cat
That they can't even brings themselves to establish an Office on Men's Health tells us all we need to know about the state of affairs. That men die years sooner than women is not deemed a health concern. My guess is they are terrified of facing the ire of women's groups were they to do so. If women were dying years sooner than men, it would be deemed a national emergency.
As much as I am of the mind set that the whole trans gender thing is a mental issue and should be dealt with on a psychological basis it may be the perfect platform to use for men’s medical rights in a medical setting. It brings hyper vigilance to people’s reproductive organs and how they want said organs treated and by whom.
Does anyone see my point and have any idea how we could Segway our concerns under the umbrella of proper treatment of transsexuals?
What if I where to make the claim that having a woman see my penis would cause my great emotional harm because I’m ashamed of having a penis and don’t want a woman to know and conclude that I am not a woman also?
This may sound crazy but I’m desperate for a solution.
Last March, my primary care physician referred me to a gastroenterologist for a problem I was having. The practice consisted of two males and one female. I made certain that my appointment would be with one of the males.
On the day of my appointment, I checked in with the receptionist and was given a clipboard with paperwork I needed to complete. The first two forms consisted of the usual health history and permission to bill my insurance company. However, the third form was one I had never seen before. It read that for any intimate exams a chaperone must be present. Since I knew I would need such an exam, I might have left immediately if the next paragraph hadn’t stated that if the physician and patient agreed, the exam could take place without a chaperone. So, I signed the form knowing I could leave if the Dr. would not agree to exclude a chaperone.
When I brought the paperwork back to the reception desk, I asked if there were any male chaperones available. The receptionist rolled her eyes at the “obvious stupidity” of my question and responded that all the Medical Assistants were female and they were trained to perform the role of chaperone. I thought to myself that it must take some really intensive training to stand in an exam room and gawk while a physician performs a rectal exam. Then receptionist added “They are there for your protection.” That was just too much bullshit for me to take; so, I did my best to put a worried look on my face and asked, “Why, do you think Doctor M. might do something inappropriate”? For a moment she was stunned into silence before she could blurt out, “No, No, of course not”. I simply replied “So why would I need a chaperone for protection” and then returned to my seat.
When I was called into the exam room, the MA took my vital signs and reviewed my medications and then she asked if there was anything else I wanted the doctor to know. I asked her to tell him that I would absolutely not accept the presence of a chaperone. She replied that patients didn’t seem to mind but she would give that information to Dr. M.
After about a ten-minute wait, there was a knock on the door and Dr. M entered the exam room followed by a very young-looking women holding a laptop computer. I was just about to say “Either she leaves or I do” when Dr. M. asked if would it would be acceptable for her to stay and take some notes about the purpose of my visit and then leave before any physical exam. I agreed to the compromise and when the time came for the exam he told the MA to leave which she did; but not before giving me a nasty look for having the audacity to prevent her from violating my privacy.
My thanks to Dr. Bernstein’s. By heeding his advice to “Speak up” I had my problem taken care of without the unwanted presence of a female for an intimate exam
MG
Hello MG,
Keep up the good work. As many more males begin assert themselves re privacy, doctors may finally recognize that some males actually prefer privacy. Your retort to the receptionist questioning whether you needed protection from the doctor is great. I think many of us will find that response useful in the future.
Take care.
Reginald
I have been away from the blog for a while and wanted to opine on several items from the last several weeks.
Dr. Bernstein
On May 5th, you posed a question asking whether it is more important to be concerned with the treatment and outcomes concerning an illness rather than the potential for misbehavior on the part of the medical staff. I could agree with you if I was in a tremendous amount of pain or suffering from a life-threatening situation, but most of the situations described in this blog happen during routine office procedures or after-surgery care. For non-emergency situations, my dignity and modesty will continue to be a top priority because the mental anguish caused by bad behavior lasts far longer than the physical discomfort from the minor procedures I have experienced.
On the topic of medical professional “burn-out”, I would agree with Jeff that dealing with insurance paperwork is a much larger factor than being asked to make an accommodation for same-sex staff for intimate procedures or to make simple changes in procedures to protect a patient’s dignity. I also hold the government largely responsible for driving the behavior of insurance companies.
JF
It was funny that you related the story of a patient who recorded disparaging remarks while he was under anesthesia. This situation actually occurred in Northern Virginia while I was living there. The abuse occurred during a colonoscopy with the Anesthesiologist being the main culprit. I actually tried to book a colonoscopy at the same office but I didn’t want to wait the 6 weeks for the next available time slot. I guess I dodged a bullet on that one.
Jeff
You pose an intriguing idea concerning the treatment of trans-gender patients and how it could be used to achieve dignity and modesty accommodations. In the current climate, I think there would be a much greater chance of success doing that compared to a cis-gendered male asking for accommodations. I am not sure if I could make a convincing presentation. Some time ago, a contributor suggested a strategy of claiming protected status under the ADA due to being a survivor of PTSD. I don’t know if it will work but I have been planning on stating that I do not feel “safe” with female staff due the abuse I suffered and the resulting PTSD.
I will be putting some ideas to the test in the next week as I am scheduled to have a consult with a gastroenterologist prior to undergoing a colonoscopy. I will be asking about colonoscopy shorts and whether he will do a non-sedated colonoscopy.
I have also been trying to work up the courage to schedule an appointment with my urologist to discuss BPH treatments as well as kidney stone treatment. It will be interesting to see if the practice is as patient-focused as they think they are and whether they actually have any male staff for intimate procedures.
EM
Great job handling that situation MG. While I can understand the feminist cultural influences behind female practitioners thinking it is OK for their male patients to be put on display for the female staff, I can't get my arms around male practitioners doing the same. Modern day feminism may take pleasure in the power aspects of embarrassing male patients, but why would a male physician do it too?
Biker wrote: Modern day feminism may take pleasure in the power aspects of embarrassing male patients, but why would a male physician do it too?
I think it is because some of them are straight up pigs. Some of them think they will get their young female employees lathered up for them. What the latter fail to realize is it isn't sexual for the young females, it is merely amusement for them.
There are predators on both sides. I remember reading an article years ago about an Australian man who had his testicles examined by like fifty different female doctors. He was arrested for some crime or other. I looked but I couldn't find the link. Some of those doctors doubtless loved to ambush and humiliate male patients with other female staff. Those types deserve each other. The rest of us are constantly fighting an uphill battle for modesty against the predators and immature types on the medical side. I am learning fast how to defend myself because it wrecks me mentally for a long time when they do that. Thanks to all here for sharing and helping.
Edgar60. Some of the female staff do get sexual gratification from seeing exposed patients. Even female patients, so an even larger number would get thrilled by seeing male patients. JF
Jeff you are absolutely right. the medical establishment, if they get a youngish decent looking patient once in awhile there is no doubt they all get aroused and very interested. as for an older man like me it is highly unlikely that i would get many motors going. Young guys and gals, don't be naive about trusting medical personnel to protect your modesty or privacy. they aren't any more moral than the rest of us and in many cases much less so.
https://www.newsweek.com/naked-photos-nurse-operation-hospital-766648
we are all professionals here:
https://www.syracuse.com/crime/2015/11/upstate_nurse_who_took_pic_of_mans_genitals_loses_license_gets_3_yrs_probation.html
it's no big deal to us. yeah, right!
This is from a nurse's forum where they joke about finding the meatus:
https://www.reddit.com/r/nursing/comments/13pkand/its_funny_bc_its_true/
they spend a shocking amount of time talking about their patients, replete with full medical history, extensive listing of treatment, all vital indicators and labs, etc. they either talk about &/or mock patients or they gripe about management. A lot of stuff on there is a flagrant violation of HIPAA.
But they are all professionals, right?
They use that "professionals" bs like a shield to deflect accurate and truthful criticism.
I'm sorry to post so much but I'm still mad. When medical personnel take pictures of their nude male patients law enforcement either doesn't do anything at all or else makes it a misdemeanor. When medical personnel do it to female patients it is a great big felony. Why do females get better protection by law enforcement?
This scumbag recorded a 17 old female who has cancer:
https://www.nbcphiladelphia.com/news/local/nurse-nude-recording-patients-bucks-county-teen-women-girl-iphone/39295/
He deserves prison, they ALL do. Whether the victim is male or female.
Good afternoon:
Cell phones should NOT be allowed out of the employee dressing rooms. They should supply employees with a hand-held walkie talkie type radio.
If things weren't bad enough.
Florida nursing school operators plead guilty to selling fake diplomas to thousands of nursing students
https://www.tampabay.com/news/crime/2023/04/11/florida-fake-nursing-diploma-degree-scheme-guilty-plea/
Regards,
NTT
Tiffany M. Ingham, anesthesiologist, said a bunch of mean things about a patient during a colonoscopy. I know that everyone has read the story but what struck me is that she commented specifically about a rash on the guy's penis. That means she purposely looked at his penis. They ALL do! If you are under, they will ALL find an excuse to check out your junk and leave you uncovered. Don't anyone ever try to convince me otherwise. They ALL do it every chance they get.
https://www.cbsnews.com/news/patient-sues-anesthesiologist-who-mocked-him-while-sedated/
not knowing is the worst, and they torture people like that.
I lived right around the corner from where that patient was violated by that anesthesiologist Bi- -ch . That’s why I won’t let them sedate me for a colonoscopy. My doctor was fine with no sedation but the nurses kept asking me why I didn’t want sedation and I refused to answer them because it was none of their business. I find it interesting that they were so perplexed by that. Needless to say I was never exposed because I was fully lucid but I guarantee you I would’ve been exposed if I had been sedated.
Had my pre-colonoscopy appointment today. I asked about colonoscopy shorts or backwards boxers and my young Indian doctor acted like I was from another planet. He asked and I explained that I had been the victim of abuse and unnecessary exposure and he said that he had never heard of anything like that in his 11 years of practice. I guess I will be doing my first sedation-free colonoscopy. He tried to discourage me by saying that they have an AI program to identify polyps and that if I am moving around (un-sedated) it will be less accurate. He assured me that there will ONLY be a nurse, a tech, the anesthesiologist (could be male or female), and the doctor in the room.
EM
Please notice that I will be updating these Bioethics volumes regarding Patient Dignity to Volume 126 tomorrow..so we don't end up with comments exceeding the 180s and the system shutting down, even for my posting further comments for that volume 124. ..Maurice.
Jeff and edgar60, that the anesthesiologist Dr. Ingham somehow was examining the guy's penis as part of a colonoscopy procedure, and nobody else in the room seemed to have a problem with that speaks volumes. How does that reconcile with "we keep you covered". On Quora when there are questions about colonoscopies and concerns about exposure are posted, the people who do colonoscopies never seem to respond. It is as if they don't want to lie by saying they don't expose the patients, so they don't say anything.
‘‘Em don’t let that doctor talk you into sedation. I had a colon spasm during mine that was extremely painful and I didn’t budge the doctor knew it was happening because he told the nurse to hold me from moving. I have since found out that they have medication I could have been given to prevent spasms but wasn’t given. I have no regrets about sedation free colonoscopy . I think that they want you sedated to keep you from being embarrassed when they expose you not because it is necessary for the procedure.
They can’t make any money off of colonoscopy shorts but they make a ton of money off of sedation
EM - notice how he says "only" four people as if that is a small number? How many do they usually have, FIFTY? Four people when you are awake will be respectful, as soon as the patient is under they go into mock-mode, and invite the entire staff in for tea cakes and reindeer games. Their promises mean NOTHING. How many do they usually have, FIFTY? The reason he has never heard of such a thing is because people like me would never in a million years submit to that procedure for just that reason.
From another nursing forum: I have also witnessed and even had my own experience of embarrassment at the hands of nursing staff, techs. Have also had a nurse tell me I used to raise their sheets just to see what they had with a wink and a smile...
they lined up at the door to take pictures of this guy when he was out:
https://www.cnn.com/2017/09/15/health/upmc-denver-patient-genitals/index.html
they shared the pictures and even got to keep the pictures which are still out there. one doctor got a seven day suspension. that was it. don't anyone ever try to tell me that hospital staff are professionals. no they aren't. not one bit.
NOTICE: NO FURTHER POSTINGS WILL BE PUBLISHED ON THIS VOLUME 125.
MOVE ON NOW TO VOLUME 126 TO VIEW AND TO INSERT YOUR COMMENT:
https://bioethicsdiscussion.blogspot.com/2023/05/preserving-patient-dignity-formerly.html
..Maurice.
I recently wrote this letter to the large Dermatology practice I go to. It goes into detail about how men feel about how they are currently being treated with regard to their privacy and dignity during medical examinations. I wrote it specifically to dermatologists but it could be easily adapted for any Specialty.
Please feel free to copy and paste any, or all, of it and send it to your doctor's practice. I sent one to each doctor in the practice and the practice manager.
I think this letter should go a long way in helping doctors and staff in understanding the truth about male modesty and how to make small changes in the way they conduct exams thereby make the examinations more dignified.
Name of Dermatology Clinic
ATTN: Dr. XXXXXXXXX Date XX/XX/XXX
Dear Dr. xxxxxxxxx,
As a concerned patient, I want to make you aware of what men are saying, on multiple blogs, concerning their visits to the dermatologist. The consensus among these men agrees with the experiences I have had regarding my privacy. Although this is not widely appreciated, most men are just as modest as women! Just like women would never tolerate having a male assistant looking on during her pelvic exam, most men find it humiliating to have a female assistant staring at them unnecessarily when they have to expose their genitalia. Men expect to receive the same dignity and privacy afforded women. Unfortunately, many men feel ambushed by a female assistant and most men feel too intimidated and embarrassed to speak-up. They state that it is very demeaning for them to be completely naked while the scribe stares at them. When this happens, they feel violated and many vow to never come back for further exams. Some even report needing therapy for PTSD-like trauma! This disregard for a man’s emotional trauma results in him not following-up on possible life-threatening conditions (i.e. Melanoma) and that likely contributes to the shorter life span of men. Women are tired of losing their fathers, brothers, sons and husbands sooner than they should. This does not mean that male assistants have to be provided. If a female assistant is needed to take down physician’s notes, then she should be TAUGHT TO REPECT THE PATIENT’S DIGNITY BY TURNING AWAY during the genital/perianal portion of the exam. This should occur without the assistant having to be told by the doctor or the patient! The doctor can dictate his findings while she has her back turned. If an assistant is needed to perform a procedure (i.e. Biopsy) then the patient should be covered except for the lesion that needs to be biopsied.
The comfort of the patient is paramount, so much so, that Congress passed the “Patient’s Bill of Rights”, legally guaranteeing the patient’s Privacy and Dignity.
Men are saying that they are fed up with this type of disrespect and invasion of their privacy. They believe that many medical professionals, particularly nurses and assistants, are indifferent to male modesty and routinely dismiss men with bullying and shaming practices, unbeknownst to the physician. “We’ve seen it all!” is of no consolation to the man being exposed unnecessarily. Some are even considering litigation.
I hope you will be willing to make these minor changes to make it more comfortable for your male patients. I believe most men would greatly appreciate this consideration.
Most sincerely,
Current Male Patient
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