What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern about what is happening in the world of medicine, medical care, treatment or science? Ethics is all about doing the right thing. Are you aware of any issues in medicine or biologic science which are being done right, could be improved or in fact represent totally unethical behavior? Write about them here.. and I will too! ..Maurice (DoktorMo@aol.com)
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WELCOME TO THE NEW GENERATION OF COMMENTATORS TO ADD TO THOSE WHO HAVE BEEN PRESENTING THEIR VIEWS ON THIS SUBJECT IN THE PAST.
REMEMBER, THE TOPIC SHOULD BE CARRIED BEYOND YOUR PHYSICAL MODESTY ISSUES BUT CONSIDER THE MORE GENERAL TOPIC OF PATIENT DIGNITY OF WHICH PHYSICAL MODESTY IS BUT AN ELEMENT OF THE ISSUE. ..Maurice.
posted by Maurice Bernstein, M.D. @ 9:52:00 AM
188 comments
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188 Comments:
WELCOME TO THE NEW GENERATION OF COMMENTATORS TO ADD TO THOSE WHO HAVE BEEN PRESENTING THEIR VIEWS ON THIS SUBJECT IN THE PAST.
REMEMBER, THE TOPIC SHOULD BE CARRIED BEYOND YOUR PHYSICAL MODESTY ISSUES BUT CONSIDER THE MORE GENERAL TOPIC OF PATIENT DIGNITY OF WHICH PHYSICAL MODESTY IS BUT AN ELEMENT OF THE ISSUE. ..Maurice.
Thank you for the work you do on this blog Dr. Bernstein. I wish all medical personnel were as professional as you are. So many just talk the talk but do not walk the walk when it comes to patient dignity.
“The true test of a man’s character is what he does when no one is watching.”
― John Wooden
Edgar60, when I was teaching first year medical students in the years from the 1980's to 2018, establishing the concept that the observance and maintaining of patient dignity was to us virtually as important as making a clinical diagnosis. The concept being taught the students is that both the patient and the physician should be working together to achieve a common clinical goal and that disregard of patient dignity would make achieving such a goal impossible. The students were taught that the patient (and family surrogates) always contributed to that goal.
By the way, dignity is not something that the patient should lose if unconscious by pathology or by anesthesiology.
This concept is as important a teaching subject as the technical methodology of making a clinical diagnosis. ..Maurice.
The most horrifying prospect for me goes way beyond just medical personnel treating males shabbily. They all carry their cell phones with them and they have no compunction whatsoever against using the camera on a whim. They photograph everything, blood clots, wounds, specimens, xrays, ekg charts, dispensing machines, hallway notices, patients naked, themselves naked. It means nothing to them. They have proven they can't be trusted many times over. Being a very private person I am terrified of being around them at all, much less being sedated and naked around them. Do you agree that it is the worst possible modesty violation imaginable?
Ashley Ann Smith, 30, of Dravosburg, is facing 30 counts — including invasion of privacy and abuse of care — in connection with photographs she took while working as a licensed practical nurse at Kane McKeesport Community Living Center,
https://nypost.com/2019/05/07/nurse-allegedly-took-nude-photos-of-elderly-patients/
Kristen Johnson, 27, was subject to a nine-month investigation after her co-workers at State University of New York Upstate Medical Hospital complained about her behavior.
She was arrested in 2015 and originally slapped with two felony counts of unlawful surveillance and a misdemeanor of disseminating unlawful surveillance.
https://www.dailymail.co.uk/news/article-3513279/Nurse-took-photo-unconscious-patient-s-penis-turns-medical-licence.html
About four terabytes of data, including 700,000 photos and 65,000 hours of video, found on the nurse’s cellphone relate to his “drugging, sexual touching (and) sexual penetration” of patients dating back to 2016, according to the lawsuit.
The nurse, Christopher Lambros, 61, who was employed at St. Mary’s Medical Center in Grand Junction, Colorado, was arrested Oct. 25 on a warrant for three sexual assault counts, according to the Grand Junction Police Department. Grand Junction is about 240 miles southwest of Denver.
https://www.sacbee.com/news/nation-world/national/article270287757.html
Patient dignity within medicine is preserved by the medical profession to follow the 4 Principle of Medical Ethics: Patient 1)Beneficence, 2) Non-maleficence, 3) Autonomy, 4) Justice.
For those who would like to have summarized the details of these 4 Principles, here is the link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7923912/
It is failure of the medical profession: Physicians, nurses and others in the profession NOT to follow these four principles. Failure to follow can lead to the patient's loss of his or her individual dignity and much of the stories written here about the hurt and misbehavior by the medical profession. ..Maurice.
..Maurice.
Edgar60 it is a shame that individuals get a black eye in the medical field that don’t necessarily deserve it. My wife worked in OB/GYN for 30 years and wore scrubs to work everyday but after I experienced the humiliation that female nurses did to me with no regard for me as a person I now find myself being triggered at the sight of a woman in scrubs even in the grocery store and looking at her with contempt. It doesn’t matter to me if she works for a dentist where everyone keeps their pants on. I don’t know where she works or what she does it has become a knee jerk reaction and the medical establishment have no one to blame but themselves. This is so unfair to people like my wife who deals with no one but women but to me the scrubs have become a big red flag and my thoughts instantly start to assume that she is willing to expose and humiliate me at the drop of a hat. These issues are a product of my mind which is why I see a psychologist every week trying to resolve my PTSD. I think it is clear that the medical establishment knows what they could potentially do to a patient by their actions but they just don’t care because they are driven by greed not compassion
Jeff I hate to admit it but I saw a woman in scrubs coming out of a convenience store and thought bad thoughts about her.
The medical "profession" tell us we can't keep our underwear on because it isn't sterile but they routinely bring germy cell phones into the OR, and use them! The article mentions some issues with that but never once brings up the issue of those scumbags taking pictures of patients in the OR which I'm sure they do whenever they want to.
Jim Wade September 4, 2020 At 11:15 am
From my expereince as an OR manager, the personal functions of cell phone use reported in this article are grossly understated. In the operating room, especially during long cases, staff are using these with impunity for games, Facebooking, shopping, etc. when they should be surveilling the room for safety concerns, breaches in sterility, anticipating case needs, etc. One element of cell phone use that is not mentioned is that these devices are dirty and are likely spreading germs which could lead to patient harm...
Beth Bridges January 10, 2020 At 11:42 am
As an OR nurse in a busy trauma surgery Dept , I found it very frustrating when trying to train new graduate nurses or scrub techs. The younger generation seems to be especially tethered to their phones –and very distracted by them. One even got very defensive with me when I told him he needed to leave his phone in his locker (he’d already been told this by admin folks on the unit). Some surgeons and residents like to get texts when the OR is set up and ready but I don’t really think this justifies having cell phones in the OR.
In previous years, parents would get phone calls at the main desk if the day care or babysitter needed them.
I just think everyone has become overly-dependent on cell phones–at the expense of patient care.
https://modernnurse.com/what-do-you-think-when-is-it-okay-to-use-personal-devices-at-work/
This is how they treat one of their own:
An employee of a hospital in Pennsylvania has filed multiple complaints after she discovered photos of her genitalia were being shown around the workplace. Sheila Harosky alleged that a nurse took those images while she was being operated on for her hernia.
Harosky, who had been working as a unit secretary in the operating room department of the Washington Hospital, alleges a scrub nurse, Sharon Bourgo, used a mobile phone to take photos of her exposed body while she was on the operating table for incisional hernia surgery in September 2016...
https://www.ibtimes.co.uk/nurse-fired-after-taking-photos-patients-genitalia-during-surgery-sharing-co-workers-1652946
Does anyone really think they don't routinely do that to people they don't know?
HIPAA only applies to pictures that can be used to identify the patient. They can take pictures of your junk all day long and get away with it.
I have found dozens of articles about cell phones in operating rooms:
Field observations have confirmed both the tendency to bring mobile phones into the operating room and the habit of using them (especially by anesthetists and nurses). Ninety per cent of interviewed personnel admitted to take with them mobile phones...
https://pubmed.ncbi.nlm.nih.gov/31834301/
Joan Rivers died while the doctor was taking pictures while she was on the endoscopy table:
https://www.operatingroomissues.org/do-cell-phones-belong-in-the-operating-room/
They only talk about the distraction caused by cell phones in the OR but they NEVER talk about the elephant in the room, the camera. It is my belief that patients are routinely recorded while asleep.
Good Morning:
This article was in the Washington Post back on April 17th, 2023.
A silent crisis in men’s health gets worse.
https://www.washingtonpost.com/wellness/2023/04/17/mens-health-longevity-gap/
By Tara Parker-Pope and Caitlin Gilbert
tara.parker-pope@washpost.com caitlin.gilbert@washpost.com
They still don't address that men stay away because of the way they are treated. Their info is coming from the healthcare side. 985 people commented while comments were open.
I'm going to email them & ask if they spoke with any men other than those in healthcare.
Jeff:
Have you ever looked into using the American's with Disabilities Act to get same gender care?
That's all I have for right now.
Regards,
NTT
I think there needs to be a television show talking about the refusal of Medicine to listen to patient concerns. Talk about the survey and how it limits what a patient is able to say. And name it What The Medical World Should be discussing with Us. Then have patients write letters or send emails and whichever concerns get the most comments gets discussed along with patients possible solutions. It wouldn't just be modesty violations. Billing would probably be the number one complaint. Also discuss what can possibly be done to remedy. Possible solutions to getting more doctors and better work from them. I'm not thinking that just anybody should be allowed to say just anything but there's too much silencing being done. JF
JF I would love to see a show like that and I would watch it! There is enough content for several seasons!
NTT when I get the courage to have procedures done that I am in need of believe me I will pull out all the stops including ADA but more than likely I will just be barred
JF,
Are the financial personnel in the delivery of medicine on commission? I'm waiting for the promised call from the caregivers re: my cataract surgery, but have been contacted three times regarding paying the extra money. I have both Medicare and supplemental insurance. The added billing is so outrageously excessive that I believe we need a new term to describe it - how about med profit [greed is too lame]? The surgery facility is charging me an extra $940 for what? How about the extra $2195 for the surgeon which seems like a tip. Doesn't Medicare and insurance pay for these?
The first time I looked at a medical bill I was sure it was someone else's bill. Then I realized all the billing clerk has to do is enter admittance date, discharge date, and procedures. The billing software has an algorithm using the medical protocol and the rest is automatic, not that items can't be added, but no subtractions.
Did you notice that your medical bill is 5 to 10 times the amount that the government and insurance actual pay? Credibility is no concern when med profit is involved. That outrageous bill is for the poor guy w/o insurance and pats hinmself on the back when he negotiates to pay half the bill, never realizing that med profit is still involved.
BJTNT
Introductory graphics from Volume 106, October 29 2019
https://bioethicsdiscussion.blogspot.com/2019/10/preserving-patient-dignity-formerly.html
At the site, scroll down the introductory passage to look at the two graphics.
Maybe Banterings, Biker and JF and JR will remember those two significant cartoons. ..Maurice.
By the way, if you have the time, I would suggest that you scan though the entire 2019 Volume and you will find more and more worthy discussions by many, including an intended controversial "A Hymn To Him" by a friend physician=ethicist and then one day later a "Hymn For Them" written by our Reginald. Enjoyable reading and contemplation.
https://bioethicsdiscussion.blogspot.com/2019/10/preserving-patient-dignity-formerly.html
Has anything changed in this topic over the last over 3 years? ..Maurice.
Reading the older comment threads reminds me that many people here have been fighting the good fight for years while I am a newcomer. I just made an appointment with a new dermatologist. Male doctor but of course a woman answered the phone so here we go again. I managed to never take my pants off for my previous (81, retired now) dermatologist (who was always surrounded by three nurses) but this time may be different. I may chicken out on my appointment or just be too chicken to ask him to check something below the belt line. My greatest fear is that I might just submit to whatever they want to do and just suffer mentally later. Best to all.
Hello edgar60,
Since most appointments have a week or so lead time, you might consider re-calling the derm office and indicating your desires for your upcoming appointment. Ask the secretary to be certain that the doctor understands your desires and, ask for a return call indicating his acceptance. If you don't hear from the office in a few days, call again. In some cases, you can indicate your desires via a note to the doc in MyChart, iHealth or some other electronic platform.
Becoming a "pest" sometimes gets results. They might mumble, "Hear comes Mr. X again!" but, who cares. Hopefully, this will prevent you from being blind-sided (some here would say "ambushed") at the appointment. I wish you well. Take care.
Reginald
Just ask all the ladies to turn around for that part or leave the room would be more dramatic. But be insistent for your sake and ours. The only way to effect change is one demand at a time
Thank you Reginald. My previous derm doc was not well liked by many. I liked him because I could get in on short notice and I didn't mind his gruffy bedside manner. The most he would say is I can't give you an opinion if I can't see the area you are talking about. To which I would just say that's fine, it probably isn't important. This new one is probably a better doctor to be honest. He is booked two months out and will soon probably stop taking new patients soon. I have zero power in this relationship. I wouldn't have had the nerve to say something about modesty to my old doc, much less the new one. (The old doctor told stories about "misplaced" modesty, he was quite bitter about it actually) Someone here mentioned finding their voice. I haven't done that yet but I can't keep avoiding going to the doctor like I used to because I am getting older now. Something has to give. I have time to think because my appointment isn't until August. I might have him look at my knee and meekly mention the other thing if I get a chance.
Good evening:
I agree with Reginald.
Just ask them 2 questions.
1. What is their Scribe & chaperone policy?
2. If required, are males available?
From these answers you can decide to go forward or find another provider.
Have a great evening all.
Regards,
NTT
Thank you Jeff. That comment will hopefully give me the strength to do just that. I will report back here on how the visit went after I go.
Hello again edgar60,
I was concerned to read in your post, " I have zero power in this relationship. I wouldn't have had the nerve to say something about modesty to my old doc, much less the new one."
You may wish to consider your relationship as patient and care-giver instead of powerful and powerless. A person who has an arthritic shoulder might ask the doc to be careful examining the shoulder due to the arthritic pain. Our modesty should be seen in the same light. (Unfortunately, as many here will attest, this is rarely the case in healthcare). Asking that this modesty be respected should not be a problem for us. Very few doctors will wish engage in a debate over this. They'll either say, "Yes, we can do that." or "No, that's not possible.", at which time we can proceed or walk. Nevertheless, you'll never know, unless you ask.
I have a great anecdote regarding this. I would visit my sister biennially and, on one occasion, we visited a mutual friend. During that visit many other friends were present. The host asked if I'd like anything. I asked if he had any home-made Italian wine. He said, "Sure!" One of the other friends asked the host why the host hadn't offered any of that wine to him. The host responded, "You didn't ask?!" I've never forgotten this simple retort, "Why didn't you ask?"
No one will know what we desire if we don't ask. Dr. Bernstein often replies, "Speak Up". I believe we're reluctant to ask because we're afraid of the response we'll receive or, because of the perception that others will have of us. It's tough, especially when we may be bucking some "all-important" entrenched protocol. Nevertheless, I do feel that speaking up is extremely necessary. The doctor will know your views and, he/she can decide whether your desires can be accommodated. You will each know the other's position and, you can act accordingly. As I mentioned before, clarifying this with the doctor before the procedure might be preferable to making the request during the exam. During the exam, the doctor's protocol is usually set and, any requested changes will probably not be welcomed.
Please be emboldened by the fact that most of us have been in your position, with mixed results. I do believe that persistence pays and, that speaking up is necessary. If nothing else, speaking up is cathartic and, you'll never ask yourself those what-if questions.
I wish you much success and good health.
Reginald
As the cause for patients to ignore the behavior of the medical profession is that you all think there is some inherent fear by almost all patients to "speak up" to their providers regarding the patient's management and other aspects of the professional's behavior? Should signs be available in many clinical locations stating: "PATIENT AND FAMILY--FEEL FREE TO SPEAK UP" or something to that effect. ..Maurice.
Hello Dr. Bernstein,
A sign encouraging speaking up sounds great. Additionally, during the visit healthcare personnel could ask, "Is there something we could do to make your visit more comfortable?" or "Are you ok with opposite-gender staff?" After the visit, the patient could be asked, "What can we do better to improve your experience?" or "What did we do well or not so well?" Unfortunately, the present 15 min. office visit paradigm doesn't allow for much of the above.
Reginald
Reginald is right about the what if questions that you ask yourself after the fact. The extreme amount of anguish that I suffer now could have been averted if I for one had spoken up at my first traumatic experience. But there are three known responses to that fight, flight, or freeze. In those settings I’m a freezer and I have sworn to myself I will never let that happen again and in another surgery with a lot more experience under my belt I had made all the appropriate requests and received assurances that my needs for no females because of nudity in the or because they refused to allow underwear for a pacemaker????? Once in the or and seeing 2 females everything in me said to get up and walk but once again I froze and was once again violated because it was against my will. I will not allow this to happen to me again and it is very likely that I will be refused their services. At this point I would rather die with dignity than allow the amount of emotional destruction they are more than willing to subject you to. I have learned that if you say nothing more than likely you will be humiliated but I have also learned that sometimes even if you speak up they may still violate you . I think for the pacemaker they thought they were safe because the versed would give them cover but once I was in there they realized that it is in my allergies no versed and it was amazing how quiet and tense it was when they knew they had been busted with the women in there. That was my Q to stop the procedure but like I said I was frozen. So I not only suffered what was done to me I have unbelievable anguish about letting that happen to myself and not speaking up
So if you know that these kinds of things are going to cause you emotional damage do what ever it takes to protect yourself because they won’t!
Dr. Bernstein, My any decent doctor in my town is booked two months out. What I was thinking is that they don't have to bother with patients who give them issues. Maybe that isn't the worst thing to happen in my case. It isn't an emergency after all. If one doctor says no I can try another. If it takes a year fine by me as long as the insurance company doesn't balk. Even if they do balk this type of outpatient thing isn't that expensive. Since specialists are in it for the money I do have power in that I can just refuse a procedure and go somewhere else leaving them unable to bill much for my 15 minute slot.
In an emergency I do feel that we are all powerless. It isn't like we can shop around at our leisure, most of the time we are in extreme pain and at imminent risk of death. I don't know how we are supposed to deal with that. We can advocate for ourselves when we are awake but once we are under they can do anything they want.
To Doc and everyone else who are so kind: My wife has a female gyn, all female staff, a female pcp, all female staff except for one young man at the front desk who probably isn't even really her employee. She got an all female mammo team, an all female dermo office. Us men never get that.
I was walking and thinking about it yesterday. When I go for my appointment I will wear a jock strap. I used to do that with my previous dermo doctor so I would remember to not take my pants off no matter what. I will ask the new guy if the exam can be in private just him and me, if he says no because he needs her help to look at the area I will ask if I can leave my jock strap on. If he says no for whatever reason then I will just leave. I feel better already. I am at the age where I don't have another 5 years to waste being mentally destroyed.
Jeff wrote: I have learned that if you say nothing more than likely you will be humiliated but I have also learned that sometimes even if you speak up they may still violate you...
Jeff my fear is that if I make a big deal out of it they will humiliate me even worse, like that female colonoscopy anesthesiologist did. It isn't easy for me to speak up and yet I feel the same way as you. In the past I either avoided medics or else used defensive body language whenever it got too private. If something goes wrong with my heart that isn't a bad way to go. I won't seek help unless I just can't stand the pain anymore. That is the vise I never want to be in again, being in so much pain that I HAVE to go. That is where I ended up with my gall bladder, it got so bad and it was clear that the pain wasn't going to go away and also equally clear that it could take months to die from it from slow starvation. Best to all.
Just watched a C-SPAN presentation entitled "Digital Health Care" by FDA Commissioner Dr. Robert Califf to the National Health Council {NHC}. Digital health was not explained, but the purpose of the NHC is patient advocacy. It was refreshing, however appropriate, to hear a bureaucrat ask the Council for help since the FDA doesn't know what to do regarding digital health [whatever it is].
How about... With the expected MD shortage, how about beta testing AI/med [digital health?] in underserved areas. Even w/o the MD shorage, why couldn't the FDA allow/approve/accept AI/med in areas w/o local MDs?
With AI/med the patient would walk into a private area [big enough for help] and say anything in their preferred language since AI can interact in most languages. Wouldn't even those who are non-literate with PCs soon be comfortable talking to even a non-person that listens and responds? AI/med would ask questions, but would tolerate rambling responses [probably a practical limit of one hour rather than the 15 minutes with MDs].
This might even be pyschological therapy - actually psychiatric therapy since AI/med can prescribe meds. Then again, AI isn't necessary in therapy sessions to keep repeating "How does that make you feel?".
Would Amazon/FedEx/UPS/USPS deliver the meds and pick up specimens. Collecting specimens is an unsolved problem. Some training would be required for a person drawing blood and ?.
BJTNT
Edgar60,
Why even ask? Just leave your jock strap (boxers) or whatever else you want on. My husband's derm. just manipulates clothing to see what he needs to see. He said if you don't want a full body exam that is your choice. He is a very nice guy. He even complains abt the state the medical community is in. He has a very successful practice. He is not owned by any hospital as he feels it is a violation of privacy for hospital's to have all your information. It is your body and you totally have the say on how much you want to expose and to who. Your medical provider is your employee. If the area is not on the genitalia then there should be no issue. However, if he wants you fully naked, ask him why as you are not requesting a genitalia exam. When patients start using the term modesty, medical providers will throw it back as you have some mental issue. While I am modest as I do not wear tight pants or low cut blouses, it has absolutely nothing to do with my requirement of bodily dignity meaning I do not feel I must expose my body to someone for their convenience, wants, or needs. If the MA tells you to "strip" I would merely disrobe whatever I felt was warranted and make them have to explain why totally nudity is needed. Put it back on them rather than you having to ask permission to protect your bodily dignity. We are not children and we should not tolerate their paternalistic attitude. We are paying them for their advice/service but as in other aspects of live, we must dictate how we want the service delivered to us. Cindy and I did a podcast not too long ago abt a female doctor who didn't want a chaperone present at her personal exams. I don't know where you reside but find out if a chaperone is mandatory as many times since no one protests, they are in there. This doctor was talking abt that some chaperones know not to directly stare at the patient's private parts while others do. If the a doctor says a chaperone is there for your comfort, then explain you would be more comfortable if they faced a wall (that is IF they are truly there for your comfort). Some will busy themselves with supplies is another way they can not simply stare at the patient. This female doctor stated that she felt chaperones compromise the doctor-patient relationship because having a chaperone implies mistrust of either from the patient or the doctor. What a way to have a relationship that is built on distrust.
Dr. B.,
Yes, I remember those cartoons and they were very good. I think things have gotten worse as I hear more and more stories of medical harm. Because there is a "shortage", hospital staff seem more empowered to take shortcuts especially where patient dignity is concerned. The medical community has become a medical mafia or cartel. Have you read about the Florida Free Kill bill which goes into law on July 1st?
https://www.floridamedicalrights.org/single-post/new-law-zero-accountability-for-medical-negligence-when-you-live-through-it
This should send chills down everyone's spine. A big thanks to Ron deSatan for making it very possible for hospitals to literally kill and get away with it. Other states will follow.
Who wrote the last posting? Please identify
..Maurice.
Here is a sample of those nice professional nurses who object so much to any implication that they might be unethical:
No other career can have this conversation: “Honey how was your day?” “Oh fine! Me and my coworker had to really get a handle on this man’s penis today, couldn’t get the tube in”
Not only do they talk about their patients, they talk about their patients on line, with strangers, in great, many times intimate, detail.
https://www.reddit.com/r/nursing/comments/13y71us/no_other_career_can_have_this_conversation_honey/
I noticed another trend that I don't like in doctor's offices. Windows. I walked by that dermo doc's offices, windows every eight feet. There must be at least two or three windows in every room. Ground level no less. My new lady pcp's office same way, huge windows, no blinds. You can't see in unless the light is right but it really adds to the feeling of apprehension. My dentist office is the same way. It is more important for them to have a view than for them to give the patient a sense of privacy. They don't care, it doesn't even enter their minds.
One more. I was reading a lengthy discussion on the nurses forum where they talked openly about trading perverted hospital patients with a male nurse or older female nurse. This, in effect, makes it less likely for a modest man to get an older female nurse or a male nurse. That is not fair, so the younger female nurses only want to work on males that they can mentally torture? Okay, thanks for putting your patients first. I understand a female not wanting to work with creeps but that just victimizes the nice guy patients even more.
That post was not originally unsigned as my id must have disappeared during all the captcha pics.
Hello JR,
Your recommendations to edgar 60 are spot on.
Reginald
James Baldwin:"The price one pays for pursuing any profession,
or calling, is an intimate knowledge of its ugly side."
https://en.wikipedia.org/wiki/James_Baldwin
An appropriate conclusion as presented by an American writer/author. ..Maurice.
To my writers here: Can you speak about your own professions and without naming names, just naming the occupation, tell us what you know about the "ugly side" of your current or former jobs. Is the "ugly" directed at you only or are others affected by this "ugliness"? Is there a treatment being undertaken for that occupation to become less "ugly"? Can you talk about it? ..Maurice
Retired from working a career in law enforcement, last ten years in a local jail. I have seen some personnel hired as officers that have no compassion or humanity. They either have truly a sadistic side or simply use the corrections position as a means to work other aspects of law enforcement. On the other hand some career corrections officers truly want to be there and take the time to really use their skills to work with the inmates and make the best of a bad situation. I think the biggest improvement over the last few years in an effort to train corrections personnel on how to deal with people in crisis. While we have our share of “frequent flyers” and it is tempting to become somewhat hardened from dealing with them over and over. Many times we deal with people who are decent and generally law abiding, they have just made a bad or stupid mistake and will never be seen again. As a corrections trainer I always stress to the new officers that while we may never make these people any better we at least should try to not make them any worse.
For the people on this blog as a matter of interest medical treatment and medical care in general causes the most complaints from inmates by far. They generally accept the other conditions of confinement in stride, but they have a host of medical problems and think the county should fix everything quickly. Sometimes they get it. I have taken inmates to the hospital after an inmate versus inmate fight and they will get a CAT scan or MRK stat. An officer trying to break up the same fight and who becomes injured may have to wait weeks (after fighting with workmens comps) to get an MRI for an injury suffered. It really makes you shake your head!
I worked as a CNA for many years at nursing homes and in recent years as a patient care tech. The flaws that I could clearly see was a whole lot of working short staffed. We weren't even allowed to tell our patients we were working short. But the patients paid the same bill whether they got good care or not. We were paid the same wage regardless of how many people we had to attend to. Then certain of the nurses liked to bully the CNA's. I remember one specific nurse who would actually unhook patient call lights and do things to set us up. There were nurses who treated the CNA's like the lowest of low of human life and there were nurses AND CNA's who treated the patients like kids.
JF
JF for all the good that these facilities, whether it be care for the elderly or medical facilities are designed to do. How is it so much evil can be found in a place that is designed for healing. makes you wonder. How did we get to this level of depravity towards our fellow human beings
Jeff. The love of money is the root of all kinds of evil. SOMEBODY got the extra money that those patients had to fork out. Passive income for whoever that person (s) was/is. JF
Teaching is much like the medical profession. Far too many teachers have certain kids they hate while at the same time thinking most parents are either stupid or have some other negative thought abt them. I have seen teachers talk abt the custodian and other support staff as they feel those school staff members are beneath them. They attack other teachers who don't conform to the mean girl club. Teaching is especially at the elementary level primarily a woman's world with a few mean sprinkled about and having men in the admin. positions which is very similar to the medical world. The teachers I have seen that actively harm students appear to feel completely justified in their actions. Rarely does another teacher report their actions which again is much like in the medical world. I saw one 3rd grade boy set alone and with virtually no instruction for an entire year except when I could take him to my room. Unfortunately, he was not the lone case as many, many teachers did the same. Just like in the medical world, some students would receive VIP status but those were usually children of affluent parents and/or parents who held some high position within the community.
And no, the ugliness is only getting worse within the educational system as "educators" now feel entitled to bypass parental rights and authority. Educators also are allowed to bring into the classroom their personal lives which I believe should stay private. I didn't give the kids my political opinions as I was there to help them form their own opinions and not to brainwash them into believing in mine. I would probably homeschool my children if I had any of school age. While some children are lacking social skills and I taught social skills, I do not believe I should teach them a certain political agenda. I do not believe schools have the right to hide information abt a child from their parents unless the legal system is involved. It truly is a sad state of affair when the school is teaching information that is not true science while at the same time saying although they believe parental rights are absurd in areas they have selected, they still expect parents to do the things the school system has decided a parent is responsible for such as financial support. This is so much like the medical world.
Jeff said... "How did we get to this level of depravity towards our fellow human beings."
The business model for the delivery of medicine is a bureaucracy with med profit. Once a medical institution is operating, it functions as a bureaucracy - meaning the quality of service is determined by those who directly interact with the people being served. The bureaucrats/adminstrators superior to the practice manager [the closest bureaucrat to actually managing] just fill slots on the org chart when it comes to patient care.
Today, the control freaks are attracted to medicine because they know that as long as they do the assigned tasks they can control patients with impunity. So, when you get that good care and write in to compliment, it's that small percentage of caregivers [exceptions] who treat patients the way they would want to be treated.
I'm hoping for the time when the investors in a medical institution decide to change to a business model. By replacing the administrators w/ real managers, the delivery of care would change dramatically over time with many improvements.
BJTNT
JR I sit and watch the nightly news and read all the craziness on social media and I find myself sitting there with a dropped jaw in amazement at where we have gone as a society. And it doesn’t matter which way you turn it’s insanity. From politics to the indoctrination of children in the schools to the corrupt medical establishment that is either gaslighting you or violating you. Nobody wants to get older but with the world that we are now living in I’m glad I’m up in years because I don’t really want to be around to watch the total demise of our country but that is exactly what we are seeing
Jeff,
I know what you mean. What is happening is the US is beyond scary. I, too, am glad I am old but the end of the US via the current system seems to be coming so very quickly. I worry abt the world my kids will be surviving in as I can see our country disappearing (being sold) right before my eyes and they is literally. It is no wonder medical harm happens and is growing because look at the lack of ethic, fair law, etc. in this country today. Depending on your politics, etc. you know you are entitled to harm and will receive no consequence for harming.
How about the attention to maintain the dignity of the client by the law profession. Has anyone here had the experience specifically as "the client" and how you were treated by your lawyer? Any differences from your experience with the physicians and nurses of the medical profession?
..Maurice.
Of course it's different. Lawyers don't display the naked bodies of their clients to everybody and their brother. That doesn't mean there aren't other problems though. One of my roommates was in a custody battle and every single appointment he wasn't there and had to be chased down. She won the custody battle in spite of him. Not because of.
JF
To me the comparison between lawyers and medical providers is apples and oranges. I have dealt with many lawyers and although I may have been disappointed in the outcome I was never demeaned and stripped naked by the female receptionist. I was allowed to leave the lawyers meeting with physical dignity intact
As a follow-up to the conclusion by Jeff regarding the profession of law and their preservation of the human dignity of their clients, take a bit of time and read the following article
Lawyers as Upholders of Human Dignity ( ers as Upholders of Human Dignity (When The When They Aren't Busy 't Busy
Assaulting It)
David Luban
Georgetown University Law Center, luband@law.georgetown
https://scholarship.law.georgetown.edu/cgi/viewcontent.cgi?article=1164&context=facpub
Without naming names in examples, does everyone agree with Jeff's conclusion based on personal experience? ..Maurice
Hello all,
Reddit closed the reddit nursing board. I am so glad. They bad mouthed patients and families constantly. They posted pictures of charts, xrays, EKGs, body parts, etc.. So many of them are self admittedly mentally deranged. HIPAA in many ways made things worse because now if unhinged medical personnel don't think the patient can be identified from the information they post on line they feel free to run amok doing that. It reminds me of a King of the Hill episode where some "artist" hung Hank's colon xray in an art gallery. It took legal wrangling to get that removed too. I don't want my xray or body part picture posted on line whether the general public knows whose it is or not.
As far as lawyers, they are in it for money, just like doctors. It is easier (and thus more lucrative) to prove tangible harm in cases like malpractice than it is to prove mental anguish over shabby treatment of patient dignity. No lawyer in Florida would take the case where the guy was exposed repeatedly for the sole purpose of letting the female hospital staff mock him. In lawsuits of pictures being taken of patients it is a mixed bag. It would certainly outrage many a jury but getting than far depends on local regulations and norms as far as I can tell from the multiple news reports I have read.
Dr B I read that article and found it interesting that they used the same words to describe dignity as we do to describe our medical treatment like autonomy but the descriptions that are given are all on an intellectual basis which is different from being physically violated or I should say feeling physically violated because in most cases I don’t think that is the intent of the medical provider but they never bother to take the time to ascertain if they could possibly be doing you emotional harm never asking if you’ve ever suffered sexual assault or was molested as a child, which is all part of trauma informed care which is what they did to me because instead of treating me like a human and person first I was just a number . So although you can do harm to an individual within the legal system and the emotional damages could rival that of a bad medical experience I guess people expect more from a medical provider because they are at their most vulnerable and need to trust the person or people that you have literally given your body to and then to have them violate that trust is something you don’t get over easily and in my case I probably never will
Every profession has competent members (or less so), honest members (or not), and decent people (or not). What makes healthcare unique and non-comparable to any other profession is that the customers (patients) often must undress for the staff, sometimes needfully and sometimes needlessly, in order to receive services. I thus don't see any comparisons with attorneys.
The closest comparison I can come up with are male professional and college athletes that often, as a requirement of being on the team, are made to deal with reporters while undressed in locker rooms. The rights of reporters to view undressed athletes is akin to the perceived rights of anyone wearing scrubs to view undressed patients, whether such viewing was truly necessary or not, and in the case of athletes it is absolutely unnecessary. The dignity of the athletes, as with patients, is deemed unimportant.
Jeff.
In my kind of work ( CNA at nursing homes or assisted living homes ) we were taught to treat all of the patients as though they might have AIDS. In the same kind of way all patients should be assumed to be modest. Unless the patient have agreed in advance that patients naked body shouldn't be displayed to anyone extra. Often there's no urgent need for the patients to be exposed to anybody at all. JF
Is there any way to absolutely avoid being given Versed, Propofol, or other amnesia-inducing agents when getting a surgery or procedure? I've been reading how sneaky they can be with it. Can I tell medical providers I'm allergic to it - or will this backfire on me one day? I don't have much trust in medicine right now.
Last writer, please identify yourself with some pseudonym.
With regard to your comment, you as a patient has every right to indicate to your medical or surgical provider what drugs you do not want to be administered to you. Since you also have full rights to inspect your medical records, you can determine whether your request was followed. ..Maurice.
To anonymous all patients have to list anything they are allergic to. I have it in my permanent records that I suffer negative reactions to versed so I don’t get any. The problem is depending on the procedure they are going to give you something to knock you out or the procedure won’t proceed
Hello this is Anonymous from the previous comment. Are there better or safer alternatives to versed and propofol? On top of their amnesia-inducing effects, I read frightening reviews of them online causing long-term issues for some people. I have sexual+medical PTSD and I hate the thought of not being in control and having my body unnecessarily exposed. I'm also more of a minimalist when it comes to medicine (I believe too much intervention - when unneeded - and too many meds can cause harm). I also have poor experiences with mind/psychiatric- (or conscious-) altering drugs
Are there ways to use local anesthetic + light sedation (i.e. by light I mean anxiety-reducing meds that don't come with amnesia or losing complete control) for surgeries or procedures? Whenever I ask for no sedation or just local anesthetic, doctor's look at me like I'm crazy and sometimes refuse to work with me. I'm actually a medical student myself and one time I was able to 'convince' a doctor to perform a colonoscopy on me with zero sedation and it was totally fine (and probably less risky + I got to drive myself home!). I would freak out sooooo much more if I were to undergo a difficult/exposing procedure while asleep or unconcious/unaware.
Alicia don’t feel alone I’m right there with you. I have so many issues with the way the medical community operates it’s unbelievable. I also had a colonoscopy done with no sedation and there are many other procedures that could be done with local anesthetic or regional nerve blocks but they still usually insist on the sedation, but it has nothing to do with the success of the surgery. It has to do with their ability to hide behind the drug that takes your memory away and they think if you’re not aware of them, stripping you naked, then there won’t be any kind of a problem with what they do to you. I know many people disagree with me, but I look at that the same, as I look at people that give someone date, rape drugs. It may be beneficial for a patient that is completely naïve to what is going to be done to them but for me the cat is out of the bag and I have experienced some horrible things at their hands
You may be interested to read my Bioethics Discussion Blog topic which I posted here on September 7 2008 titled
"Muslim Culture and the Practice of Medicine: Issues of Teaching a Muslim Medical Student in the United States". This topic covers the current discussion here on Volume 126..but from the Muslim points of view.
https://bioethicsdiscussion.blogspot.com/2008/09/muslim-culture-and-practice-of-medicine.html
Let us know what you think about this specific subject and what you have recently observed with this religion, if you know.. no names described please. ..Maurice.
My take on muslims and the issue of privacy is that it seems to be centered around the women. That is, a female nurse is not to see male patients of any religion in the nude. A female muslim patient is not to be seen by male doctors or nurses. It is the same in a way with our issues but does not address the issue of male patients being seen by non muslim female doctors &/or nurses. To me it matters not the religion of the female healthcare providers. Unnecessary exposure of myself (male) to female medics is unacceptable in all cases and it has nothing to do with religion.
Our religion ( Seventh Day Adventist has the same belief but I guarantee you that many members aren't aware of it. One down side of our "more than a prophet" Ellen White having written so many books and publications is that many if not most haven't read all of her writings. JF
In fact, now that I think back, there was a group of muslim women who got special privileges at the ymca swimming pool where I worked. They would come in to swim at 8:00 a.m. on Sunday before the ymca opened. It is either a locker room thing or else they don't want to be seen in swimsuits either. I guess if a group makes enough noise things can change.
Dr. B. mentioned that as a patient you have the right to mention which drugs you will or will not allow. This is true but and it is a big but--they may or may not honor it. I noticed by the way he said it, Dr. B. is aware of this too. First, in conversations with CMS which generally sets the protocol for how medical care is to be delivered, a supervisor told me that a doctor has the right to administer any drug they want even if a patient has refused it. This should send chills up and down your spine.
I have said this before that my husband told the hospital that he refused both versed and fentanyl because of prior adverse reactions. It looked at though they were noting it but not only did they plan on giving him both, once we got the medical records we saw they had intentionally omitted this information. During his registration process for cardiac rehab., he told the admitting nurse the same information. We actually saw her write it on the record. He only attend three cardiac rehab. because they delayed his start and by that time we were able to request those records and we saw that his statement about versed and fentanyl had been crossed out. It was still there but again they clearly intended to be able to drug him against his will. He didn't do cardiac rehab because he could not trust them not to harm him. Also, the nurse insisted each time that he had to remove his button down shirt in order to fit the monitor which he stated was not necessary. They stressed him out because they felt entitled to sexually abuse him. Yes, I know men go shirtless but it their choice and because he had suffered sexual abuse from female medical staff, this was and is a trigger for him.
Alicia, it is terrifying not to have complete control of your body and how it is exposed because of medical/sexual PTSD. We have found most medical staff do not understand this as they feel entitled to your body. I haven't found any type of sedation that does not affect your memory. Using a local or even a regional gives you a better chance of remembering. However, once the IV is in, they are free to do whatever they want. Sedation is a big money for them plus it gives them complete freedom/convenience. Most patients believe they must be sedated too. In Europe, it is different and they rarely sedate for procedures that use sedation in the US.
As long as patients refer to bodily dignity as a need for modesty, the medical mafia will continue to act as though bodily dignity is a mental health issue of the patient rather than a basic human right. No patient should ever be unnecessarily exposed because you don't know the gender preference of the medical provider. With the trans issue being so rigorously pushed by a political system along with the medical itself, you have no way of knowing what sex you provider is at that moment. Every patient also should be fully informed of what exposure is needed and who will be present and who they will accept to be present. This is a matter of safety for the patient. Again, sexual abuse/assault is most likely to occur when the patient is sedated or in transit while sedated. Sexual predators who work in the medical field know they are protected from discovery not only because of the system itself was constructed to protect them but they have help from drugs used in sedation. We know sedated patients are less likely to be believed if they are sexually abused/assaulted.
There is some doctor who is accused of sexually assaulting a woman in his home using drugs. However, abt a year before this, a young female patient accused him of doing the same while she was in the hospital. She was not believed. However, in the search of his house, police found video evidence of her sexual assault. It is so horrifying that patients are not protected and this is allowed to happen time and time again.
On the Muslim issue, though Muslims are a relative rarity in Northern New England, it is not unusual for me to see what I presume are Residents wearing hijabs at the large teaching hospital I get my scheduled care at in NH. I have never had a female Muslim involved in my care however and wouldn't know if I have ever had a male Muslim.
Many years ago, a family friend worked in Saudi Arabia as a nurse in a hospital for military officers if I recall correctly. I never asked her any questions specific to this discussion but I do recall her talking about how the patients liked her and how well they got along. She had a personality that drew people to her, but at the same time didn't take crap from anyone. Had any of those men been rude or inappropriate she'd of shut them down real fast.
Jr you just reminded me of something. After my heart surgery I went to rehab and had to have that monitor on my chest! They instructed me where to place it and sent me in to a dressing booth, to put it on my self and when I came out of the Booth I was fully dressed. The reason I bring this up is to show how dignity and modesty can be handled when a little effort is applied and obviously they weren’t concerned about preserving your husband’s dignity. Don’t get me wrong outside of that rehab facility they managed to degrade and humiliate me at every turn. It’s just interesting to see the different way
that the same procedure is handled
One way bolsters your dignity, the other destroys it, and it always ends up being their choice
9:35am visitor, please identify yourself with your pseudonym. Thanks. ..Maurice.
Sorry 9:35 was Jeff
Reginald wrote the following here, earlier today:
Hello,
Many here have deplored the inaccuracy of medical records. Please be validated by the following:
https://www.statnews.com/2023/06/20/medical-records-errors-copy-paste/
Take care.
Reginald
For whatever reason I'm not able to open and read. But if hospitals and doctors offices are anything like nursing homes there's a lot of false documentation that goes on. But in court documentation is accepted as evidence. As a former CNA I can tell you it isn't safe for us to communicate if and when we're not able to complete our assignments.
JF
https://www.fsmb.org/siteassets/advocacy/policies/report-of-workgroup-on-sexual-misconduct-adopted-version.pdf
Look at the list on the right side of the screen that talks about what constitutes sexual misconduct. Although this article mainly talks abt doctors, I believe it applies to all those working in a medical setting. Failure to drape/gown properly along with watching a patient dress/undress top the list of sexual inappropriate behaviors by medical personnel. Most of these are inflicted upon male patients by female staff which really does make it a sexual offense. Another article from which part of the above one was taken--https://doctors.ajc.com/doctors_sex_abuse_resources/ - gives more details. Cindy and I did a show on this today along with errors in the EHRs especially when a patient refuses a medicine. Thanks, Dr. B. for reminding me to once again to talk abt this.
There is a relatively new area on Quora which Cat is an admin for called Advocating for a Change that tackles patient dignity issues. There has been quite a lot of activity on it so people are interested.
Reginald, Thanks for posting that article. It confirms what I and many others know. Because of all the 100s of lies/omissions in my husband's EHRs, we scrubbed them and only use what we are almost sure of as we can never really be sure about anything a hospital who intentionally harms did. Even the stent card he carries, we have scrubbed the id #s, doctor, and place because we do not want any link to the hospital and the fake EHRs. We found not only libelous entries but entries that could actually harm him like fake diagnosis, fake procedures, and even fake treatment notes. I imagine this is not uncommon but many people will never realize their EHRs are dangerous.
How do I find and join the Quora community?
Alicia,
Do a search for Quora and make an account so you can ask/answer questions. I don't remember if you can just read without an account but I believe you can. You can then look and ask to join Advocating for Change if you want.
Good afternoon:
Alicia go to quora.com. From there you can setup an account.
Regards,
NTT
Is what is being dissected and discussed here to be considered "opinions" or "facts"? A worthy presentation of the contrast between the two I found on Quora
Zane Fatima:
BS English in Philosophy & Linguistics (Uni Master's), University of Sialkot (Expected 2024)Wed
Can an opinion be wrong?
Opinions are subjective expressions of personal beliefs or judgments, and by their nature, they are not considered to be right or wrong in the same way that objective facts or statements can be evaluated. Opinions are based on individual perspectives, experiences, values, and personal preferences, which can vary from person to person.
While opinions themselves cannot be "wrong" in the objective sense, they can be based on incorrect or flawed information, logical fallacies, biases, or misunderstandings. In these cases, the reasoning or the evidence supporting an opinion can be challenged or refuted. People may disagree with an opinion if they find it illogical, inconsistent, or contradictory.
It's important to distinguish between opinions and factual claims. Factual claims can be objectively evaluated and proven true or false based on evidence and logic. However, when it comes to matters of subjective judgment, personal taste, or individual preferences, opinions cannot be definitively labeled as right or wrong.
In discussions or debates, it is often more productive to focus on the underlying reasons, evidence, and logic supporting different opinions rather than simply declaring them right or wrong.
When discussing Patient Dignity here what form of expression are we using to make our point? ..Maurice.
Dr. B. That is an interesting way of looking at what is discussed here because that line gets blurred between the two depending on who you’re asking.
The medical professionals who are tending to you declare that they are merely dealing with the facts of your medical situation but in our opinion we were treated poorly?
Who is correct in this evaluation?
It depends on your perspective!
The problem is the line becomes blurred between the mentality that there is a specimen before you with an issue and then you have the specimen that actually has feelings and fears, family, values, moral beliefs in other words a human being. Not something you can treat like an object that is not going to suffer emotional harm. If someone determines that my opinion of bad treatment is unfounded who has the right to make that call ? Wouldn’t that be the sole right of the person that feels violated and aren’t those feelings as much a fact as the procedure that was just performed on you?
I came up with an analogy of what happens to medical professionals after time in their profession. Take a young boy drafted into the German army in WW2 and he has the luck of being stationed at a concentration camp. The first time he is ordered to harm or kill one of the prisoners he is horrified at what he has just done and may even suffer nightmares at first but as time goes by he becomes desensitized to his actions and it no longer bothers him. Don’t get me wrong I’m not insinuating that practicing medicine is the same as that what I am pointing out is how a human being can dull their conscience and desensitize themselves to do almost anything to another human and not bat an eye. And then you have the select few that in an effort to alleviate their own stress take a fragile and vulnerable patient and exploit them in a sexual manner to get a good laugh.
What is one person’s opinion can easily be someone else’s fact and reality
What became one person's laugh and then another persons fact/humiliation. Became the patient's reason for avoiding care that they needed and could have benefited from. It would be incredibly helpful if parents could have the ability to voice concerns and communicate to other people with the same needs. JF
Excellent extension by Jeff and JF of what was presented in the Quora writing by Zane Fatima. Thanks. ..Maurice.
Hello Dr. Bernstein,
I noted in your previous post that "opinion" was explicated; but, there was not similar amplification of "fact". Indeed, in Ptolemy's era, it was a FACT that the sun revolved about the earth. Euclid's geometry (and the shortest distance between two points was a straight line) was a FACT until Riemann's geometry was found to better fit the world in which we live. Until the 1400's it was a fact that the earth was flat. Newton's physics were totally FACTual until the General & Special Theory of relativity. Even the principles of logic might be found erroneous if, at some future date, the principle of non-contradiction might be found wanting. Finally, knowledge, our accumulation of agreed upon FACTS, has been considered as justified true BELIEFS (i.e. opinions). Where does this leave us with our bifurcation of FACTS and OPINIONS? Is the simplistic division of the two really so marked?
Reginald
"Oh my" Reginald. Without any consideration of the "bifurcation" of facts and opinions, where does that concept leave us with, such as exemplified in the title of this blog: "Bioethics DISCUSSION"? ..Maurice.
Even facts vs opinions becomes like ships passing in the night when it comes to patients vs staff. What a patient considers factual needless exposure (extent, duration, or audience) is viewed as the patient's opinion by the staff, not a statement of fact.
Healthcare poses as fact that anyone that dons scrubs is a professional and that all of their actions and thoughts are purely clinical. Patients see that as rather convenient opinion used to perpetuate a system that ignores the humanity of the patients.
Facts vs opinion? Depends upon who you ask.
Biker,
Your recent posting is very well stated per usual.
I consider this a recent improvement that never should have had to happen. When my wife had cataract surgery in 2006 and 2010 with two different ophthalmologists, she was naked except for a gown. For my cataract surgery in May and June 2023, I was told to wear confortable clothes which I kept on.
BJTNT
BJTNT, I agree that things are better than they used to be, I think if for no other reason that people are more apt to complain. My parent's generation just quietly accepted whatever "authority" told them, and that included anyone working in healthcare.
Still, though better than used to be the case, healthcare is nowhere where it needs to be. The system isn't moving uniformly to the better however. As women rapidly come up to be equally represented amongst physician ranks, which I agree is a good thing in most respects, no consideration is being given for example that perhaps the goal shouldn't be even representation in urology which is dominated by male patients, nor are there any attempts to balance the gender mix below the physician level, especially in urology where male staff is almost non-existent. This trend does not bode well for improving the healthcare experience for men in at least urology practices.
Biker wrote:
Healthcare poses as fact that anyone that dons scrubs is a professional and that all of their actions and thoughts are purely clinical...
And then they go on to prove how two faced and unprofessional they are as soon as the patient is sedated.
Dr. Bernstein,
For me it is totally subjective. It goes to how I feel about the encounter after it is over. If it bothers me for years, it was a bad encounter, if it doesn't, it was acceptable. It is the patient who is objectified by medical people. The patient is often seen merely as a way to make money, and sometimes for amusement too. I'm sure they don't give their callous shoddy treatment of patients a second thought. Objectively, taking pictures of patients is over the line. It is a hideous abuse, and should be a felony imo, even if the legal system doesn't always see it that way. Another abuse is having people sign waivers two seconds before they are put under. they know good and well people are in no position to read those.
Biker, with regard to your passing ships analogy, I understand that there is universal international marine rules regarding this passing event of ships specifically as to which sides of a ship can or cannot be passed. Does this weaken your analogy? I am not and never had been a mariner. ..Maurice.
the patient doesn't get a ship. the medical establishment is the uss gerald ford, the patient is in a canoe with no paddle.
On Quora there was a commentor who said a nurse handed him paper underwear for hernia surgery. He asked why bother if its just going to be cut off anyway. The nurse said its not going to be cut off and thats standard procedure. So, if wearing paper underwear is standard procedure in this facility, why isnt it in all? Doesnt standard mean just that? Why dont all facilities have the standard of paper surgical shorts? The ONLY conclusion can be THEY DO NOT CARE and THEY ARENT convient for the staff. Cat
No Dr. Bernstein, just as passing ships have rules, the healthcare staff vs patient rules say that a patient's privacy and dignity can be violated so long as the staff are polite and maintain a proper gameface while doing so. The other fundamental rule is that both sides are expected to make believe that healthcare is gender neutral and is always purely clinical. Patients that do not accept and adhere to these rules are deemed to be problematic and in need of being fired as patients.
Biker, I must disagree from only a personal experience and view with respect to my personal past history as a medical student educator and clinical practitioner and, of course, a patient. This is why I was more than surprised by the host of upset replying contributors after I started Volume 1 of "Patient Modesty" Well, as you know, after all these years of reading the stories written here, I am skeptical of my own initial statistical experience and conclusion about the medical system in general. I am sure I have been educated here.
In terms now of the title Patient Dignity (as first suggested by Banterings), I found an interesting relatively recent article (2017) of a study which was carried out in 2 Iranian hospitals regarding "Patients' Dignity and Its Relationship to Contextual Variables". Here is the link to access an article worthy of reviewing even regarding patients in other major countries:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5348662/
..Maurice.
I have zero doubt that patient dignity is better protected in Iran than in the usa. Some questions from the link:
Did medical staff ask your permission before entering your room? NO. NOT ONCE DID ANY OF THEM EVEN BOTHER TO RAP THEIR KNUCKLES ON THE (USUALLY) OPEN DOOR. NOT EVEN WHEN THEY COULD SEE THAT I WAS USING THAT PLASTIC URINAL BOTTLE DID THEY EVER OFFER TO STEP OUTSIDE
Did staff avoid disturbing your sleep or your rest? THEY LEFT STUFF BEEPING ALL NIGHT LONG. THEY WOULD COME IN TO MY ROOM LATE AT NIGHT TO WORK BECAUSE MY ROOM WAS A PLACE TO HIDE FROM THEIR OTHER PATIENTS. THUS KEEPING ME AWAKE.
Did male staffs take care of male patient and female staffs take care of female patient in the ward? YOU'RE JOKING, RIGHT?
As far as the proper way ships pass each other I have no clue
But I would be rude if you were to pass and not wave on your way by
Jeff said: As far as the proper way ships pass each other I have no clue
But I would be rude if you were to pass and not wave on your way by
I do appreciate a MD with a personality. When I was working and had my annual company medical checkup [my only MD at the time since I was younger and healthy then], my assigned MD at the contract medical institution was lost for a response when you greeted him.
Approximately every four months I visit my PCP. I always try to remember to thank him for not having a scribe. Female scribe is not mentioned, but it's understood that 90% [99%?] are female. Last month when I thanked him, probably with more than my usual enthusiasm, he replied "You saw your urologist recently".
BJTNT
Edgar61, I see you are emphasizing your point of view with text which was not in the Iranian study. On the other hand, the statistical table of responses to various questions presented to the patients as documented in the paper does not support full preservation of patient dignity...at least from the patient's point of view.
..Maurice.
Dr. Bernstein, a piece of this topic that perhaps has not been fully flushed out are the differences between physicians and the rest of the staff. A significant majority of the patient experience is with the staff, not the physician. No matter how well medical students might be trained to not needlessly expose patients, that same degree and emphasis in training is not likely universal across non-physician training. As I look back at the times that I felt I was needlessly exposed, it was always on the part of the staff, never the doctor.
In office practice settings one presumes that it is the doctor that sets the tone as concerns patient privacy and dignity, but it's a fair question as to how far that goes beyond being polite and some core fundamentals such as closing the door etc. It is totally understandable that a doctor might operate with an expectation that staff has been properly trained by others and that they do not need to be re-trained in these matters by the doctor.
The female sonographer that lifted my gown up to my chest fully exposing me before giving me a towel to cover myself before doing my 1st bladder scan did not expose me on orders of any doctor. She did so on her own initiative. The same can be said of the female sonographer that did the same before a testicular ultrasound. I doubt my urologists ever told the female RN's to leave me exposed after the cystoscopy prep was complete & we waited for the doctor, but told the male RN's to cover me up. I doubt a doctor told the RN to, moments before putting me under for my 1st bladder cancer surgery via my penis, to say in a decidedly sexual manner "we're going to get to know each other very well". When I was an inpatient for a cardiac ablation I doubt it was the doctor who decided that I wouldn't have my groin shaved one side at a time in private while keeping my genitals covered and to instead do it after I was sedated and naked on the table in front of at least 6 people. The doctor just expected I would be fully prepped when he entered the room. It was the staff that decided to shave me before an audience.
Dr. Bernstein, this was a long way of my trying to explain the difference between how you trained medical students and what we patients keep complaining about. It isn't the doctors. It is the staff.
Biker,
While you are correct in saying the staff is a huge issue, it is also the doctor during office exams that comes in with the unannounced scribe or the young female chaperone. They do have a role in all this but I do agree a lot of times it is mainly the attitude of the staff. I do know that some doctors and one in Florida comes to mind that is present in the OR to position the patient and therefore, is part of the problem.
When we recently addressed a cardiologist about his female MA's behavior, he certainly acted as though they do have the right to require whatever nudity they feel like at that time. I patiently explained to him again about Trauma Informed Care and patient dignity and also mentioned that I do a weekly radio broadcast about these issues. I did also say to him that as head of cardiology at the hospital, he should want to make these visits as less stressful for patients so outcomes would be better and that patients would continue to follow-up. I gave him Misty's brochures for both men and women. I also reminded him that sexually abused patients are also leery about medical providers and their methods just as a woman who has been raped going to her car will be more on guard in the future. This time I also reminded him that sexual inappropriate behavior is just not a male provider sexually penetrating (or other sexual acts)a female patient but can be any medical person who acts in a manner of authority to sexually harass or intimidate a patient. I reminded him that unnecessary exposure is for the benefit one person the medical staff which makes it sexual and that no medical staff should be putting their hands on a patient to undress them unless the patient has asked for help. I again gave him information of the medical bras for women and COVR garments for all.
JR in summary what was his response to all of the points you presented to him?
Was it one of indifference or did he act like he had any genuine concern?
On the other hand, the statistical table of responses to various questions presented to the patients as documented in the paper does not support full preservation of patient dignity...
I am not surprised. Also, I did not realize that I had scrolled past the body of the Iranian study. Apologies for that. That you all for accepting me into this community.
Jeff,
He probably will do nothing. He said thank you for the info but it probably went in the trash when we went out the door. I don't think they truly try to understand how it feels from the patient's perspective. It is very traumatic for my husband to have some female medical member order him to strip his shirt off and to have her lunge at him. I pity the women who have a male MA as this office has one and he tells them to strip from the waist up for the EKG. Of course first, they would have their blood pressure taken while they are sitting there naked. Not a problem?
JR,
What you said about him telling you Thank you, immediately made me remember an incident that happened at one nursing home I worked at. Some kind of scandal happened and our Director instructed us to thank whoever questioned us about it and refer them to a nurse. In that case telling them Thank you was just a politely ignoring them. JF
JF,
I think so too as I had a milder talk with him before where he said he would put me in touch with the appropriate people at the hospital to talk to them about patient dignity but he never did. I believe most medical people believe they have the right or are entitled to handle a patient's body and care in the manner in which they see fit. I believe they are taught differently via the books but in learn this in practice.
Hopefully, you can reach and read this article in Medscape Medical News:
https://www.medscape.com/viewarticle/993522
"You Can Dismiss a Difficult Patient, but Should You?"
Is there anything in this article that might support your views of the doctor-patient (or better still on this blog thread:
"patient-doctor" relationship???)
..Maurice.
Dr B
My phone wouldn't let me read the article. I know in my job I had to still attend to patients/residents who were abusive. I also am aware that sometimes it's the staff who are abusive. I don't know what my opinion is a about your question but wouldn't it be awesome if the abusive staff and the abusive patients should have to deal only with each other? JF
Dr. Bernstein, I read the article and thought it was very well stated. Patients can fire their doctor at will, though in rural areas finding a replacement isn't necessarily easily done. At the same time I agree that doctors should be able to fire patients for the kinds of reasons stated in the article, while recognizing the process and potential legal aspects of doing so.
I wanted to encourage everyone to bookmark this other blog that has articles about abuse in medical settings: Medical Me Too.
Misty
Did anyone else see about the LPN Nathan Sutherland getting a comatose patient pregnant? According to other staff he seemed like a normal person and even a Christian. But most medical sexual abuse doesn't end in pregnancy for the victim. Even if it would it would still be questionable whether it was done in the medical settings or out and about. It just illiterates how criminals can pass off as normal decent people if and when that's what they want to do. JF
I am scheduled to go in for ketamine infusions next week and was wondering if anyone had any knowledge of the treatment. I have been seeing a psychologist once a week for a couple of years and have made absolutely no progress in the alleviation of my PTSD from all my medical experiences.
I guess this is a last ditch effort and I am hopeful that this can alleviate the constant nightmare I live with.
I wish so much that I could share with the medical community the amount of damage they did to me and I’m sure many others but they have proved to me time and time again that they just don’t care!
One of my sisters has talked about a procedure EMDR that took a big chunk of her trauma away from her past devastating memories. She highly recommends it. If you're interested maybe check and see which insurance covers it. JF
Jf I'm holding on to the EMDR card in the event the Ketimine doesn’t work
Jeff,
Ketamine infusions are kind of a scary prospect. I went on the DEA.gov site and Ketamine is pretty a versed like drug. I know they are using it but again, they say they have no idea why it may work which would worry me.
What are you trying to achieve with the infusions? Do you want to totally forget what happened? If so, a good hypnotist can usually wipe your memory. One offered this solution to my husband which he did not accept because he said he doesn't want to be ambushed again. One of the things we use is Kava Kava which relieves stress. St. John's Wort can also be helpful. We don't use it but will say we do if ever questioned by a medical provider because its use prohibits the use of benzos which versed is one. Of course, the medical community does not like Kava but for us, it works. We also use music, hobbies, work, our animals and other diversions such as walks to help with the PTSD. There are triggers which we cannot prevent like seeing some bleached blonde bimbo in scrubs in a store or one on tv. I also believe in Karma which gives comfort. People always say they wouldn't wish what happened on their worst enemy but why not?
JR I have done a lot of reading on this and what it’s goal is it allows the brain to re wire your Nuro transmitters . It is scary because how much it changes you as a person I don’t know but all the evidences so far are very promising. I just don’t want to keep living like this. It’s very expensive and insurance doesn’t cover it. I wish I could give the bill to the hospital that did this to me
Emotional ventilation can also be therapeutic and that is why I am pleased that this blog thread and those on other subjects within this whole blog itself permits such emotional ventilation. So, in some ways, you can instill blogs like this as a routes to physical and emotional therapy. And there are no therapeutic fees charged! ..Maurice.
Dr.B that is why I vent so much on this site.
It allows me to express the thoughts that trouble me so deeply. The more you internalize these feelings the more damage they do
Thanks for the no charge part of it, with all the venting I do I’d be broke by now
Here is a question to my writers of a blog thread, never discussed before, where a whole host of emotions are being expressed by those writers to the readers: what is the role or value of being able to publish on a blog such as this: a writer selected EMOJI as an addition to the published text? I see no blogger.com function allowing emoji publication but out of trying to understand the quality of what is being written by my visitors: if you were able to insert emojis on this blog or blog thread would or should that be acceptable and of needed value? Can a true understanding of the nature and degree of agreement or disagreement with what is or has been written can be expressed with a published emoji? Can quality and quantity of an issue be simply and directly expressed with emojis? Do any of my readers or writers here have experience with reading or writing emojis on other internet resources? What is your opinion both as a reader and possibly a writer here. ..Maurice.
https://www.newsweek.com/former-nurse-who-sexually-assaulted-impregnated-incapacitated-woman-gets-10-year-sentence-1655664
Sexual abuse is an ugly heinous thing and I hope this doesn't come out wrong. But I wonder if the boy conceived through that nurse abusing his patient might possibly been a huge blessing to his family. He would likely take his mother's maiden name. I hope I'm not belittling how horrible what the nurse did. He deserves the 10 years. JF
JF her doctor didn't even know that she was pregnant until she delivered the baby. That's some fine medical care all the way around.
This comment has been removed by the author.
In today's 12:42 posting, I found I was able to incorporate an expressive EMOJI (a thumbs down) to be actually published but I removed it.
I still would like to hear from our readers and writers here about the role of EMOJI use and the "good and bad" properties of these graphic expressions as some point is attempting to be made by the writer to a reader. Would an EMOJI actually distract from a valid attempt for the writer to make a point? What do you think? No EMOJIs yet to be published. ..Maurice.
Dr. B I use emojis occasionally but I’m not that big on them personally.
Jf hearing what you had to say about that baby that was conceived through the sins of another reminded me of a guest speaker that came to our church to give a talk. What she declared to the congregation blew me away. She was the product of rape and her mother decided to carry her to term. As I listened to her speak with such eloquence and a kind loving heart I couldn’t help but think what a loss this world would have suffered had she not been allowed to come into this world. God can raise mighty people up from the pits of hell. We live in a cruel world, but there are rays of light if you look for them
I use emojis when I text and stuff but with the tone of this subject matter I just can't think of any I would use much here. It is a nice idea so it wouldn't hurt to try. I guess it would depend on which emojis were available.
I would push the like button or dislike button if we had that option. Occasionally I would push the barf button to.
JF
JF. Jeffery Dahmer was a nice quiet person according to his neighbors. Al Bundy was this wholesome guy. Every murderer out there had people talking about how they are in shock he/she was so respectful and helped everyone. Cat
The great Dr Nassar just git stabbed in prison. Karma is getting him back Cat
I would use mostly monsters and demons LOL
I went to my new dermatologist today for something on my back (which has given me problems before). He had a youngish female PA who did the initial assessment. I had to take off my shirt for her to look at it and it was a bit uncomfortable but not just awful. I'm so glad I wasn't there for something below the belt because I am horrified that I would have complied. Scratch that, I KNOW that I would have complied. I get the feeling this guy is decent and is really close to where I live so I want to keep going. egad I just hope that day never comes when I have to cross that bridge.
Is this a distinction without difference?
I accept female MDs [forgetting the incompetent female hospitalist], but not any other female caregivers, including PAs and NPs, for below the belt exposure. Starting thirty+ years ago, and for the many years that she stayed in the same medical institution, my then female PCP did my last physical exams including below the belt - acceptable. Now the MDs relie on lab panels and my current MD involves no touch labor even though he used to verify my blood presure taken by the MA [they have finally learned that the arm doesn't have to be bare]. Or is it simply now that I'm an old man it's not worth the effort - I've lived long enough per my MD's decision [I like and respect him]?
BJTNT
I don't have a need for emoji's myself as I never use them but don't care one way or the other if others do.
Good evening Gang:
To answer your question (is it simply now that I'm an old man it's not worth the effort) BJTNT, the older we get, the less they do.
The so-called physical I get nowadays consists of check BP, do EKG, get blood work results if any, & that's it! In & out in 10 minutes.
We've been put out the pasture.
Have a great evening Ladies & Gents.
Regards,
NTT
Good Morning:
I've been pondering on a thought.
Due to no cause of their own, women lost & want their reproductive rights back. They don't have the votes to go it alone & get them back.
Men want their dignity & privacy in medical settings.
Might there be common ground here to come together & help both sides?
I wonder.
Regards,
NTT
NTT, good point. I wonder if JR and her active participation in her media resources is satisfied with her spreading "the word" regarding both genders and all the permutations also within transgender potential patients. Maybe the court system needs to be the resource. JR, any observations and suggestion in this matter of preserving dignity for all genders. ..Maurice.
There's a lot of Republicans in this group so I'm surprised nobody is chiming in against abortion.
(I'm not a Democrat I'm just very much against a certain person who is a Republican ) In my opinion the only good time to avoid having a baby is BEFORE a pregnancy has started. Vasectomies and tying tubes. These things can be reversed later on. So why isn't it done oftener? Possibly because the cost is higher than can be afforded? JF
Dr. B.,
Because of all the "permutations" is why I say that unnecessary patient exposure must be stopped. You can be a female patient with an all female team and still suffer from sexual abuse/assault whether they do it for outright sexual pleasure or from a sense of getting a thrill from being a person in power and control over a defenseless individual. I find so many people do not understand this and believe that same gender care will cure this. No, it won't because you have no idea about the sexual preference of your medical care team. That's why unnecessary exposure must stop along with other safeguards in place for the patient such as a person of their choice to be present at all times as well as if the patient wants to have the encounters visually recorded and all video given to the patient for their safekeeping. I also preach that all patients have the right to be informed of any genital exposure for any encounter and to also have the right to say who is present. I constantly repeat that chaperones are not there for the benefit of the patient but to protect the provider from any claim of misconduct from the patient. No patient should trust that a provider's paid staff member is there to protect them. Dr. B., I have suggested to you more than once that it could be an experiment for some of the harmed patients and/or their spouses to take part in a discussion with some medical student and/or medical providers/teachers/hospitals. I believe actually hearing stories of patient harm from harmed people would have an impact such as MADD does with students around prom time.
As far as the legal system (court) being a resource, the legal system has already proven they care nothing about patients. The legal system allows for the continued abuse/harm of patients when a patient files a malpractice claim. The legal also has proven it is not a good system to safeguard the rights of all individuals. I think there should be a system that is made of harmed patients (or those who truly represent patient rights) as well as legal/medical. It should be an equal mix of the two and I say two because I feel otherwise legal and medical would almost always override the patient position.
Yes, I guess I do get a certain amount of satisfaction from "spreading the word". Like most harmed patients, my husband and I know he will never receive justice for what happened to him. I do believe in Karma and know that eventually Karma will be delivered. We most likely will not know it but I do have faith in Karma as I have known of other deliveries of Karma. In fact, someone sent me an article abt an abusive doctor who scammed elderly patients forcing unnecessary procedures on them. This doctor bought a plane with his ill gotten money and I think you know where this story is going. He died in that plane. Cindy and I do weekly radio broadcasts that have been steadily growing in views. I still do social media and I talk about medical harm whenever I have the chance. I do get satisfaction from knowing I will not be silenced by the medical mafia but also I am sad that since covid, it seems medical harm is growing at an alarming rate as they got away with the biggest scam of all and show of power and control.
JF,
Having a vasectomy or tubal ligation is a very drastic measure to prevent an unwanted pregnancy. While there is a higher success rate for vasectomy reversal, a tubal ligation should be considered permanent. I have also read that a vasectomy is not as high in preventing pregnancy as a tubal ligation. There is access to free birth control as well as simply restraining from have unprotected sex in the first place which costs absolutely nothing. Tubal ligation is not done as often as vasectomies not because of finances but because the medical world has deemed this not acceptable for a woman of child bearing years unless they want to be transgender. So much for their crusade of saying a woman's reproductive rights are being violated by the SCOTUS abortion decision when many of them deny a woman control of her reproductive rights in wanting a tubal ligation. Just one of the many conflicting views of the medical community. Of course, correct me if I am wrong Dr. B., but most catholic hospitals will do neither vasectomies or tubal ligation but that may change with the progressive and different pope who still denies children are being sexually harmed by his workers.
It is scary to "be very much against a certain person" for no apparent reason that allowed a person to be in charge who has no issue in killing babies. It was no secret that Joe felt this way. Abortion should not be a political issue but rather should be a moral issue. Making it political as has been done only serves to divide even more. I feel that anyone who allowed Joe to be in office should not be upset about the abortion supermarket when he was very clear he would do whatever he could to guarantee the murder of babies or fetuses as they are called if they are unwanted. Maybe we should pass a law defining when we can call a being a baby or must call them a fetus?
Dr. Bernstein,
I am not a big user of emoji's myself and would not add them to my posting but don't mind seeing them.
I have to agree with NTT on the subject of physicals. They are really simply a wellness checkup. I go in tomorrow for my annual and do not expect to be touched except for bp and perhaps my doctor listening to my heart/lungs. I have thought about asking about a DRE just to see the expression on his face, but will leave that for the urologist. I have been having more urination problems the last year and my PSA jumped from 2.2 to 3.9 so I afraid I will be going for an urology consult. It will be interesting to see if my urologist (male) tries to bring in a female observer/student like last time. I am hoping it doesn't reach the point of submitting to unpleasant procedures/testing but if it gets to that I will comment on my experiences with testing such as Cystoscopy, urodynamics, ultrasounds, and biopsies etc as it relates to having male personnel available.
Next week I have my long awaited/dreaded colonoscopy where I will be doing it without any sedation since my doctor expressed that he had never heard of colonoscopy shorts or that any bad behavior had ever occurred during the procedure. I am tempted to print out an article on colonoscopy shorts as well as the story where a man recorded the OR staff dogging him once he was sedated, but it probably wouldn't register with the doctor.
EM
EM, giving the doctor literature on colonoscopy shorts is a good idea but I wouldn't also give him anything about abuse stories as that could come across of accusing all gastroenterologists of the same no matter what you say to the contrary and would take away from the educational benefit of colonoscopy shorts literature.
An aspect concerning colonoscopy shorts having been developed at all is why were they deemed necessary if there isn't any needless exposure of the genitals? That and the fact that I have yet to see commentary from staff involved with colonoscopies saying that patient genitals are never exposed. This is telling given they only need access to your backside.
colonoscopy shorts or a jock strap are a great idea. what kind of doctor wants people's private areas getting all over the equipment? don't let them dare try to tell me that they try to keep that ridiculous gown on while they are manipulating patients bodies all about. I have seen how the nurse rubs and massages on the abdomen to get that instrument to make the turns. you would think that if the nurse had any self respect she wouldn't want that either.
This is what the world is coming to:
https://www.cnn.com/2023/07/13/us/ohio-doctor-tiktok-license-revoked/index.html
Edgar,
I find it ridiculous that some medical professionals argue that removing underwear for procedures is for sterility reasons. I do not like the idea of people’s private parts touching equipment. I think patients’ private parts should be covered as much as possible for sterility reasons.
Have you seen this article I helped to write on Medical Patient Modesty’s web site: Unnecessary Underwear Removal For Surgeries?
Misty
Everyone is encouraged to check out this new case we received by a man who had a horrible experience with a female ultrasound technician at href="http://patientmodesty.org/modesty.aspx.
Misty
And for your comfort as a patient, how do you expect a physician should be dressed? This was discussed in a blog thread from 2008
https://bioethicsdiscussion.blogspot.com/2008/06/how-would-you-want-your-doctor-dressed.html
And here is the response from one anonymous writer:
At Thursday, June 19, 2008 10:01:00 AM, Anonymous said...
I don't think I would mind my doctor wearing casual clothes during an office visit or discussion of my health. But during the physical exam procedures I would prefer the traditional attire. Picturing my doctor in street clothes giving me a breast or pelvic exam would make me very uncomfortable. Somehow the white coat advertises the doctor's credentials, and that it's OK to be naked in front of him. For me, the environment at such times should be 100% clinical in appearance.
..Maurice.
Misty yes I have read and visited patientmodesty.org a number of times. Thank you for the link. (I wholeheartedly agree btw)
Dr. B. I never really thought about that but my old urologist whom I have a low opinion for other reasons always wore street clothes, including shiny leather street shoes. Now that I think about it that is one more thing to not like about him.
To alleviate these types of concerns, we recently started allowing spouses / partners of our high-risk surgical patients to put on a scrub suit and accompany their loved one into the O.R. and stay with him / her through intubation, prep and all the way up to ‘Time Out’ (right before incision). We have found this avenue to greatly enhance the comfort our patients and their families not just in terms of patient dignity, but also in terms of comfort for out patients as they drift off. The only exception is an aortic trauma case or a dissection, where time is so urgent that we literally are trying to get the chest open as fast as possible.
This is a reply i just read on Quora. She is a first asst for cardic surgery. WHY cant all facilities be like this? Not just for these types of surgeries, but ANY. This doesnt mean the jokes dont come after the family member leaves, but in MY eyes it does show you have a more professional team. Cat
EM. Buy a couple of size larger "tightie whites" cut a hole in the bottom 1/2 of the flap, then put them on backwards. Dont say anything and just dont take them off. They ONLY need access to your rectum and they have that. My husband asked his dr at his appt but never said anything to the staff. Yes, one nurse laughed when he rolled on his side, saying she never saw this before. Well now she has and another nurse and the doc afterwards said it was a very clean colonoscopy. So now 3 nurses have seen shorts be worn and HOPEFULLY will not agrue with patients in the future, knowing full nudity isn't necessary. The thing that bothers me is his doc had ABSOLUTELY no problem with the shorts, but my husband had to ASK. Why isnt it given as an option 100% of the time?
Opps shorts comment was from Cat
My OB/GYN has 6 docs. Only 1 wears street clothes 100% of the time. 2 wear the light blue hospital issued scrubs with one of them wearing a lab coat. 1 wears scrubs 1/2 the time, but in various scrubs other times. 2 wear their own scrubs. Cat
If they are unnecessarily exposing me, I don't care what they wear as the clothing doesn't make the crime any the less. I believe that the wearing of scrubs/whitecoat seems to make them feel more entitled to their need for power and control. Scrubs/whitecoat is seen as a badge of authority that most of the public has been taught to obey.
I find women dressed in scrubs triggering even in public settings because of the negative experiences I have had at their hands. I know that may not be fair to a vast amount of medical workers that wear scrubs but I can’t remove the trauma that was caused me by people in that kind of apparel. To me it has become a badge of disrespect and cruelty
Admittedly part of me is old fashioned and might prefer that professionals dress the part, but Northern New England is culturally very informal, including our manner of dress. People generally don't feel the need to impress in this regard. I am thus accustomed to healthcare staff dressing in a more casual manner. It isn't anything I think about when I have an appt.
I read the reddit nurses forum daily, and it is back up. It is frightening how many have mental problems. Anxiety, adhd, the list is endless. then there is the self treatment by substance abuse. I would guess that at least half on that forum are total basket cases. then there are the callous, hateful, and sadistic. It is pervasive. I view the medical establishment like a male black widow spider views sex, get in, and get out, without being killed by her. it is sad.
a quote:
This woman shared something that completely changed my perception. She has massive complications from a surgery (20 additional surgeries, her final one this coming week). “I’m scared. Over the past few years I’ve been treated so badly post-surgery. Why are they working as a nurse when they make me feel like they hate me?”
https://www.reddit.com/r/nursing/comments/151vr8g/casual_conversation_with_a_customer_changed_my/
Is this observation a change in our social norms or just a one-off?
We have attended many live performences at four different theaters in the past 25+ years.
Last Saturday, during intermission, a man escorted a 9-10 {?} year old girl [father, daughter {?}] into the men's restroom. When I was leaving another man escorted a 8-9 {?} year old girl into the men's restroom.
Granted the live performance was The Wizard of OZ which had more children than usual in the audience. Then again, this theater usually has one play each season that appeals to children, but this was a first time experience for me at any theater.
Is this experience a change in our social norms or just a one-off?
BJTNT
To All that offered advice on my upcoming colonoscopy and the concept of wearing dignity shorts - Thank You.
I think I will simply provide the doctor with a printout describing colonoscopy shorts and not hit him with stories of abuse. He reacted somewhat negatively to my initial discussion so I don't want to antagonize someone who will be performing an intimate procedure on me. If this was going to be a regularly scheduled procedure, I probably would have found another doctor who was more sympathetic. With any luck, it will be uneventful and not needed again for 5 years.
I am going non-sedation so I can control or attempt to control exposure.
I never thought about how doctors were dressed before but I am generally conditioned to expect a white lab coat. I do think my PCP wears a polo type shirt that is branded with the practice name and his name. I guess I need to be more observant in the future.
EM
Looking around at the rest of our world I would say it’s the new norm
I have a feeling that Jeff's last statement was a response to the posting BJTNT had written here yesterday. And Jeff, you beat me to the "punch" with regard to the significance and possible etiology of what BJTNT had observed, disquieting him. If there was a large number of children at the concert, it could be that there was a good possibility that some of the biologic pre-teen females had changed their active gender to males and their decisions was supported by their fathers who escorted them to where the youth expected to go: "men's restroom".
I think the subject matter presented by BJTNT was very appropriate to discuss on this blog of bioethics which should stress the maintenance of personal dignity.. in this case the dignity of pre-teen biologic females who have changed gender. ..Maurice.
Hello,
I had a DVT Ultrasound today for a possible (probable) leg blood clot. During the visit I noted two glaring breaches of patient dignity. (Maybe there should be a survey category asking for noted breaches of patient dignity?) The first breach was when a couple arrived for a visit they thought was scheduled for today. They were told that the appointment was actually scheduled for 22 Aug. Both were sentient-appearing individuals who had obviously been having trouble navigating the health care maze. They were older adults, possibly in their 60’s. The facility did not make appointments; instead, patients were referred by doctors only. The receptionist could have easily called the doctor to verify the date of the appointment to, at least, appear to be helpful. Instead, she merely reiterated that the couple was mistaken. As the couple left, I followed them out the door and suggested that they call their doctor to verify what they had been told. They thanked me for the common-sense advice. Why couldn’t one of the three receptionists have done this? It was such a blatant disregard for patient dignity.
The second incident involved me personally. I was called to the ultrasound room and the tech identified himself. I asked about the diminutive young lady accompanying him. He said, “Oh, she’ll be with us today.” Red Flag. Blood pressure alert. I’ve been following Dr. B’s blog for too long to fall for this! How does one respond to this breach of patient dignity? I had an appointment in an hour and was dressed in a shirt and tie. I’m 79 years old and have multiple university degrees. Is this the response you give to me – or to anyone for that matter? A respectful question deserved a respectful answer. “Oh, she’ll be with us today” meant, to me, that the young lady was learning the procedure. Why the subterfuge? What was wrong with telling the real reason for her presence? As with the above instance involving the lost couple, what was wrong with a dignified approach? They left me to disrobe. When they returned, I mentioned to the tech that I’d be more comfortable if the young lady was not present. (A response I learned from this blog.) He asked her to remain outside. I said nothing during the procedure, only responding to questions. I thanked him at the conclusion of the procedure.
When the PCP notifies me of the results I’ll ask for a referral to another surgical practice. I’ll be asked why, and I’ll respond with my tale above. He’ll think I’m an idiot and say that this is the only practice available. But, hopefully, he’ll pass my concern along to the practice and, maybe, other patients will be told the true reason for the presence of unnecessary individuals. The practice will probably place a note in my file that I’m a “difficult patient”.
I wish all of you well and very few medical encounters. Things haven’t seemed to have improved.
Take care.
Reginald
Hello Dr. Bernstein,
Can the many years of postings on your blog be summarized as a desire by patients to have their dignity requirements respected by health care personnel? Instead of dropping the Hippocatic Oath, maybe it should be extended to read “First do no harm to the physical, emotional or spiritual dignity of the individual”. Where “dignity” is defined as the values which an individual cherishes regarding his or her bodily, emotional, or spiritual care. Is this such an insurmountable task for healthcare? Could this expression of dignity also be extended to the nursing staff? Could their dignity be respected with fewer patients per shift? Doctors could also be afforded the dignity of their decisions without interference from insurance or bureaucratic “bean-counters”. Rather than the statement “leave your dignity at the door”, instead, should the sign read “How can we enhance your dignity today?” Rather than the tremendous number of useless intake form questions, how about “How can we respect your dignity during your stay with us?” Please, please help me to see why the respect for patient dignity is such a formidable task in health care!
Reginald
We have had writings about the topic of how doctors and nurses should treat patients who are also doctors and nurses on this blog.
I thought, it has been a while since this issue has been described here, so it might be helpful to bring up a research study of this topic. I decided to put up a link from the British Medical Journal published 8 years ago. Here is the address:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735183/
An interesting question I would bring up here and now: Should ill doctors or nurses be treated by doctors and nurses as if they were not doctor or nurse patients? Should treating them not as sick professionals but as "a patient" be the most effective way of reaching the best of professional behavior to ALL patients? ..Maurice.
Doctors and nurses shouldn't be treated like regular patients. Regular patients should be treated like doctors and nurses. JF.
Dr. Bernstein,
JF makes a great point. Let's not lower the bar. Let's raise it for everyone. More dignity for everyone can only enhance our entire society.
Reginald
Reginald, I agree with what you just wrote. Now, in the United States, let's make sure that every politician "raises the bar". I am not sure that they are all following that rule regarding dignity. ..Maurice.
I believe NH has very strict laws regarding patient dignity/rights. WHY cant/wont other states follow suit? Maybe everyone should start going there for their healthcare. Its a gorgeous state ( we go there for breakfast often). Cat
CAT, what NH laws are you referring to? I get all of my scheduled care at Dartmouth and have found them to be far more professional than what I have experienced elsewhere but I just assumed DHMC was a more modern operation in this regard. Not perfect but better.
Good evening Everyone:
This is in 2 pcs.
Part 1.
I have a Theory
Society has branded the male species as not having any modesty which is why today's healthcare system treats men the way they do.
I believe the origin of this stereotype has its roots back in the 1920's.
During the 1920's there was a construction boom across the country of public swimming pools. YMCA's, schools, cities were all in on it. They were built to promote fitness & teach swimming lessons because at the time there were a lot of drowning deaths across the nation.
During the same time frame, the country was also obsessed with personal hygiene & fighting disease.
Health officials back then worried that if they allowed potentially dirty fabrics into public pools the fabrics could introduce germs and germ-killing pool chlorination had not yet been invented.
Also, the pools of the time had primitive filtration systems that could have been easily clogged by fibers from the fabric of the swimsuits worn at the time.
So, in an effort to keep bacteria at a minimum, pool filters from clogging, & ensure MALE swimmers were clean, a group of what were at the time called public health professionals from the American Public Health Association (APHA) came out with a recommendation in their 1926 standards handbook:
Get this.
XXI. Suits, Towels & Caps.
A. At indoor pools used exclusively by males, nude bathing should be required.
At indoor pools used exclusively by women bathing suits should be of the simplest type. Suits when used should be of wool or cotton of simple design and of undyed material or tested for fastness of color.
These weren't regulations from the federal gov't., they were just recommendations from a membership group of so-called public health professionals. For reference, I use the word so-called because IMHO, these were the dumbest recommendations EVER made. They actually believed at the time that making males swim without bathing suits would keep pools cleaner.
Even though they were just recommendations, those guidelines turned out to be more influential than anyone ever thought they'd be. They had NO CLUE how far reaching these recommendations would be to the future of the male species.
Those recommendations steered policies at YMCA's, schools, & boys clubs all across the nation for DECADES. Even mothers thought that if public health professionals thought it best males swim naked, then sobeit.
The practice became so wide spread that if a pool didn't have the policy in place they were out of step with the rest of the country.
As far as the double standard for boys & girls goes, things were different back then & double standards were just an accepted norm.
Hence ladies & gentlemen it is my theory that by making those far-reaching recommendations those so-called public health professionals of the time inadvertently created a new stereotype about males not having any modesty & hung it on the male species & in turn our healthcare system picked up on the stereotype & has been running with it ever since.
By mid-20th century better & more effective chlorination had been developed, pool-filtration systems were dramatically improved, & bathing suits were being made different so the concern about pool germs & fabric fibers became a thing of the past so in 1962 the APHA rescinded its recommendation that males be required to swim naked.
Although the recommendation was rescinded, the damage to men & boys had already been done & engrained in society. Some schools & colleges kept that policy in place for another 20 yrs. even over some parent's objections. To pass it off on the students, guys were told that girls have more to show & guys have only one thing which is why they have to wear bathing suits.
Part 2. The Theory.
As the 70's rolled around, guys started to rebel against the policy. I know one HS in Chgo. where when the guys were told to go get ready for swim class, they said no then proceeded to break a bunch of glass & threw it into the pool. Pool had to be drained & refilled. They were told to get ready & they did it again. More glass in the refilled pool.
By the end of the 70's nude male swimming came to an end because schools still doing it couldn’t fight federal Title IX rules that required equality in physical education classes. Gym class were going co-ed & co-ed naked swimming wasn't in the cards.
So, the recommendation died back in the 60's, society stopped the practice in the late 70's, but the damn stereotype lives on 98 yrs. later fueled by the american healthcare system's refusal to change their ways.
That, is where we are today. The pieces fit like a glove but, it's just my explanation from researching articles & talking to people though.
That's all for now.
Regards,
NTT
NTT, I grew up in a community that didn't have a community pool or a pool in the schools, and my family couldn't afford for us kids to join the YMCA. Off I go to a predominantly male college in Massachusetts in the autumn of 1971 and find out during orientation that all boys have to pass a swimming test and fitness test. I show up at the appointed time at the pool with my bathing suit only to learn that boys were not allowed to wear suits in the pool. Thus I found myself standing in a very long line of naked freshman boys waiting our turn. Not having had lessons or much opportunity to swim as a kid, I failed the swim test (but passed the separate fitness test), and as a result was obligated to take a remedial swim class as one of my gym requirements. Those classes were also held in the nude. Note all of the testers and instructors were male and the remedial swim class was all male. I never saw a female there. Note also that this was a brand new state of the art athletic facility and would have had whatever the then latest filtration system was. I guess it was just tradition at that point rather than filter necessity.
Girls were not required to take any swim or fitness tests.
Good morning all.
Hi Biker. Unfortunately, high schools & colleges were still enforcing the practice in 1971. Young men started rebelling against the practice in 1974.
Title IX federal regulations weren't issued for athletics until July 1975. High schools and colleges were given three years, and elementary schools one year, to comply. So the rules weren't enforced on colleges & HS until July 21, 1978.
Have a great day all.
Best regards,
NTT
Hello, I've had some health problems and posted this review, hoping things will change.
I entered the office with a tucked shirt and tie. I was asked by the female tech to remove my shirt for a chest X-Ray. After the X-Ray was completed, the tech indicated that I could re-shirt. Obviously, there was no way to replace my shirt without unfastening my pants and lowering them. This was rather awkward with the female tech present. Usual medical protocols indicate that patients should be given privacy when dressing and undressing. I wondered why the tech didn't direct me to a dressing room. She could have easily directed me to a dressing room around the corner. On a previous X-Ray for my wife, my wife was directed to a dressing room and given a gown. A didn't need a gown but, a little courtesy when re-dressing would have been appreciated. I hope that the office reads these comments. Men are not as ready to ask for privacy accommodations as women are. Nevertheless, men also appreciate privacy. "Equity" is a word we often hear today; nevertheless, it doesn't seem to apply to men. I hope the office considers adjustments to their protocols for men.
I keep trying!
Reginald
I'm a medical student and I chronically feel so much distress, anger, anxiety and sadness about how medical culture approaches patient dignity. It is so hard to go through. I feel like I'm one of few who cares to ask patients ahead of time (before they're in a vulnerable position) if it's okay for me to watch or participate. A lot of medical students feel that it is their right to watch in order to learn, even if its a specialty they are not interested in pursuing. It feels so voyeuristic to me, especially in situations where patients are more vulnerable such as L&D wards and surgery. Truly the person who matters most here is the patient - us medical students have lots of opportunities to learn and many patients feel comfortable with us watching/participating. I feel like I'm being overly sensitive when I see how much other health care staff are so careless with exposing patients, ESPECIALLY when they're sedated. My significant other is also a medical student on an OBGYN rotation right now and I'm losing sleep over the stories he is telling me. This leads me down internet searches where I find many negative stories on forums of what patients have gone through during gynaecological issues/surgery/pregnancy experiences. It makes me so sad and sick to my stomach with anxiety. I know I will do better for my future patients - I already do what I can and it is appreciated. But I feel hopeless since it is so widespread. I'm honestly so unimpressed and disenchanted with how unprofessional people in medicine can be sometimes. Things in medicine are done that put patients in very uncomfortable positions that are not even necessary or evidence-backed (a few examples: shaving hair before some procedures/surgeries, manual cervical dilation checks, manual pelvic exams, unnecessary catheters, unnecessary clothing removal). The weight of this and how common it is makes it really hard to be in medicine sometimes. I love the field but the lack of humanity is slowly killing me overtime.
Alicia, as I have written here previously, in my many, many years teaching introduction to clinical medicine to first and second year medical students it has always been for them to attend to the interest, desires and concerns of PATIENT, PATIENT, PATIENT. Hopefully this attention would continue into years 3 and 4 and beyond. ..Maurice.
Alicia,
Are you from Great Britain? Don't let the system kill the humane part of you. You can make a difference. You can teach others that patients do have a right to bodily dignity. We need people within the system that truly do not want to do any harm to patients. What so few of them understand that treating a patient like a non-person by unnecessarily exposing them affects their mental state which in turn affects how they physically recover from illness or a procedure. I agree that many things are done such as shaving that actually do very little for the well-being of the patient along with the other items you mentioned. Please stay on here. I do a weekly radio broadcast and if you would like to come on and talk about what you are experiencing we would love to have you. You can do it without giving away your identity. Please ask Dr. B. for my contact info if you would like to be on the show.
Hello Alicia,
It's so refreshing to read of your concern for patients. Please seriously consider completing your medical education. You have the compassion to be an EXCELLENT doctor. YOU are what the medical profession desperately needs. Please, please continue to become a SUPERB doctor.
Take care.
Reginald
Maurice - thank you, this really needs to be emphasized. Unfortunately I think this message is lost the further into medical training people get.
JR - I'm Canadian. And thank you, I agree with everything you're saying. Trauma has massive impacts on a person and health care providers are in a position where they can alleviate/mitigate trauma in difficult situations OR cause some serious trauma due to the inherent vulnerability of being a patient. It is so frustrating because we all know that very small actions can make a world of a difference on whether someone's experience as a patient is comfortable (and maybe even positive) vs traumatic.
I would be open to speaking on your radio broadcast. I'll reach out to Dr. B.
JR, in response to Alicia and I am sure others too, I would approve postings with information detailing how to observe or attend your public presentations. Thanks. ..Maurice.
Thank you for your kind and encouraging words, Reginald. There are a number of things about medicine that bother me. Things I guess I expected going in (a drive to 'do better' was what pushed me to apply), but I didn't anticipate just how mentally and emotionally difficult it would be at times... trying to navigate these larger issues when I feel strongly about a different approach. I just care about people a lot. I'm unable to comprehend why a medical student/physician/nurse wouldn't want to do everything they can to make a person comfortable. I will keep going - I know people deserve this type of care and compassion.
Alicia
Hello again Alicia,
During your education and internship you'll probably feel very frustrated when you see or hear what seems to you to be very callous treatment of patients. In your debriefing sessions, you may wish to put your dissent in the form of a question. "Dr. X, do you think that the patient would have been more comfortable if her private areas were covered? Did the patient's genitals need to be completely exposed for this procedure? The patient male seemed to be exceedingly upset when his genitals were exposed in the presence of females. Should we have asked his permission to have women in the room?" Ask these questions, when appropriate, in an inquisitive manner with as little emotion as possible. Expect some raised eyebrows or frowns or expressions like "what planet is she from?" Every great innovator faced these challenges. If your professors are thinking individuals, they may see some value in your concerns. You may even be lucky enough to affect some change. Once you implant the idea of respect for patient dignity, you never know when others may see your point.
Many years ago, a doctor I was seeing would order blood work after the appointment. Since this was his regular habit after each yearly appointment, I asked him why he did this after the appointment instead of before. I explained that if the blood work was done before the appointment, he'd have the data available to analyze and discuss with me personally during our visit. This would avoid having him later send me a note regarding the results of the blood work. Presently, he now asks ALL of his patients to get their blood or urine work done BEFORE their appointment to save everyone time and delay. Sometimes a small change does become a sea change.
Be courageous and remember that your compassion is not misdirected. We elevate humanity most when we assist others in their quest for dignity.
I wish you much success.
Reginald
The previous medical student to write to this PATIENT MODESTY issue about her own
experience was for Volume 42 in June 2011. I published this extensive history and
commentary on the introductory display and then others commented later in the Commentary section.
Go to: https://bioethicsdiscussion.blogspot.com/2011/06/patient-modesty-volume-42.html
and read the introductory page which will be the first display. ..Maurice.
Oh Alicia... i am so bummed for the US healthcare system, but so happy for the Canadian system. You truly are what we need. PLEASE do not get discouraged. Reginald gave great advice. Ask the questions and make suggestions during your debriefing. You know how actions speak louder then words? When you are dealing with patients infront of your fellow students. Keep them covered. Grab a drape and put it over the genitals then lift gown out from under. Talk to the patient so your fellow students can hear you. Maybe they will get curious and ask you why you did it that way and not just remove the gown, wouldn't that be easier and quicker. Explain WHY. If/when you hear fellow students talking/gossiping about patients. Nudge them and ask if they have any flaws. Change comes from within. When others see it truly takes no extra effort to protect a patients dignity they in turn may start the practice. Now... we have an apartment for rent. If you EVER want to become an American ( dont know why youd want to when many of us wsnt out) its yours to finish yoir studies and knock some sense into this American staff members. Cat
Hello Dr. Bernstein,
Can the many years of postings on your blog be summarized as a desire by patients to have their dignity requirements respected by health care personnel? Instead of dropping the Hippocatic Oath, maybe it should be extended to read “First do no harm to the physical, emotional or spiritual dignity of the individual”. Where “dignity” is defined as the values which an individual cherishes regarding his or her bodily, emotional, or spiritual care. Is this such an insurmountable task for healthcare? Could this expression of dignity also be extended to the nursing staff? Could their dignity be respected with fewer patients per shift? Doctors could also be afforded the dignity of their decisions without interference from insurance or bureaucratic “bean-counters”. Rather than the statement “leave your dignity at the door”, instead, should the sign read “How can we enhance your dignity today?” Rather than the tremendous number of useless intake form questions, how about “How can we respect your dignity during your stay with us?” Please, please help me to see why the respect for patient dignity is such a formidable task in health care!
Reginald
Reginald, if symptoms of an illness are considered at initial contact with the patient as primarily non-emotional or non- psychological, then it means, to the physician, that the symptoms are organic and should be promptly attended to as such. The urgency of further diagnosis and treatment may set aside matters of defining and attending to dignity of the patient. This approach is not what, as medical student teacher teach, but this is the result of physicians' later challenges. ..Maurice.
Hello Dr. Bernstein,
It doesn't seem like this needs to be an either/or situation. Just after my recent post, I read the following article. Eureka! Maybe dignity is finally finding a way into medicine. On page 4 and 6 of Hospital News Aug 23 (A Canadian Pub) there's an article titled "Why Being a Patient is a Hard Pill to Swallow?". This article is basically what I've been advocating for a very long time. It's designed to put personhood back into medicine. Hopefully, it will migrate south with the geese. This may be encouraging news. I recommend it to all posters.
Reginald
https://issuu.com/hospitalnews/docs/072923_hospitalnews_edition?fr=sOTcyOTYyODk3NzY
The vast majority of patient-doctor/nurse/tech encounters are not life or death emergencies. Most of us will never experience such an event. Even our occasional trip to the ER is rarely a life or death scenario. Yes extreme emergencies in which every second counts might necessitate that patient privacy and dignity be set aside, but in every other instance it does not have to be an either or. Patients can be treated in a respectful manner and receive quality care for the ailment at hand at the same time. Yet so many act as if it is an either or.
Good Morning.
Welcome to the group Alicia.
Today on the people side of healthcare, they have lost compassion, empathy, & integrity. They need to inject humanity back into the system. People aren't cattle.
They need to STOP thinking & teaching the idea that men & boys have no modesty. When a male nurse isn't available, pull in a male hospitalist to assist. No more excuses.
Have a great day everyone.
Best regards,
NTT
Dr. B.,
I do 10 minutes segments along with Cindy Schwarz who produces them on Planet Vero Radio, WAXE 107.9/1370. Our segments are played at random times both on Planet Vero Radio and IHeart Radio. We also can be found in various social media sites such as Spreaker under Patient Partners. We talk abt a wide range of medical topics. For instance, we talked to a doctor abt Direct Primary Care which to me sounds like an excellent way to go. I was impressed that he mentioned he would rather spend the time building trust with the patient rather than staring into a computer screen. He takes his time with patients too. He also visits them and coordinate care for them if they are in the hospital. We would love to talk to you abt why you do the Patient Dignity site. Might get you more coming to the site.
If anyone wonders why we didn't didn't call ourselves Patient Advocates, it is because many times advocates such as those employed by hospital do not really advocate for patients. Anyone who wants to tell their story is welcome to get in touch with me. Jeff did and he done an excellent job making his point(s). You don't have to identify yourself if you do not feel comfortable but in the end you'll know that you got it out there in the open and somehow it might help someone else avoid what you experienced. It is therapy to know that.
Hello,
As I pondered why dignity is such a hard concept for healthcare, I mused regarding what has changed – realizing that what happened in the past was not always something better.
Thirty years ago I had a cardiologist as a GP. Yes, a cardiologist as a GP. That this was possible was astounding, even at that time. I visited him once a year and, the visit lasted for almost an hour. The session started in his office. Yes, in his office, not an exam room. His first statement was, “Tell me what has happened in the past year?” He’d then listen, respond, and ask further probing questions. After at least 30 minutes he’d invite you to the exam room while he followed with his black bag. (One would think that he was a doc out of the 1800’s.) The exam was complete – nothing missed – no rush. Bowel issues might be addressed in the exam room via a sigmoidoscopy, a modified colonoscopy without anesthesia. There was no need for another office or hospital visit. The exam might be interrupted as he was called out to answer a patient’s phone call. He could be heard saying, “No, Mr. Smith. You must take that medication for the rest of your life.” He’d return to the exam, apologize, and continue. His wife was his assistant and his receptionist. This was in Santa Ana, CA not in rural America. Sadly, when he heard that the insurance companies were limiting payments to 15 min. visits, he retired. He was too professional to be directed by non-medical entities.
What’s changed? Aside from the fact that a cardiologist could also be your GP, your visit took some time and the doctor LISTENED. An hour-long visit will not return but, LISTENING doesn’t really require much time.
Today, few in health really listen, nor do they ponder what they’ve heard. A quick diagnosis is made and you’re on your way. In a hospital setting, no one will listen to you AT ALL. For any procedure there’s a protocol and the protocol comes before the patient. Dignity issues are not addressed because they are not part of the protocol or, because they interrupt the procedure. No time is given for consideration of the patient’s requests for dignified care.
I do believe that this is at the heart of our responses (real or perceived) to what we consider breaches or dignity. Yes, there are bad actors; but, overall health care personnel don’t plan to harm. They don’t listen and, they are unwilling to spend the time to consider how protocols might be revised to accommodate INDIVIDUAL dignity. Group “dignity” is attended to via politeness and courteous; however, individual dignity is never addressed. This would require time and, getting to know the patient as a person and not a procedure. Is there any hope that this will change? What can we, realistically, do to affect change? Maybe, more importantly, the question is Would anyone in healthcare even consider the above explication of individual vs group dignity?
Reginald
I have established Volume 127 starting out with Reginald's dissection of the topic on the opening display of this new Volume.
NO FURTHER POSTINGS WILL BE ALLOWED ON THIS VOLUME 126. PLEASE START YOUR COMMENTS NOW
ON VOLUME 127
https://bioethicsdiscussion.blogspot.com/2023/07/preserving-patient-dignity-formerly.html
..Maurice.
Dr B. Finally I was able to get on Volume 127 but I still can't post.JF
I will try fix the problem tomorrow Saturday. Maurice
You should be able to post your comments now on Volume 127. ..Maurice.
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