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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posted by Maurice Bernstein, M.D. @ 6:19:00 PM
163 comments
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163 Comments:
Interesting question about VIP youth. I suspect documentation or even anecdotal reports would be hard to come by. My guess is that the children of VIPs are given VIP treatment in general, including being responsive to modesty concerns that get raised by the kids, but in the absence of it being specifically raised by the kids or their parents my guess is that adolescent male VIP kids do not automatically get same gender care. Of course adolescent males are almost universally too embarrassed to raise such a concern themselves.
In reading Joe's post, I did a little research on the urolift.com site. What they said to the patient was different than what was said under the physician section. Under the patient section, it said mentioned a local anesthesia could be given but under the physician section it said it could be done under a local or a general. That is a big difference and very misleading bc as in Joe's cause he was knocked out. Why is it they think they must knock out patients rather than giving a local where they would know what is going on It is clear they do not want patients to have much recall of how they act or the conversations they have during procedures. Clearly Joe was upset about having all the female staff present. My question to Joe was did he not know what type of anesthesia was going to be used? Did they not present to him different options? It also said in the patient info on the site this procedure can be done in an office setting so why would a uro practice not be setup to do this in house? Why put a patient through all the emotional trauma of having a procedure done in a hospital setting when it was not really necessary?
JF is right. While we women may have more personal dignity choices in office visits or when we are conscious, when we are under we too become victims of however, whoever, etc. of the medical system. The drugs allow them to have the upper hand. Drugs are what gives them unlimited power and control and adds to the overall greed process bc a drugged patient requires more staff and care. It is pretty simple.
As many of you know, I have a large issue with the term conscious sedation bc it has a very misleading name. With conscious sedation, generally you are dosing lightly but can be awaken by sound or touch. It is supposed to be calming although if given w/ fentanyl it really is not necessary as one of fentanyl's properties is to make you feel like all is well & wonderful. You may be able to answer yes or no questions and you may be able to follow simple commands. Some may be very talkative as it is also like a truth syrup. But the thing it is used for is to try to totally erase your memory of what happens right before, during and after a procedure. This why many don't remember release info. or just bits and pieces. There needs to be more truth in disclosure & actual patient informed consent. The medical industry should not be able to automatically make the decision that all patients should have conscious sedations for the procedures they are using it for as some don't or wouldn't want it. If some want it after it has been properly explained, it is okay but they are not truthful about it. It is their primary tool they use to exploit patient's dignity/modesty.
Biker,
VIP children are just given a cursory exam. The genital exam is skipped unless specifically asked for. Even if a genital problem exists (such as a UTI), treatment (antibiotics) is usually prescribed first before invasive exams.
In many cases, school forms, etc. are signed without being seen. That is because the physician knows the health status through social interactions. Physicians know that there is no value to the annual physical exam (except building a relationship between patient and physician). Being a VIP, the relationship is built and maintained in other arenas.
I know this from personal experience.
-- Banterings
To be fair, when looking at the drawing, there are a few things that seems puzzling to me (and it could be that I am not "seeing" the same way others might). My interpretation is of a young person (gender unknown - but I am leening toward male simply because no stirrups are depicted) who is accompanied by a relative, most likely his mother (it is not obvious the woman to the side is a nurse, or MA). The position of the draping strongly suggests he's not seeing this doctor (PA? NP?) for an earache.
I can only rely on my own personal experience but, to me, this picture seems all kinds of wrong. Growing up, my pediatrician was a male doctor. I understand in some areas in can be difficult to find a doctor so parents might not be that picky over gender but I am fairly certain I would not have gone along with this situation (I'll explain later). I guess I was lucky in that respect.
Getting a physical was a yearly thing for me but, as far as I can recall, there has never been anyone else in the examination room other than me and my doctor. My mom new better than to stick around during the examination (and I would have been quite vocal about it otherwise). She understood this was embarrassing for me and didn't want to add to it. Chaperones? Pfft! Get out of here! I would never have put up with that. And I still won't. Thankfully chaperones are rarely used where I live. And their use is definitely not SOP for the CAF.
As a teenager, I think I was 14 years old or so, I got fed up with this doctor and told my mom I was not going to see him again. And that was that.
So from the age of 14yo until I enrolled in the military, I was without a doctor.
I did have to see a doctor at 16yo and that's when I learned what a DRE felt like (not going to rehash this story).
Even throughout my service, I was very firm in not allowing certain portions of the physical examination to take place.
If you ask me, I think boys and teenagers are very poorly treated by the American health care system. I would be very surprised if any consideration is given to their modesty. The sad fact is that there are ways to mitigate these, but no one seems willing to do it. VIP treatment? Maybe for wealthier families but I wouldn't bet on it.
Dany
What that youth would say and do? What he ( or she ) says and does in more cases is after the fact. Who is the person sitting next to that boy? Is it his mother? Or a staff person? Same gender or opposite?
Dr B, I think you disagree with me but I think healthcare workers often have abusive tendencies that makes humiliating patients pleasurable to them.
All those years of studying doesn't make them decent and good.
Sexual pleasure may not be their one and only reason for practicing medicine but it also didn't delete out that part of their nature.
Many intimate exams shouldn't be happening at all. And the unlocked door in the doctors office with people coming and going while patients are exposed is for many patients a problem. Not a solution.
I once heard of a doctor doing an intimate exam on an older teenage boy in front of the boys mother. It permanently damaged the mother and sons relationship. More than damaged. He moved out as soon as possible. When he married and became a father, his mother wasn't allowed to have any access to the kids. It's exactly what she deserved in my opinion. The doctor didn't have any consequences though. Just whatever pleasure he got from humiliating that young guy.
Biker, oops! I accidentally prevented your last posting to be published but I have a copy of it and it follows. ..Maurice.
From Biker:
JF, I have no way of knowing of course, but my guess is that doctor did not purposely humiliate that teenage boy but rather either acceded to the mother's demand that she be present or he just didn't think twice about the fact that she was watching. In either event the doctor showed a profound lack of judgment and empathy. Given how angry the boy was with his mother, my guess is she insisted on being there.
Biker, My opinion was the mother was taking the place of a chaperone. The rest of the story was the mother blamed the doctor for the way her relationship with her son falling apart. As far as the doctor just not thinking that a 16 or 17 year old boy ( or even a girl ) wouldn't be upset by that kind of thing? I don't believe a word of it!
Too many healthcare workers are legalized sexual offenders.
Mothers and fathers who come with their teenager should sit in the waiting room while their offspring communicates and is examined by the doctor unless the teenager requests to have the family member present. The parents entry into the consultation room with final discussion of findings and plan along with the teenager after the exam is under most circumstances appropriate and in cases necessary. Sometimes, it is necessary for the physician to speak to the parent at some point separately from the patient.
In conclusion, it is essential for the physician to communicate with and examine the teen in a private setting with a patient acceptable parent or chaperone present during the exam.
Medical student are specifically taught about all this as they learn about their interaction with an adolescent--a special and separate topic regarding their learning about history taking and physical examination. Adolescent relationship to the physician is a special and important category in medical education. ..Maurice.
Dr. Bernstein,
I would have to agree with Biker's assessment that any male adolescent, VIP or not, would be too embarrassed to object in the moment. As to the harm done it would depend on the relationship with the young man and his mother and the degree of exposure involved. With her sitting by his side it may have been possible that she did not actually see the exam itself, in which case he may have not been so embarrassed. I can't think of any reason that any parent would want their child to be traumatized, but no doubt it has happened.
Imagine a similar image of a young female patient on the exam table with a male doctor about to perform an intimate exam, and the father by the patient's side. How would that go over?
58flyer
I have both a son and a daughter. When he was very young, I was in the exam room with him. After he reached an age where I no longer assisted him with bathing, I stopped but then I also gave him the choice of having the genital exam which he refused so it was made known to the doctor. The same with my daughter until in high school she had a lump and she wanted me in the exam room but I turned around so I wouldn't see anything. I made that decision on my own bc I am very aware of personal privacy. As a girl who the doctor had me take off my upper garments to listen to my lungs when my father was present, I will never forgave or forget that doctor. It was not my father's fault but it was the doctor's fault bc he didn't need me to strip the upper part of my body just to listen to my lungs. As a child, I knew it was wrong and I protested but the doctor said he would have a nurse do it. My father was as shocked as I was and said nothing but to his credit he averted his eyes.
As far as the picture, I think it is very misleading as never has son or even my husband been gowned and with a drape for additional cover. It just doesn't happen very often for males. Yes, with a female although when it was done to me I didn't have either but that was many years ago. My husband never had those issues nor did it really bother him until his nightmare experience. For older men like my husband, the lack of acknowledging that males have the right to personal dignity has been a standard operating procedure. The medical world does not acknowledge males have the dignity needs too bc it would cause them to have to change the sexist method in which healthcare is delivered.
JF is right in saying that "too many healthcare workers are legalized sexual offenders." I also agree that many have "abusive tendencies." I think they believe they are supreme beings in charge of us rather than paid advisors who are in our service to provide us with care. It is like Banterings has pointed out numerous times that the nudity is used to control to us. The exposed, naked patient is less likely to be assertive or defiant clothed person who is on equal footing. It is the thought that nakedness makes people more timid and unlikely to challenge authority. For most I would say that is true.
Dr Bernstein,
I find it disheartening to realize just how unsympathetic a majority of health care professionals are to patient dignity. What is the ethical or moral impetus in imposing chaperones on unwilling patients? Somethings that is not even required by law.
There is no benefit for the patients, unless they specifically ask for it, but there are quite a few detrimental consequences. And some of these can have long lasting effects.
A chaperone is saying "I don't trust you" and yet patients are asked to almost unconditionally trust their providers.
A chaperone increases the level of embarrassment in an already difficult situation. It is not an easy thing to allow a stranger to look at and touch one's body (especially the genital / perianal area). I fail to see how adding another person in the mix is going to make patients more comfortable. This is not helping at all.
The negative emotional impact (the feeling of shame, embarrassment and humiliation) might just stay with patients for their entire lives. I would even go as far as suggesting this might be a contributing factor to the many men not "taking good care of themselves" by avoiding or putting off recommended screening and simple health check ups.
I am not entirely unsympathetic to the difficult situation providers are in. It certainly is a concern in a litigation prone culture. But if a provider is going to enforce this (by withholding care if a patient disagree), the onus lies squarely on that provider to ensure this has the least negative impact on their patients.
Here's a few suggestions:
1. The use of chaperone should be made crystal clear to patients even before they set foot in the clinic. I would suggest that discussion takes place when booking an appointment.
2. Do not lie to patients by attempting to legitimize the reason for that extra person in the room by making them perform some menial tasks.
3. Have on hand designated staff of both genders available and ask for the patient's preferences. The worse scenario is a female provider seeing a male patient and the chaperone is also a women simply because the provider isn't willing to but the effort (or money) to have a male staff.
4. When dealing with an underage patient, certainly offer the parent to fill that role but be cognizant this might make things far more embarrassing for the child.
In an ideal world, chaperones shouldn't be used. Giving the apparent lack of emphaty from most health care professionals, let's at least try not to leave patients emotionally scared. Is it so much to ask?
Dany
JR: Believe it or not, the admitting nurse told me I was scheduled for general anesthesia. For a procedure like this, urolift, I felt it was overkill and not warranted. When the Doctor/Anesthetist came to pre-op, on the morning of surgery, I told her I didn’t need to be put under general. She balked. I told her my urologist told me she had no problem with me having a mild sedation, like used in heart caths. I told her that I had a cystoscopy only two weeks before and had not had any sedation. She argued for a while, (while my wife just rolled her eyes), but told me that she would consider conscious sedation. I told her I saw no reason to be put under, with a breathing tube ran down my throat. I informed her that previously I had seven, yes seven, heart catheterizations with mild sedation. (I’ve had four heart operations over the past seventeen years) She finally agreed …yeah….surem she did!!! And, as I mentioned before, I was put out right after I was positioned on the OR table and asked to place my feet up in a stirrup type devise. I would have like to have remained awake to make sure I was provided a proper amount of respect.
As an aside, when the surgeon met me that morning in pre-op, after the anesthetist left, I reminded her of our agreement from two weeks before. She said the anesthetist was the final word on patient sedation. That he or she represents the hospital and the surgeon was simply being allowed to operate within.
Joe Testa, thank you for joining us on the current Volume of the subject which is obviously of concern to you and as you see, from years ago closed Volume when you originally attempted to post, has continued.
I am also pleased observing that my Volume 107 graphic has contributed directly to pertinent responses and views by the writers here.
..Maurice.
A young female in a similar imagine? She would probably be completely humiliated. It would be equally bad as the mother/son thing. One thing that would be less bad though is with her father by her SIDE,
he wouldn't be seeing anything x rated body part.
If I as a teen would have had that kind of check up with my dad present, I think he would have reacted like JR's father did. My mom though would relish the humiliation I was feeling. She would have happily told about it to anybody and everybody and right in front of me and the small amount of mother/daughter relationship would have been permanently destroyed.
Dr B, I somewhat agree with Dany. But patients shouldn't be given intimate exams at all unless they have specifically agreed to it in advance. I AM ok with a chaperone so long as she isn't seeing anything x rated. I had a male med student in the room observing once but he was up by my head so I was ok with him being there. The best chaperoning policy I've seen was,.a doctor had a person in the room. She was working at her desk. She wasn't watching us but if I would have expressed distress, she would have heard it. A doctor examining a male patient could share a room with a male person working at his desk and not watching.
Hello,
JR please read the article below re Dr. Mathieu falsifying medical records. Fortunately, he'll spend a few years in prison for his efforts.
Reginald
https://www.justice.gov/usao-sdny/pr/doctor-and-occupational-therapist-sentenced-prison-participating-30-million-scheme
Here is a still developing story with many large red flags that could at best be described as extremely disturbing. As a compliance officer and risk manager at a very large medical center I’ve seen just about everything in my career, but this is disgusting. You can search for other articles about this investigation (I just provide one link below) but the facility has had lots of deaths and other allegations, including of a sexual nature against the director. But an “arousal” study on patients that can’t consent. Why would their guardian consent to such a study, IF they were even informed of it (which I suspect they weren’t). Oh, I’ll venture a guess 100% of the patients were male.
Shocking what can be done under the guise of “health care”
https://www.desmoinesregister.com/story/news/health/2019/12/12/doj-glenwood-details-ethics-rights-regarding-human-studies-state-center-disabled-iowan/4414227002/
Maybe Dr. B can give a medical reason why there is a need to monitor sexual arousal in male mentally disabled patients. — AB in NW
Anonymous, Dr B isn't one of the bad guys. He has Sometimes struggled to understand why and IF there is trauma over exposure because he isn't expecially modest himself. But SOMEHOW he became aware that some patients were being harmed. He tolerates hearing his profession being bashed and HE isn't a sex offender. I have Sometimes wondered why he doesn't get angry. Other times I wonder if he at anytime in his life has felt embarrassment over being seen naked.
I drilled down a bit on the article AB in NW posted about that facility in Iowa. As others here may have surmised, what we're talking about is sensors being attached to patient penises to monitor their getting erections. While I can understand that some pervert might exist who thinks this is acceptable to do to patients who can't give consent and to do so without the consent of the guardians of these patients and without a proper ethics review, it is unfathomable that such a person could also get the staff at this facility to go along with it. Yet he apparently did. Tell me again that anyone who dons scrubs is a professional that respects the privacy and dignity of all of their patients.
JF, for clarification, I presume you were referring to yesterday's "anonymous" who identified himself as Reginald though I didn't find his impression of me as you suggested as a
"one of the bad guys". However, thanks for your support. I should be looked upon as a "middle man" who sees and appreciates the "good and benefit to patients" provided by the members of the medical system but also disgusted with the mild misbehavior or extending to gross criminality of members of the medical system which I clearly recognize the latter is occurring. I acknowledge that the "bad" is riding with the "good" in this profession. Actually, this conflict is the reason for this entire blog itself--bioethics--discussing the attention to ethics present or missing mainly throughout the medical profession. And yes, I do get angry by behavior of others in the profession but I don't base it as a reply to all my medical experience as a physician or as a patient. With regard to "felt embarrassment" being 'naked" I don't recall consciously aware of "naked" and with regard to genital exposure, I have not seen any behavior by others, male or female, to have concern beyond hoping clinical success. But that's me, based on my own experiences and my understanding of the rules of our profession.
Now..all go on to read my next posting. ..Maurice.
If you have time, as a supplement to our "preserving patient dignity" forum here is at present 52 posting discussion of the experience of visitors or their family members as they respond to the subject Does End-of-Life, Hospice, Comfort Care Represent "Murder, Euthanasia, Killing"?" beginning in 2012 and continuing to yesterday. You will see concerns as we have seen expressed by JR and others here but directed to professional behavior or actually misbehavior toward patients toward the end of life.
Feel free to contribute specifically to the topic there since it is still active. ..Maurice.
Oops.. I didn't get the link to the above blog thread to work..so here is the linked title.
..Maurice.
Dr. Bernstein, how I would have answered your hospice question before reading those comments on the other thread is different than how I will answer now that I better understand a couple things that didn't make sense to me years ago.
Hospice was great when my Dad passed (cancer) but he died at home before they actually arrived. We had no idea what we were supposed to do but called them and they made the necessary phone calls. We were very appreciative.
Fast forward 2 years and I'm helping my sister-in-law care for my brother (cancer). It had spread everywhere, he was in a lot of pain, and was steadily going downhill; each day noticeable from the day prior. Hospice comes to his home, sets up a hospital bed in the living room, and a nurse came that evening to stay the night. He was in a coma quickly after her arrival and passed in the wee hours of the night. Afterwards she took charge of things which was very helpful in that regard but his going into a coma so quickly after her arrival and being gone hours later makes me wonder did she just give him the drugs necessary to end it quickly.
My mother-in-law went from living on her own to dead in a little more than a week, and again I wonder if it was hastened. She took ill, was hospitalized for a few days and they said she has terminal cancer & needs to go to a nursing home. She gets admitted to a nursing home and was dead in a day or two.
My mother had a massive stroke that could not be stopped. She could not speak or move but she was aware we were there. Despite it having been established she would not recover the hospital kept running tests until my brothers and I told them to knock it off and just let her be. They then kicked in palliative care which was described to us as stopping all tests and attempts at treatment and just keeping her comfortable until she passes. They left out the part about putting her into a morphine induced coma, and that they'd keep increasing the morphine until she passed.
Doctor assisted euthanasia is legal where I live and I support it including for myself if that's what I see as best for me some day. My life my choice. The difference with hospice and palliative care efforts is it seems others are making the choice because they think it best that patients pass quickly. Families are understandably bewildered and stressed and maybe worn out at that point and maybe easy prey to be taken advantage of by those who think they know better when the patient should die.
Biker, thank you for telling your story (and perhaps you can add it directly to the blog thread). We are talking about a point within the patient's illness and life where the decisions become no longer clinical directed to cure or patient tolerable existence by the patient's physicians and really becomes decisions made by the patient if conscious, patient's surrogate and Advance Directive, if present.
It is not rare at all, but unfortunate, that such decisions cannot be made by the patient who clinically can't communicate and has no available surrogates and has to be decided by the hospital ethics committee in the form of a "surrogate committee" made up of hospital ethics members including community ethics members. Again, Biker, thanks for your family story. ..Maurice.
A bit more about the source of decision-making in the early years of ethics committees when the patient had no surrogate or advance directive and was unable to communicate. In Los Angeles County, the medical and legal associations decided that it would be proper for the patient's physician along with one other physician would make a life and death decisions based on the concept of "best interest". "Best interest" of the patient was characterized as what decision most competent patients would consider as to their own "best interest" and the treating physician would then be permitted to proceed on their own conclusion. In the current "surrogate committee" we put ourselves as though we are members of the patient's family, essentially stakeholders with the patient's physician providing us information make considerations perhaps as a family would, open to differences and not under the bias of being the patient's physician as a decision-maker. If we should substantially disagree as this sub-committee, the ethics committee treats this as though the conflict was expressed by the patient's true family and the entire ethics committee would then meet with the "family" (just as if there was the real family present) and help them work out a conclusion which all find acceptable. It should be noted that hospital ethics committees are involved in educating and mediating the conflicts of the family and physicians but the final decision is set by the stakeholders themselves (in this case, family and patient's physicians). Unfortunately, the main stakeholder is the patient and the problem is that he or she does not have the capacity to participate.
I hope this description what I and other members of our hospital ethics committee do with regard to dilemmas in patient decision-making is of interest to my blog thread visitors. ..Maurice.
Reginald,
I read the article. It is amazing that 30 million dollars was allowed to be taken before the government did anything. But as in our case, it was as if we were doing something wrong by reporting the fraud. It took almost a year before the fraud was corrected and the medical records are still full of lies and fraud so they are completely unusable. We don't fact from fiction. An interesting fact about that dr. in the story you mentioned is that he was number one in the nation for "prescribing" adult diapers. How stupid is the government? But in my dealings with CMS and Livanta, I believe they really don't care about abuse of either the patient or the financial aspect. They make all kinds of excuses for the lies and the fraud and freely admit they believe only the medical provider and what is in the medical records so it is that attitude that encourages criminal behavior in those who choose to do so. Also, we had to repeatedly request the itemized billing and it took months to get it which put filing a complaint outside of the CMS allowed time period. The hospitals know how to play the game which made the complaint even harder bc we had to justify being late in complaining. The end game of most medical providers is to hide what they do to be able to keep on doing what they do as they see fit and they is not necessarily in the best interest of the patient. It is all about power, control, and greed.
DR. B.,
The trouble I have with the concept of if there is no relative or directive available and the hospital making the decision is that they have carried that further by doing it to patients and their families who are able to make decisions. They argue that treatments they choose are "gold standards of treatment" and they are entitled to perform those treatments bc any sane patient would want that treatment. How do I know this? It is bc we were told that when we said my husband did not want CARB or PCI (angioplasty as they called it w/ no mention of stents or risks, what it involved, etc) but rather he wanted the least invasive which were the anti clot meds so they drugged & isolated him so they could perform their chosen treatment. So when patients have differences they do think they have godlike rights. My definition of medical treatment is the patient is in charge or their appointed family member. The drs from the 2 hospitals decided his medical treatment completely ignoring the my husband's wishes & not being honest enough to even argue his decision. Maybe the hospitals you have been a member of are more honest, open, and even respectful of the law but not all are as evidenced by what happened to us. I am also sure we aren't the only ones this has happened to. I can see what you have described working for patients w/o family or a directive but I also see the ability for hospitals to think they have sole control of any patient which they in theory don't but do in practice. I also believe from your postings you would make the best decision you could but not knowing others in the same position then I would be very apprehensive about them considering what we have already experienced.
As I have said before from the experience I have had with hospice (Satan's Helpers as I now call them), I believe they are hired to kill their victims as quickly as possible. At the hospital my father was in which is another location of what I now call the hospital from hell, the hospital had already made up its mind that he was to be put in hospice service or in a nursing home. They did not want him dying in their hospital and messing their stats up as CMS gives penalty marks for patients dying in the hospital. This is really why hospice came to be.
His hip broke probably bc he had taken warfarin for many years & now it is known that warfarin causes bone fractures as do statins. They never attempted to fix his hip but condemned him to lay there w/ a broken hip unable to move. My stepmother was influenced by their catholic advice bc she felt they knew best.
So they brought him for us to take of. We knew nothing but he came w/ morphine, a versed type drug, and 2 more knockout drugs. He could be given them every four hours but there weren't any concrete instructions. He also came with one to dry up saliva. They were no ivs or nutrients to be given. In order words, he was also to starve to death. The drugs did not stop him from being hungry or thirsty. Morphine was the only painkiller. As I have said before, versed & those type of drugs aren't painkillers. You experience the pain & are in agony but may or may not forget it. So he spent the less than half a week of his life unable to communicate or even think clearly bc being drugged to die is the name of the game. They wanted us to perform all his bodily needs for him which would have humiliated him to no end. They didn't care as long as he was out of their hospital. My dad would not have wanted me or my sister or his granddaughters to see his genitals but they didn't care. Luckily, my son gave him care which still he would have been upset about. My one niece is a social worker in a hospital so she bulldozed her way until my son told her to move aside so he could take care of my dad. What is amazing is she listened bc he gave her no choice. The RN talked down to my stepmother even saying that she wasn't smart enough to understand so she would talk to my niece bc they both had degrees. Well my niece may have a degree but hers wasn't from the right school as my son was the one sitting there with his degrees from IU. When that nurse acted so horribly I thought my son would take her through the roof bc he shot her a look they should have melted any wicked witch. It wasn't until I called & they sent a male rn out that we actually got info on how to care for him w/o harming him.
Hospice is something I would never use or recommend to anyone. Its whole purpose is to speed along the dying process in a drugged like manner. My father wasn't able to communicate w/ us bc of the drugs and each and everyone of us w/ the exception of my niece feels guilty that we allowed them to do this to him. Did he really have to die or did we allow them to make him die? We will never know. Only old people like Jimmy Carter, George Bush are important enough to keep treating. The common people are willed to die by the establishment. That is the way I see it. Every time I see one of Satan's Helper's cars, I know I am seeing this being carried out to some other poor unsuspecting family.
JR, final clinical decisions are always made by the patient or surrogate unless in a life-threatening emergency where patient is unable to communicate and there is no stakeholder present. However, if the patient or stakeholder requests a procedure which is not clinically rational or possible, then the physician is obligated along with the patient or surrogate to attempt to find a physician who will accept and perform the patient requested procedure. If no such physician can be found within a stated limited time, there is no ethical or legal obligation for the patient's current physician to perform the requested procedure.
If the physician had presented the patient or surrogate a limited series of options, it is, of course, the option of those parties, after discussing with the physician, to have the physician carried out the option selected by the patient or surrogate.
Example:If the patient or surrogate doesn't want the patient to be sedated for a procedure and after being informed by the physician the rationale for sedation and which is not accepted, it becomes the option of the physician not to perform the procedure but must participate with the patient or surrogate to find a physician who will follow the patient-request. Again, if none is found in a limited time, the procedure requiring sedation may not be performed. This approach to decision-making by both parties is appropriate and ethical. ..Maurice.
Dr. B.,
While I understand what you are saying as being reasonable, it is not an "always" for ALL hospitals. Also, there are different degrees of emergencies. As if my husband's case, there was time to have the consultation as 2 hours passed before anything was done. There was time & he was completely stable. However, that hospital did not follow the guidelines you set out. They never had any intention of letting him--the patient or me--his health advocate be involved in the decision. He was given no choice about sedation or drugs--they just did it. In theory what you say should be what should happen but it is not. It is probably a difference in medical ethics. Some are good, ethical medical providers and others are not. You never really know which one you are going to get until it is sometimes too late as it was in our case. Perhaps you can see a little understanding as to why some patients are upset bc their basic rights have been taken away all in the name of control, power, and greed. On a footnote, it seems that the PCI procedure is having a lot issues about how the trials are being conducted. Stents themselves are problematic and the use of them is not as good as had been presented.
For all, I read these posts on Quora. One is from Maureen Boehm, a former internal medical physician and the question to look for is "What does no one tell you about hospitals?" The other one is by Tom Condray where the doctor said he would never let his wife spend a night alone in the hospital. (Boy does that hit home!) This one I found to be very amazing and it certainly fits what we are talking about. It is by BJ James, studied medicine & healthcare and the question is "Do female doctors need a nurse in the room when doing a male physical?" I think this guys story will absolutely floor you.
Here is the up-to-date article reviewing the current day doctor-patient relationship (what the doctor and what the patient expects of each other). A worthy read and pertinent to what is being discussed here. ..Maurice.
Dr. Bernstein, I would agree that it is harder for meaningful doctor-patient relationships to exists than used to be the case. Growing up the "family doctor" managed all aspects of our healthcare. Unless it was an ER scenario, he did the rest. He delivered all of us kids, gave us our vaccinations, filled out any required health forms for school or otherwise, and was the only doctor anyone in our household went to for illness or injury. He decided if surgery was needed. He had a handle on every aspect of our health. There wasn't any referring out to specialists. Despite it now being almost 50 years since I saw him I know his name vs my having long forgotten the names of most doctors I've seen in the ensuing decades.
Now our healthcare is tended by various specialists who each focus on only one narrow aspect of our healthcare, and even then much of the actual interaction is handled by medical assistants and nurses. The new electronic records systems will make our info available to anyone else we see but the reality is they mostly just focus on their one small piece of the puzzle. Throw in hospitalists and doctors being pushed to see more patients in less time and it is just all the harder to develop much of a relationship.
Biker, I agree. In fact, I would extend your argument to beyond "specialists" in general but to the presence of hospitalists and residents within the hospital system. So where is the patient's own family primary physician (GP or internist) to make rounds on their own hospitalized patients, monitor and attend to their own patients and their own patient's concerns with the system. Gone. Absent. Not there in attendance.
As a recent example of above, in my two hospitalizations beginning in July, my own longterm family internist was not present to attend to me clinically or more importantly but simply to be a supervisor of what was going on relative to my concerns, if I had any about the system itself. After all, those who were involved in my medical care and management were folks I never knew before and never had the many years of knowledge about me and my behavior and concerns.
Yes, times have changed and my duty to attend to all my own patients who were hospitalized has been now handed over to others who are busy with multiple patients, previously unknown to them.
Yes, times have changed and the system offers a greater chance for relationships between hospital patient and physicians to become upsetting and even toxic. ..Maurice.
A question regarding one of my frequent visitors whose origin is Huntington Beach California as indicated by my StatCounter program. Would it be OK with you to identify yourself if you are one of our contributing writers? If you are not a contributor, your interest is shown by your frequent presence and I am sure that your presentation of your views would certainly be welcomed by me and other readers. I hope this posting doesn't turn you off but I am eager to hear from you even while you remain anonymous. ..Maurice.
At the hospital from hell, the hospitalists are actually private practice doctors that are owned by the hospital. I think the lower ones on the totem poles in practice areas are the ones who have to serve hospital duty. Like the one who did PCI on my husband, if you look at his experience factor, he had much lower experience so they stick in emergency pci to get that experience to boost those who volunteer to have pci. The ER patients literally have no choice. Those drs. are not meant to form relationships. They referred the drs. according to where a patient lived. The quack who did his pci was not on the referral list as he was not in our area. There were several others who were in the practice that contributed to his MRs but none of them were referred either. They actually setup who they choose for him to see. I think they choose the area then choose whoever needs more patients. So there is not relationship building going on in the hospitalist atmosphere. In fact, the PA saw him rather than the dr. The dr. just signed off at several visits.
When I was a kid, my parents entirely paid the dr's bill so the dr clearly worked for us. Nowadays the drs are beholden to insurance and government to pay and approve of them. Patients do not matter. Referrals magically come while patients come and go. There never is a shortage of patients. However, I remember from over 30 years ago when reading MRs for disability, the drs. comments were very subjective & downright insulting many times. Patients rarely saw those records as the drs. claimed the patient's MRs belonged to them. And yes, those relationships do become toxic bc patients are abused & the medical staff wonder why patients are so angry bc many truly believe they have total control over patients & the patients should accept that premise. Many do not understand their advice is not mandatory nor are they in control of the patient. Many also do not understand they cannot ignore an ordinary patient's wishes or beliefs even if outwardly they do not appear to be of a different culture or religion. For those who appear to fit the stereo-typical American person, we too can have needs of modesty/dignity, permissions, etc. We also have drs. who can barely speak or understand English so conservations are sometimes short or misunderstood. We also have patients who cannot understand or speak the language used by the medical staff.
They know there is a problem as they spend big money on advertising they are compassionate, understanding, patient-centered but those mean nothing to most of them. They continue to operate as they please knowing they are plenty of patients & that ER patients have no choice but to suffer through whatever they want to inflict on them.
We were told the MRs would be sent to a primary physician to inform them of what had been done rather than to supervise. They really didn't care about the primary if he had had one but rather it was just to keep them informed so they could get their cut from future services too. Of course, he did not tell them nor will he give any records from this hospitalization to a primary dr.
JR, I know I sound like a broken record about this, but it's because the common people have little to no voice about laws. Insurance companies have taken the power from us and turned us into people who have no ability to fight back. I wish EO was around more. She knows how to voice what I am saying better than I can.
JF,
You voice it just fine. You are right but w/ the addition of the medical community & their huge lobbying efforts we have no voice, control, power, or choice. I read somewhere maybe on MedPage that the only way change comes about is through lawsuits that force them to change otherwise they don't or won't. That supported what Banterings has long said lawsuits but I know from experience that getting representation for a lawsuit is impossible unless it is clearly big money and easy to win. They don't take the ethics lawsuits. I miss seeing EO too.
When I was reading that one Quora post about the man needing a physical to return back to work I think, but he had put in his record that he formally had hemorrhoids. So the nurse told him to completely undress. She stayed in the room & watched. She handed him a clothe to cover his genital area with and left. The female dr. came in & done part of the exam. She left & returned w/ the nurse. She asked for the clothe & told him to get on a stool facing them. She then had him lay back & bring his legs to his chest & to hold them behind his knees. She did the rectal exam w/ the nurse watching. The dr. left & the nurse used the clothe to clean him up. Once cleaned he got up & walked over to get dressed. The nurse washed her hands & left.
This story is mind-blowing. The dr. needs a female nurse in the room to do a rectal exam but leaves the male patient alone w/ a female nurse to clean up his genital area? Tell me why the dr. needs a chaperone when a nurse doesn't? There is no rhyme or reason. Why is this allowed to be the norm for a male patient? How sick are these people?
JR, That doctor didn't need a chaperone, she wanted one. As far as the nurse wiping him, he could have done that himself. Even though I have talked about many healthcare workers don't get sexual gratification from attending naked patients, some do. There used to be people posting on here who said, people who get something sexual out of those kind of encounters gravitate towards this kind of work.
The procedures were made up by somebody but not by the common patients. Also some doctors who have been accused or even found guilty of sexually abusing patients during intimate exams are sometimes just required to just not lock the door to their office when doing an intimate exam. That way the doctor never knows when somebody is going to come strolling in and that supposedly protects the patients. In my mind it's a problem all by itself. But there is a mindset by whoever made that rule, that if the medical worker gets pleasure from veiwing patients genitals/bottoms,
they aren't doing anything wrong so long as they don't take it any further. That mindset is FALSE and the person/people who made rules based on that mindset aren't good people.
You maybe have heard me tell of this before, but when my best friend was pregnant with her first baby, she was on the examining table with her feet in stirrups and her doctor walked in with his group of med students. She had not been informed,let alone asked. Her doctor examined her then said "Next" but she told him No. In all fairness her son is now 38. She was forever traumatized. She never went for that kind of exam alone after that. She has since died of Cancer.
It has been mentioned here about knowing what to expect from a procedure. Here is a really EXCELLENT patient education book that explains what will happen during intimate exams.
It is the University of Maryland's University Health Center "Patient guide to Sensitive Exams" (adapted from the University of Southern California's Student Health "Patient guide to Sensitive Exams").
What makes this booklet so good is the language used; they do NOT use the words "NEED TO..." Instead the language used is:
You will be offered to have an assistant present along with your provider during the exam. You are in charge. Ask questions and say something if you are uncomfortable or need specific clarification on what is going to happen.
The provider will explain what the examination consists of...
Some patients may not be comfortable talking about their sexual history... You have the right to refuse to answer any questions...
A trained medical staff member can be present at all times during a sensitive health exam; you may request an assistant of a specific gender. You can also choose not to have anyone else present.
You are in charge during the examination, and you have the right to stop the exam at any time, as well as the right to seek care elsewhere.
Tell your health care provider if something bothers or frightens you.
Be clear about your modesty needs. If for religious, personal, or cultural reasons you need to have a provider of a specific gender identity, the University Health Center has male and female providers available and will make every effort to accommodate your preference.
If you need to remove your clothing to be examined, you will be given a gown or sheet. Only the part of your body being examined should be uncovered. If the gown or sheet is too big or too small, let your provider know.
The exam descriptions are clear and concise as t the steps and what will happen.
This puts the patient in charge.
-- Banterings
Good Evening:
JR, as far as your gentleman needing a physical goes, what happened to him with the hemorrhoids issue happened simply because the gentleman may not have known he had the power to control what was to happen or the two females had him sufficiently embarrassed and humiliated so as to be too afraid to speak up. At that point, he just wanted to get it all over with.
After the nurse told him to take off all his clothes She should have handed him the cloth to cover himself after he stripped then left to give him privacy.
By her standing there watching him strip then handing him a cloth to cover before leaving, she basically was telling him "I'm in charge here". After she asked him to strip & didn't leave, he should have asked her to take a hike and waited to undress.
When the doctor returned with the nurse, he had yet a 2nd chance to take control of the situation. At this point, he should have spoken up & asked that the nurse leave the room as this was an intimate exam and he didn't feel comfortable with another person (chaperone), in the room.
My opinion is that this gentleman didn't know he has the power to control how medical appointments should go. It takes time & friends that have gone through it before to guide you along.
Regards,
NTT
I agree with Banterngs that the U of Maeyland's guide to sensitive exams is a good one. However, I doubt that it does much to protect male dignity and modesty. If you look at their web site and under Hours of Operation follow the hours and location link you will be able to click on Meet out Staff and then see the clinical services provders. The staff consists of 17 females and one male. Given that fact, I would think a male student might have a long wait to see the single Male practitioner and he will most likely be pressured into seeing one of the females.
Finally, this is not an unusual situation. The colleges my two nephews attended also had health centers that were were overwhelmingly staffed by females.
MG
MG is correct. The school's policy statement is excellent but with only a single male PA amongst their staff, it doesn't seem their intent was seriously aimed at treating male students with the same degree of deference as they do female students. My guess is they are betting the male students are too embarrassed to speak up. Still, it is excellent in that they provide an avenue for males to speak up if they chose.
I think I mentioned it long ago but I am very familiar with a large elite co-ed boarding school (9th - 12th) and am friends with one of the top people there. This place caters to the children of the country's and the world's elite and is difficult to get into even at upwards of $70,000 per year cost. Most colleges would envy their endowment and facilities. They have their own accredited 16 bed hospital on campus and although it is small, no expense was spared. Other than a male medical director, 100% of the staff is female. I asked my friend about their not making provision for male students that are modest. The response was "they just have to suck it up". Even the male children of VIPs are 2nd class when it comes to respectful care.
There is no doubt that more and more females are entering medical school to become physicians and therefore there will be more and more female physicians involved in patient care of either gender. Why has this increase in female physicians happened? Do you think that women had felt left out of clinical diagnostic and treatment decision-making by studying nursing and becoming a nurse? Do you think that the mechanism of the increased female admissions was really some decision by medical school faculty themselves to accept more females who applied? But why? What would be the faculty's rationale for that decision?
And now let's talk about males in admission to nursing school. Is the paucity of this gender in nursing based on male disinterest or their worries about competition with female nurses or because males have regularly looked for better paying professions or..or..or do you think it is based, unlike medical school teaching staff, nursing schools are simply still prejudiced toward the female gender?
What I am looking for is the pathogenesis or "causal mechanism" for this dichotomy between the influx of males vs females into the two medical professions. To cure the medical system disorder, as with all medical conditions, we must look for the etiology (the cause). Any suggestions?
..Maurice.
Dr. Bernstein, the rationale for admitting more women into medical school was not wanting to be labeled sexist and not wanting to be sued for discrimination.
Anti-discrimination laws as applied to women and minorities brought tremendous change to society. This included taking anti-discrimination a step further in actively encouraging women and minorities into certain professions even to the point of preferential admissions and hiring. Society saw a problem and great effort was given over to address it.
Sometimes these anti-discrimination efforts were carried as far as compromising the privacy of males so as to achieve what was deemed a greater societal goal. Female reporters in male locker rooms. Female prison guards observing male showers & strip searches, and even carried to the same for adolescent males in juvenile detention centers.
Discrimination against men on the other hand remains a largely unaccepted premise. The overwhelming gender imbalance in nursing is not seen as a societal problem in the way the former overwhelming gender imbalance amongst physician ranks was. All-female environments in healthcare settings is not seen a discriminatory against men, thus no need for efforts to bring men into nursing.
Specific to the pay issue, RN's earn far more the median wage in our society and are certainly competitive with what most men might earn with 4 year degrees. Pay is not what discourages men from pursuing nursing careers.
My thoughts on what Dr. B. asked above:
I think that society feels that men are bad. They have suppressed and prohibited women and others for ages and now it is their turn to be suppressed and prohibited. Thus is why when men are abused and assaulted it is thought to be their just reward. There is a double standard that exists. Anyone not previously in a certain of aspect of life thought of as being a man's world should now break down the door and expel all men. However for men it does not hold true that they should be allowed to break down the same doors keeping them from entering such aspects that have mostly been prohibited to them. For women, they should become doctors while still barring men from becoming nurses since nursing is mostly a female profession. There is much documentation on the Internet about how badly males entering the nursing profession are treated and this ill treatment even continues once they enter the working world. This type of discrimination is sanctioned and approved by most as is any abuse/assault men receive as patients is also sanctioned and approved. It seems the mindset of society is to make all men pay for the past when it was indeed a man's world but then times were different. Too many women nowadays want to break down the barriers but when confronted with the reality of what happens in real world workings fall back into the poor me mode. Men on the other hand do not get to play the poor me mode but have to suffer what society thinks they must pay for bc men are bad. The reversal of gender based roles only are reversed for females and most will now support males going after those roles. Society itself needs to fully become enlighten that all is fair for both the goose and the gander. Our society thrives on fueling reverse discrimination to supposedly right wrongs.
Does everybody here agree with the explanations detailed by JR and Biker?
Are women considered by society over the eons as "mothers" in whatever profession they select and men have a domineering potential both in work and in men's relationship to the female gender. And now there is a showing of a change in the consideration of the role of the female gender: more power and more control of society.
Interestingly, as in the development of the practice of becoming a physician, women are also more and more entering the "profession" of governmental politics. No longer just the mother or wife of a male politician but now more and more a politician herself. Interesting changes in American society. ..Maurice.
DrB, I agree to a certain extent to what Biker and JR said. But that isn't the whole story. Sometimes our government does things to pit us against each other. Like poor people getting Welfare checks. Especially minorites. Any kind of self help was discouraged. Females discouraged from having their boyfriends/husbands living with them even if he was her çhildrens father. She wasn't supposed to take part time work or under the table jobs like babysitting or cleaning or whatever. And in big cities there maybe would be a huge liquor store, where as there should have been a factory offering decent wages and benefits. Close enough to these poor folks so they could walk or ride bikes to work.
Otherwise I think sexual deviancy and arrogance is part of it. If it was just reverse discrimination, why would a male doctor allow female staff to come and go from the room when he is with a naked patient? Other than HE looks so dignified and important with the slab of meat nobody important patients. Do those people not have staff meetings where he could tell them not to enter without knocking first? I strongly suspect if one WERE to knock he would invite them in anyway. F$#@ the patients! He doesn't need them. They need HIM!
Good Evening:
Women in this country have been on a power grab frenzy since the rise of the meetoo movement a few years back. I don't have a problem with that if its for the right reasons.
Where the problem comes in is when these ladies abuse their new found power on innocent men. What I see happening is women are taking out their new found power rush on ALL men when there was a limited number of men that did take advantage of and abuse women.
In healthcare as it is today, men have little recourse should they be abused by a female healthcare worker unless the abuse is so egregious that the system just can't hide it & say it never happened. Like what happened to Mr. Kirschner.
So, if he's left unnecessarily exposed or extra female personnel are added to an intimate male test or exam, or unnecessary comments are made about his physical appearance and he files a complaint about it, it will more than likely fall on deaf ears and here's why.
With this power grab. Facilities now have female personnel at the supervisor and manager levels along with females at the director of personnel level should it rise to that level. Managers & directors aren't going to want to upset their female rank & file over a man's complaint.
If he tries to escalate & go legal, his chances of finding a lawyer that will take his case are next to none as lawyers only take slam dunk cases when it comes to healthcare. If he goes to a nursing board, more deaf ears there.
Like I said. I have no problem with their power grab. I do have a problem in that men & boys have virtually no real recourse when female abuse of a male patient happens. It's funny how facilities don't really protect the doctors from patient abuse cases but their seem to go out of their way to protect female personnel.
That ladies & gentlemen is my take on the situation.
Regards to all,
NTT
I'm not offering up a suggestion. I'm offering up an OPINION! The court cases you all mention will be helpful but what will be the missing piece to get a lawyer to take a case that isn't quick and easy? I keep saying nobody law abiding will resolve this. A large enough criminal types assaulting Hospital Administration and Human Resource staff and/or their families with notes left on them. Every other bone in their bodies broken. Do I think it justified ? I don't know but I don't have to think it justified. I'm just voicing my opinion about the one and only workable way to be listened to by medical workers who care zero whether patients ever return for needed care or not. Attacking the staff nurses, CNA's and scribes would just prevent people from going after those jobs. There's no way of measuring how many would be patients are dead because of this issue. Or how many suffer long term. There's also no way of measuring how many suffer and die because of overcharging.
If you are interested, and I am sure you are, here on "Medscape is a listing of the Physicians of the Year 2019 demonstrating the "best and the worst". Perhaps reading about some of the "worst" is the aspect that may poke your particular interest. On the other hand, yes, there are indeed physicians who are considered the Best. Let us know how you evaluate the Medscape selection. ..Maurice.
Dr. Bernstein, like with every other profession, medicine has its angels and demons. The problem for patients is medicine is often reluctant to weed out the demons.
While in theory Maryland's policy looks good it is do they really practice what they say? I doubt it. Even the hospital from hell said on paper they respect a patient's privacy, choice, family, wishes, etc. but in reality they did not. Textbooks have the proper methods in them but they are not followed in real life. The individuals and institutions make conscious choices to disrespect and ill treat patients. I don't really care about their excuses of being overworked, tired, overpaid, etc because the bottom line is the patient is the one who suffers and has life-long issues that actually put their future health (choices) in jeopardy because of their heinous actions.
NTT, you are correct in what you said. I am a wife and a mother of a son. When I was single, I was more passionate in women's rights but having changed my status to being a wife and mother, I still want women treated fairly. However, equality should not come at the expense of another group. Men & women are not necessarily equals because of physical characteristics so I think to be treated fairly is more appropriate. Races should be treated equality but that is not so on either side.
As far as the Best & Worst, again in the eye of the beholder. On paper or the EHR, my husband's treatment appears to be good. However, it was the actual treatment and what was not written that is the issue. Too many patients aren't aware of what happens and don't really tell what really happened due to no memory (drugs), they don't want to talk about it because of fear either from being made fun of or thinking the medical community will take revenge on them. Anyone can be made to look good on paper. Anything can be spun to be something it is not. It is all how it is told and by whom. Depending what side you are on, just look at what is happening today in the world of politics for confirmation. People (who I don't know) keep voting nursing as the most trusted. Clearly, these people don't know how too many nurses really act against their male patients.
Biker, how would you "average out" the population "angels" and "demons" in the medical profession? And then, how would you characterize the professional population in between those two categories?
I have a feeling that those medical professionals "in between" are characterized by their patients based on duration of care and frequency of contact and communication, patient attention by the professional and the clinical outcomes.
What the "demons" don't know or don't pay attention or "don't care" to is that all that is meant by "laying on of hands" is for purely diagnostic or therapeutic value to the patient and not for any personal financial or sexual value.
I think there is one maneuver of physical contact in terms of "laying on of hands" may be worthy to both the patient and physician. "Introductory shaking of the patient's hand" which we teach is of professional value as the initial act of communication between physician and patient. This behavior can tell a lot to the patient about the physician and provides a host of clinical information to the physician. So, it would be of interest in this discussion if whether you ever took the initiative or was given the opportunity to shake the hand of the physician or nurse. Maybe this act on the part of the parties involved should be more publicized as of value to both parties. What do you think?
..Maurice.
The link below will lead to a video of a elderly male about to have urological surgery. Just as it was in my case, you will note that when the patient is wheeled into the operating room there are six, count'em, six female nurses.This is SOP at most all hospitals. My only question is was he advised beforehand about his all female team and was he offered an all-male team.
https://www.youtube.com/watch?v=Lv1KhK3y_WU
Joe, odds are that urology center doesn't have a single male nurse, and so they are not about to advise the patients.
We don't have those kinds of centers up here, likely due to the sparse population, but I think I'd be leery of them if we did. I went onto their website and didn't see any MD Anesthesiologists on their staff which means they are using CRNA's exclusively. If something goes wrong during surgery there will be a delay while you wait for an ambulance to get you to a hospital. If an anesthesia-related matter occurs during surgery beyond the scope of a CRNA, hopefully the patient survives whatever it was.
Dr. Bernstein, personally I think there are more angels amongst physician ranks than demons. Most are somewhere in-between.
I'm not a touchy kind of person and so I'm perfectly OK with a friendly verbal greeting rather than a handshake but when the doctor offers their hand I reciprocate so as to be polite. I've never had a nurse offer to shake my hand, and that's OK. Just greet me in a friendly manner and use my name Mr. so and so.
What I really want is for any staff member to make eye contact and act as if they are interested in whatever they are there to do. I know it isn't their fault that they are over scheduled and in a rush but in the few minutes they have with me, be there with me mentally and emotionally.
Good evening:
Looked at the video Joe. He would NOT have been advised beforehand about his all female team. They don't want the patient to stop the procedure beforehand as they'd lose money. They'd rather ambush him hope to get him into a "deer in the headlights" situation where he's too afraid to do anything but what he's told.
This video is mild. The ladies all look to be older rather than the 20-something most guys get these days.
To answer your other question, Facilities NEVER offer an all-male or female team for women.
You have to know to ask at least a month out from surgery so they cannot say there's not enough time to put a team together.
That's all for now.
Regards,
NTT
Biker, thanks for your response regarding an initial handshake offered by the physician to the patient.
Beyond, the clinical information value of the handshake itself (which I won't go into the technical aspects but here is a link to an example case), I do think it can represent a sign of starting out the illness venture, together.
Biker, I would be interested to read here what our other contributors think about the value to both parties of that introductory handshake. I am looking for anything, any act, that can establish from the outset a "togetherness" that would facilitate arriving at the hopefully expected worthy goal of this relationship.
By the way, the physician's grip of the patient's hand should be present but mild and no big "domineering" squeeze which would also diminish it's clinical value. ..Maurice.
Dr. Bernstein, I think that establishing the professional relationship is the most important step in getting to know your doctor. Remember the saying, you only get one chance to make a good first impression. I expect that any doctor I am seeing wants me to have a favorable impression of him or her, as I strive to make a favorable first impression as a patient. I always go to the doctor dressed nicely, not coat and tie, but certainly business casual. I have found that I am better treated than when I used to dress in a T-shirt and blue jeans or shorts.
Back in the 1980s, most first time patients were escorted to an actual office to meet the doctor if it was your first visit. There were framed diplomas on the wall, along with pictures of the doctors family, along with photos of activities he liked to participate in, etc. It was just a good opportunity to get to know each other and then discuss the reason for the visit. I regret to say that I have not seen an actual office when going to the doctor in many years. Now, the first time meet up occurs in the exam room. At every office visit I do expect an offer of a handshake, and I do appreciate it when that happens. It's just common courtesy between a patient and the doctor. I notice that the handshake NEVER occurs between a patient and a medical assistant or nurse, at least not in a doctors office. I did get a handshake from my prep nurse for both of my hip surgeries in the hospital.
58flyer
Joe, In looking at the video what struck me was the presence of curtains that may be used for extra privacy. I am encouraged by that, it says a lot about their commitment to patients. Of course, the real test is if they actually use them.
At my primary care facility, my most recent EKG was preformed by a male tech. After entering the room, he instructs me to take off my shirt and put on the gown with the opening to the front. He then left the room while I did that. He also pulled a curtain closed behind him as he left the room. He knocked upon entering, and came in after my response. He shut the door, then walked around the curtain making sure it was still drawn all the way across. After the EKG, he left me to dress by myself. I thought that was really cool, he's a guy, I am a guy, yet all this respect for my privacy.
Contrast that with my current Urology practice. No curtains. Curtains would have made me much more comfortable.
58flyer
Dr. B.,
Most of the time when the dr. arrives, you are already compromised by having to remove your clothes. I think handshaking at that point is ridiculous but also very germy. Biker made an important point of which I mandate is that they do not get call patients by their first names but rather show respect by calling them Mr. Mrs. Ms. Titles are a show of respect. Drs. expect to be addressed by their titles. Nurses and office people should never address a patient by their first name unless the patient has given permission.
As far as there being a middle ground or in-betweens, either they respect a patient's dignity by not exposing them, by not telling them what they intend to do but rather explain & ask, etc. or they don't. It doesn't really make the act of being violated any less if they did it for entertainment or they just don't think they have time to treat you humanely. The fact is you were violated. There aren't degrees of violation based on their motives and furthermore, you probably won't know their true motives bc they wouldn't admit to any wrongdoing. This applies to the ones who do not actually do the physical violation but witness and do nothing. Guilt by association. So therefore, I feel that way too may fall into the bad category based on the amount of unnecessary patient exposure that happens. That is my take.
NTT,
Even if you ask and are told, just look at some of the cases on Misty's site where they were told but then it didn't happen. Once the drugs start flowing, anything can and will happen. Look at the one ladies' case posted here that although they drugged her she begged them to stop but they didn't. That is why the pre-sedation is given so they have total control. Also, you are right that most are young women who absolutely don't have any respect for men.
The hand shake of the physician and as accepted by the patient represents the beginning of a relationship beyond the use as clinical evaluation for the physician. It is also the prelude for possible subsequent more intimate "laying on of hands" during the physical examination. It is important but the physician's hand is simply extended for the patient to hold, if the patient desires. Hand shake with the patient is desirable regardless of the gender of either the physician or patient.
We also advise the medical student to sit or stand at the eye level of the patient during the history taking.
An initial office history and consultation should not be performed with the patient already undressed for examination and should occur in the physician's office. That's how it always was when I was in my own office practice. Obviously, now with limited time for each patient, the "office" becomes the exam room but the patient should still be dressed. Of course, the initial physician visit of a hospitalized patient or one in the emergency room is usually performed with a gowned patient but dressed attenders.
I say a partial solution to the entire medical system behavior or misbehavior is we need more physicians, nurses and techs, of every gender, to attend to the more patients entering our clinical environment and less in the way of unnecessary bureaucratic distractions. All agree? ..Maurice.
..Maurice.
Hello,
I posted a comment at the Yakima urology clinic referenced above. Other posters may wish to do the same.
Reginald
Maurice,
Boys are at a disadvantage in school. In simple terms, girls were falling behind and money was spent to catch girls up. What happen was overkill and girls were given advantages (that boys didn't have) and they surpassed boys:
Thirty years ago it was girls, not boys, who were lagging. The 1972 federal law Title IX forced schools to provide equal opportunities for girls in the classroom and on the playing field. Over the next two decades, billions of dollars were funneled into finding new ways to help girls achieve. In 1992, the American Association of University Women issued a report claiming that the work of Title IX was not done--girls still fell behind in math and science; by the mid-1990s, girls had reduced the gap in math and more girls than boys were taking high-school-level biology and chemistry.
Some scholars, notably Christina Hoff Sommers, a fellow at the American Enterprise Institute, charge that misguided feminism is what's been hurting boys. In the 1990s, she says, girls were making strong, steady progress toward parity in schools, but feminist educators portrayed them as disadvantaged and lavished them with sup-port and attention. Boys, meanwhile, whose rates of achievement had begun to falter, were ignored and their problems allowed to fester (page 53). Source: Newsweek, EDUCATION: BOYS FALLING BEHIND GIRLS IN MANY AREAS
Society has noticed the gap which started in the early 2000's and continues today. See: Why Men Are Falling Behind in Schools
Feminism has been blamed for falling behind. Men are portray as the cause of society's problems and sexual predators. There is an anti-male sentiment of men. Reference: Why Are So Many Campus Feminists Anti-Male?
Now masculinity is toxic. So what is toxic masculinity is ? In psychology, toxic masculinity refers to traditional cultural masculine norms that [supposedly] can be harmful to men, women, and society overall.
For decades, we used terms like “macho,” “red-blooded” or “machismo” to describe the kind of hulking masculinity that men were, on some level, expected to aspire to.
Now we have “toxic masculinity” — an expression once relegated to women’s studies classrooms that suddenly seems to be everywhere. Source: NY Times, What Is Toxic Masculinity?
There you have it, men are evil.
-- Banterings
I will ditto 58flyer's "business casual" dress when going for medical appts. I always do that too as a sign of respect that I am going to a professional setting and so as to convey myself as a professional.
Similarly, I too appreciate the presence and use of curtains that block the view from the hallway when the door is opened, as well as a pause for an answer before opening the door after knocking. Both are signs of respect and professionalism. Curtains are useless if they still walk in on you while you are undressing.
The handshaking thing I could live without but that's just me. Addressing me properly as Mr. so and so is far more important to me. I also like the "eye level" interaction noted by Dr. Bernstein, and actually making eye contact.
Specific to ER's when the niceties discussed above might not always be practical, having had several ER visits in recent years, a piece that I find very unprofessional, and irritating, is when the person handling the insurance and/or basic patient data & consent stuff just walks in w/o knocking if there is a door or otherwise around the curtain without first knocking or asking if it is OK to enter. They don't know if the patient is lying there exposed or in the middle of treatment.
What is needed now to end the current year and start the New Year is a bit of humor in the midst of all the angst which has been writing here over the years. The following is from the Thesaurus of Humor by Meiers and Knapp, Crown Publishers 1940. Enjoy and yes, you can return comments.
Let's start out with hospital to get into the mood.
HOSPITAL:
832: How is the best way to get to the emergency hospital?
Just stand there in the middle of the street.
DOCTOR:
838: Doctor: "There goes the only woman, I ever loved."
Nurse: "Why don't you marry her?"
Doctor: "I can't afford to. She's my best patient".
842: "Just do as I say and you will be another man"
"Okay and, Doctor, don't forget to send the bill to the other man."
848: Doctor: Stick out your tongue.
Man: What for? I'm not mad at you.
849: Is the doctor in?
Yes, but the doctor is practicing.
Well, I'll come back when he is perfect.
GAS:
607: We're going to operate on you. What will you have--gas, chloroform or ether?
I always believe in patronizing home industry. Give me a local anesthetic.
More..later. ..Maurice.
How about some more from the same resource?
Category: SICKNESS
741-Did you take my advice and sleep with the window open to cure your cold?
Yes.
Did you cure your cold?
No. I lost my watch and pocketbook
744- And then I got clothing sickness.
Clothing sickness? What's that?
My tongue got a coat and my breath came in short pants.
761-Why do you keep looking down all the time?
The doctor told me to watch my stomach.
774-The doctor told me he would be all right---just take a bath before retiring.
Well, the way business is now, he won't retire for 30 years.
828-Weren't you in the hospital last week?
Yeah, I had a terribly high fever.
What did they give you to slow down your heart action?
An elderly nurse.
860-Doctor: It's most essential that you should refrain from doing head work for the next few weeks.
Patient: Yes, doctor, but it's my living.
Doctor: Oh, are you a scholar?
Patient: No, I'm a barber.
and finally for today's humor examples:
890-So the operation on the man was in the nick of time?
Yes, in another 24 hours he would have recovered.
To all: As in other professions, I suspect there is a host of other misstatements and ambiguities in patient-doctor and patient-nurse communications which may lead to misunderstanding and interference in proper medical diagnosis and treatment and add to the dichotomy between the medical system and the patient. Can you present us with a example(s) of such incongruity in communication with the healthcare providers? ..Maurice.
Concerning Banterings most recent post about anti-male feminism, we know it has crept into physician ranks as evidenced by the steady stream of "victimhood" articles on KevinMD and elsewhere by female medical students/residents/physicians. If it has infected physician ranks, it surely has infected all the mid and lower levels too.
I am glad that women can be anything they want and am glad female patients have the option of female physicians if that is important to them. I am not glad knowing that some of those I turn to for healthcare might see me as something lesser on account of my gender. I am not doubting but that I will receive the medical care I need at a technical level. It is instead the soft side of things as to whether my privacy will be respected to the extent they would for a female patient.
Here are two recent examples. A few months ago I noted a good friend (male)was an inpatient for a few days at the small local hospital. When it came time for a shower and he hesitated, the female LNA literally told him "you don't have anything I haven't seen" to embarrass him into compliance, and it worked. Very recently my wife had both knees replaced at that same hospital and was there for 3 days. All of the nursing & LNA staff were female and they were very protective of her privacy. A male occupational therapist she had needed to show her how to put pants on and before starting he affirmed she was wearing underwear. Every aspect of her care was respectful. When asked if she wanted a bed bath and she declined, there was no pressure but rather just a simple let us know if you do want one. Why did she have a very different experience than my friend in the same very small hospital?
Dr. Bernstein, an example of the dichotomy between provider and patient is in the use of terms such as "minimally invasive" or non-invasive". Healthcare staff measure "invasive" in terms of incisions, use of catheters etc whereas many of us here measure "invasive" in terms of exposure.
For example, those new urocuffs are advertised as non-invasive whereas I would see it as extremely invasive to stand there putting it around my penis while a female tech watches to make sure I do it right and then standing there urinating while it inflates and deflates with her watching me the whole time. So when the urologist tells the patient who has no idea how his urodynamics study will be done that it is non-invasive, there is going to be a very shocked and probably embarrassed patient.
Good Afternoon.
A happy & safe holiday season to all.
Nightmare Before Christmas
It was the night before Christmas; and all through the ward
not a patient was complaining; and the nurses were bored
So, they all sat around; with nothing to do
I know someone said; check out the hunk in 122
With a wink and a smile; they headed down the hall
as someone then said; I can’t wait to check his balls
When they got to his door; they took a look around
not a person was stirring; there was not a sound
So, one nurse entered the room; not a word was said
as she gazed upon their target; sleeping quietly in his bed
He was in a coma; from a bump to the head
he looked so peaceful; some asked was he dead
They posted a guard; and the rest quietly went in
as their eyes began to bulge; to match their grins
They gathered round; each side of the bed
oh, look at his bulge; one of the nurses then said
With a nurse on each side; they reached for the cover
in great anticipation; of what they would discover
In one swift motion; they pulled it down
only to discover; he was wearing a gown
They came this far; to get a good look
everyone knew; they’d do whatever it took
They pulled back his gown; to see their prize
as they saw they smiled; with wide open eyes
They looked and admired; then out came the phones
snapping away; as they heard someone moan
He was covered back up; when they were done
then back out into the hallway; where it had all begun
Each nurse was grinning; ear to ear
as they knew there’d be more; in the upcoming year
More patients exposed; for them all to enjoy
the best perk of this job; is seeing them boys
Well on this Night Before Christmas I grabbed the newly arrived Jan. 2020 National Geographic to read. Not good for the blood pressure. There is an article "How Women's Health Gets Shortchanged". The author is an ER MD. You guessed it. Women's health doesn't get the funding or attention or respect that it deserves. That women are now the majority in medical school, as college grads, as earning masters degrees, and as earning doctorates is merely "progress" towards equality. Every statistic in the article bemoans how tough women have it. The article by omission of mentioning men's health issues at all infers that the health system has addressed all of men's health needs to the detriment of women. Even the stat she included that women outnumber men 2 to 1 over age 85 is posed as a negative because as a result more women develop Alzheimers. I'm guessing all those nasty men haven't cured it given it impacts more women than men. I suppose the healthcare system somehow advantages men by having them die at ages too young to develop Alzheimers at the same frequently as the much longer lived women do.
The future of healthcare for men does not look real rosy given the prospect that women like the author of that article will soon dominate the physician level too.
Good Morning & Merry Xmas to All:
I agree with Biker on "minimally invasive" or non-invasive".
If men are to be treated as 2nd-class it's time for providers to tell their male patients EVERYTHING about ANY exam, test, or procedure they want run so men can make a truly informed decision as to whether to go forward with it or not.
I've not been told everything by the provider, go to the testing & found out the details there & have walked out on the test. Then when I see the provider the next time I give them an ear full because I asked for all details & they didn't tell me everything.
Their excuse is we didn't think you go through with the test if we told you everything beforehand.
In other words, better to ambush. I told the provider I won't be ambushed by hospital personnel anymore.
Between ambushing & their drugs to make one compliant, patients have to always be on their guard these days.
That's it for now.
Regards,
NTT
NTT,
Very witty poem! Glad to see you recognize they do use drugs to make patients compliant.
Biker,
Could you post the author's name & email if it is in the article. I would like to give her an opposing point of view from a female. Although it is doubtful if it would penetrate their liberal head bc it is more do as I say but I don't have to do as I tell you to do. Your definition of what a patient may view as invasive is spot on.
Dr. B.
Some examples are asking the patient for adverse medication effects and then deciding not to include it in the MRs. Telling a patient they will be going to the next hospital & family/patient will be consulted before anything is done knowing that was a lie. Telling family/patient that family would be able to visit within 30 minutes. Telling patient they had a widowmaker heart attack when they did not. Telling a male assault victim to just get over it. Saying that female nurses could not and would not be a sexual predator. Telling patient that are just going to give a little something to relax them (meaning fentanyl and versed) and they will remain awake during procedure when they know that is not true. Telling patient they will have an all male or female staff but using whomever once the patient is too drugged to resist. These are things that did happen to us and others are things I have heard others say.
One nurse said that it is highly unlikely that my husband was sexually assaulted (they don't recognize forced nudity for no medical reason as assault) and besides it goes against their code of ethics. Someone should tell the victims of other crimes that bc it goes against their code of ethics their assault did not happen. It certainly supports the medical community's code of ethics that male patients do not matter. Certainly it also supports their code of ethics that patients who enter their doors are their property until the medical community decides to release them. I did ask this nurse if she would be willing to forfeit her license if her blanket statement was proved incorrect? Of course--no response.
Come January, I am going to start contacting hospital chaplains, senior centers, church groups, and anyone else I can think of to talk to them about patient rights especially patient dignity/modesty that is lacking for all but especially is not recognized in any degree for men. Writing to politicians, reporters, etc. has been a total wash so maybe taking it public will be better? I need to do something in helping stop making patients victims of the medical community.
JR, this is National Geographic magazine. They don't give contact info for authors. You'd have to write to the magazine itself. The author's name is Zoanne Clack. She is an ER MD.
JR, some time ago you posted that you intended to picket the hospital where your husband's abuse took place. I recall that you intended to contact local authorities about the legalities involved. Were you able to make any progress with that, or is it still ongoing? Best of luck,
58flyer
58flyer
After checking into the legalities of picketing I found that the law only allows for employee picketing. Picketing a business is an iffy proposition. I was also advised the hospital from he'll is very aggressive and tolerates no negative actions. That is why I have changed tactics. One way doesn't work try another. I have decided to picket the legislature during its session.
JR,
Thanks for the response. Let me throw out another idea. My local news affiliates all have some kind of investigative reporters who look into issues brought up by viewers and help with getting some kind of justice or in some way confront the problem people on camera. They often, but not always, get some good results. It's just a suggestion and you may have already done that as I don't get to read every posting here due to time constraints. Businesses, and hospitals are businesses, do not like negative publicity. Could this be another avenue if you haven't already looked into it?
58flyer
58flyer,
I have not contacted an investigative reporter by name but rather news tip hotline for the local stations. I have not received any response but then the hospital from hell is a large advertiser on the local stations. Lots of ill-gotten money to spend to spend their false sense of goodness and sunshine. But thanks for the suggestion. I will send out a little snippet to the investigative reporters. Anyhow, any suggestion is welcome as my mind is going a mile a minute to try to get this topic out in the open and recognized as an issue that affects healthcare for many or more the lack of healthcare. From talking with others who have had issues with this hellish hospital, they are real barracudas when anyone tries to object or have issues with care. There is no help for the medical and sexual assault suffered by my husband but my hope is to try to prevent others from the same but it seems to be an impossible mission. Some people have actually said that you must suffer whatever to get medical treatment and be glad you are alive. It leaves me shaking my head that are rubber stamping the heinous ways treatment is delivered in this country. They don't realize that turning a blind eye will only lead to worsening conditions. As I have said before, we never dreamed that what happened on that terrible night could happen to us but it did. It can and could happen to any average Joe or Josephine for that matter.
JR, Maybe by hiring a lawyer,a staff meeting could be held. Voicing our issues. If that could actually happen , you ( us ) would need many people saying the same thing. Otherwise you/us will be told we are the only person (s) on the face of the Earth who have these concerns.
Perhaps we should all consider, at this point, in the almost 15 year history of this blog thread about modesty particularly with regard to male patients..an aphorism:
"Actions direct to the medical system speak louder than simply writing words on a blog" is a good aphorism to employ when attempting to change the system. Maybe JR is moving in the right direction.
What do you think? ..Maurice.
Dr. Bernstein,
While venting on a blog certainly has some benefits, taking action is the only thing that will bring about change. That can range from picketing a hospital or clinic, to approaching a legislator to bring about a change in laws. As medical consumers, it is up to us to tell medical providers what we want and expect when we go in for treatment. They shouldn't tell us what to expect, but rather what we expect as patients. In any other consumer commodity, they ask the consumer to do surveys as a measure of how they are performing. That is not the case with healthcare. They may do surveys, but they do not ask the questions of how to actually improve their delivery of service. It is up to us to modify the survey. I recall when I was given a survey at my dermatology practice, instead of answering the questions they provided, I provided my own critique. It resulted in some changes, but there is still more work to be done. Overall, I still think the best solution is legislation.
58flyer
I too agree that legislation is needed to make all hospitals and medical providers follow the same basic standards of care when delivering medical services i.e. patient dignity and rights. Although there is a federally mandated Patient Bill of Rights and many hospitals have them, they are too vague to mean anything. Furthermore, their definition of patient dignity and rights are many times not the same as what the patient considers to be their rights, respect to dignity. However, I believe that legislative changes will only come with pressure from the public. Hence is why I am pursuing what I am. The more people out here that are educated and voice their concerns, the less they can ignore us, a big voting block, rather than only serving big pharma and the medical lobbyists. People need to be made aware they don't have to suffer through medical indignities and lose their basic human rights such as freedom of choice. They also need to learn it is okay to share what has happened to others can be educated and changes can occur. It is not good enough to change just one hospital or area within a hospital because they can change back, other areas still don't follow the more humane delivery of treatment, or you don't know which hospitals are humane. ER is a problem area in all hospitals. Just because treatment needs to be quickly delivered does nor should not mean they can skip basic humane treatment of the patient. There are those who have said they are okay with however they are treated in ER but if what happened to my husband happened to them, I imagine it would be a different story. That is why change in all areas is important and clearly needs to be mandated. Unconsciousness patients should be treated with the same respect as a conscious patient. With all the money hospitals rake in they can afford to hire more to make sure someone has the 2 seconds to make sure a patient is properly covered. It is really not that difficult. Hiring practices need to be revised to provide ample staff for both sexes. Discrimination in filling spaces in not only for female physicians but also for males in nursing needs equal attention. They say it is a man's world but once a man enters a hospital it is a woman's world. I don't see the world as a man's world because it has in the past been the duty of the man to protect and to provide then die. For the average man, it is a tough life but one they took pride in. Maybe it is a man's world for the very rich but there are fewer of them than the average man. But it is the average man that gets the blame for all the problems in the life of women. But I see the world as someplace where both men and women should be working together and watching out for and taking care of and for each other. Society has gone too far in the blame game. It is like for my husband and I, we know that some female nurses can and have provided intimate care without any abuse or assault involved but now it has occurred to me they are all suspects until they prove otherwise. I have known for years about some male drs. molesting female patients so I have always been watchful. At the time, I knew what he did was wrong and it deeply affected my future view of drs. but I have had male drs. in limited contact. Although I now see what he did as sexual assault, it nothing like what happened to my husband or maybe time has dimmed it? I guess at that time I too was helpless as my husband was but now I am not so I will continue this fight. I may have to continue to change how I do it but I won't quit the fight. Again, any and all suggestions are welcome.
JF,
You are right. That is why I want to bring the issue into the public sector. They will find it more difficult to keep ignoring a crowd rather than just one. And maybe if one hospital does embrace change and they can prove it helps their numbers maybe others will follow. About all, greed is on the top of the list for hospitals. But legislation is still needed to bring about uniformed and lasting change.
JR, Your not allowed to protest outside of the hospital? One time in 2007 a co-worker's boyfriend viciously attacked her 11 month old baby. They had been in trouble with Children Services before. Kids had been removed from the home and returned. People were at that time trying to get Çhildren Services involved again, but weren't having any success. After the baby was assultted, there was a HUGE protest against Çhildren Services. It wasn't outside of the building though. It was on both sides of Main St. Not in the actual street but huge numbers were there with banners . It was shortly before actually entering town with our Walmart and other stores and places of businesses.
JF,
You can but you can face arrest if they do desire. The law only allows for employees to protest against employers. Private businesses can call the police to have you removed or arrested. I will not give the hospital from the satisfaction of having me arrested as they very well who I am. Everyone I have talked to about them have said they are extremely aggressive and will not tolerate anyone telling the truth about them. The big drug company here in Indiana does allow protests because I guess they are so big they do not care. CPS is a government agency so you can protest. Hospitals aren't government entities though so it would be like protesting against a store like Walmart for bad customer service. They could have you arrested too. You have the right to protest government but not much else. I talked to a local attorney about this and he advised to find another way because in his opinion that hospital is a--hole. He didn't mince words about how evil they are or really the state of medicine in the US. He said he couldn't represent us as he didn't feel he could do our case justice as it was not his practice area. He also said we would have difficulty finding an attorney because most do not want to get into the ethical issues of what happened but he said he thought if someone would take the case it would certainly make a big splash for many different reasons.
I am not a lawyer but my guess is anyone can picket private businesses so long as you stay on public rights of way (sidewalks), aren't blocking ingress/egress to the buildings and roadways, and aren't creating a public nuisance (bullhorns for example) or otherwise threatening people. If this hospital is in a city as I suspect it is, the sidewalks in front are likely city property.
In my county's shire town there is a solitary woman out every day on the sidewalk in front of the Planned Parenthood building picketing.
The reality as has been noted is that hospitals are major employers wherever they are and are major advertisers in local media; making it difficult to get public or media support for any grievance.
Maybe permission could be obtained from the police in advance ( or at least you could check ) I think help could be obtained from my church denomination ( Seventh day Adventist ) if more members knew what Ellen White said about our issue. We've been accused of making her the god of our church.
About the lone woman picketing outside of Family Planning... Somebody should hand her a baby to raise. I disagree with abortion also. But there needs to be COMMITMENT to the babies and their mothers AFTER the babies are born. Too many people SAY they are anti abortion but aren't going to inconvenience themselves once the babies are born.
Yes, you can picket a private business but there can be consequences like being arrested or being sued especially if I were to decrease their business which is what I would hope to do. I am not sure if this hellish hospital is a for profit or non profit hellish hospital. Even though I would not have told our story, I would have alerted future patients to what could happen as a patient like unnecessary exposure, un-informed consent, like of males for male patient intimate care, privacy invasive chaplains, etc. It would be my hope that potential would be aware of what could await them. Planned Parenthood is a not-for-profit and also a target of accepted protests whereas hospitals aren't. Biker is correct in saying that they are major advertisers in local media so therefore it buys them silence on negative stories. I haven't gotten any responses to even the articles I have sent as generic articles. As I said, this particular hospital is very aggressive and a local attorney advised they would do something as that is their nature to quash anything that portrays them in a negative manner. He has had private dealing with them and also does not like them. Also, when I called the city about doing the picketing they were not very helpful and were somewhat hostile when I explained where I wanted to picket to I got the feeling as far as they were concerned, I could expect issues with them too. However, it would be perfectly acceptable for nurses to strike for higher wages but not for patients to picket for better treatment. It is a mixed up way of thinking. As far as there being sidewalks in front of the hospital, I don't remember but City is the whole of _____ County. This hospital is not in the city proper so there may not be sidewalks near the road as it sits far off the road. I will have to ask someone about the sidewalk situation. I know the one near to me does not have sidewalks near the road nor does what is left of the one in our small town have sidewalks near the road. The sidewalks at both of those places are at the building. For now, I will concentrate on picketing the Statehouse.
JF,
I hadn't thought about asking for help like that but that's a good idea. In my opinion, they are less likely to react aggressively if there is more than one. Yes, I did call the police dept. for guidance but got a cold reception and little information. I just don't want to give the satisfaction of causing further harm to us by whatever action they may take. They have done enough harm already. I do believe you have to have a permit but I could stopped pursuing it once I talked to the lawyer. But now a new year is coming up, I am thinking maybe I should revisit it if I can find some others to join me. And yes, I don't abortion either but sometimes in certain circumstances like rape, it may have to happen because I can't imagine carrying something inside of me from such a horrible violation. It would probably make me go crazy. It would be a horrible decision to have to make. But yes, you are correct that more should be done to help the babies we have. I certainly don't support late term murders like some politicians are. Giving birth then killing them is no different than raising a child then deciding you the woman don't want that child alive after all. In that case, they now call that murder but could that change if after delivery abortions are approved? I know--discussion for another blog.
But in any case, I am going to protest at the Statehouse and find chaplains, senior groups, women's groups, churches, etc. to talk with in order to educate them. I have brochures from Misty to give out plus some material I have been putting together. I don't plan to make this just about what happened to us but rather what can happen to anyone especially males or when drugs are used. I have been in contact with some LGBTQ groups and have had several ones express interest even though he is not gay but they thought he was. Could how they treated him come from that? I also have reached out to misc. national investigative organizations but so far nothing. I am going to reach out to the AARP as this behavior is more likely to affect seniors and they have a huge lobbying effort. Any more groups you can think of let me know? Somewhere something will stick to the wall and break it down. I am going to look for some national patient advocacy groups too.
I fully agree with JR, simply expounding frustration and anger on a blog thread such as this one will accomplish to resolve nothing much other than maybe attracting some others to write here. But that does nothing to make an active effort toward any accomplishment to make changes in the medical system.
More should be written about the techniques of following JR's concept of action. ..Maurice.
Maurice,
I dis agree with you. This blog has allowed me to network with others, vent, and a sharing of ideas for us to take action. I am sure that JR strongly agrees with me.
Many of us take action that others do not see. I have reported many instances of patient abuse in the news to Attorney Generals' offices. Just because they make the news, they may not be reported as crimes. The hospitals or licensing boards conduct their own investigations....
-- Banterings
Dr. B.,
I was one of those who used this blog to expel my anger and frustration. But I owe a debt of gratitude to all on this board for helping me over that and to focus on finding ways to work towards changes. I even have to thank PT because if he hadn't been such an A--, I might not have taken such a good, hard look and realized I was not accomplishing anything. I was still reeling from the shock of it that I forgot the golden rule from a wise man that mentored me years before that don't just complain have a solution available. Even though I haven't made much if any progress in getting changes made, I do feel better that I am doing things that might help bring about changes. I owe an eternal gratitude to Banterings because he helped me see that what happened was wrong and we (husband and I) weren't alone. I follow him on Twitter and others now and all are a wealth of information that helps me in my quest for change. Misty's work at Patient Modesty has been extremely important as there all a lot of resources already at my fingertips. This board does too because all have information to contribute or even are just a sounding board Like JF suggesting I get some church groups involved in helping picket. I didn't think of that. Biker and 58 Flyer are men of reason and vast knowledge. NTT works hard at getting info out there. There are others that I haven't mentioned but all are invaluable. But Dr. B., you have provided us the place and also keep this blog going. It has been a long time since I have spoken in a positive manner about a doctor but thanks for providing the opportunity. Even though you haven't experienced what some have, I feel you may even see there actually is a problem with how healthcare is delivered. I don't know if I will succeed but I will keep trying because the end result will be worth it. I also have been on other sites trying to bring others to this board and my website because I know others suffer and I want them to know they are not alone. That is what this board does. It gives us a place to know we don't have to suffer in silence. That is comfort that is hard to come by and is invaluable. I am vocal while others may work more quietly but I was a squeaky wheel in my younger days and now the tragedy that happened has propelled that squeaky wheel back into action. Banterings is right that many things done go unnoticed because there is a lot of opposition to change and letting the public see all the dirty little secrets of how medical care is delivered.
Banterings, great! It is those describing "doing actions that others do not see" which should be documented here for others to consider as approaches to make the medical system changes.
I know you all hate my expression "personal moaning and groaning" but except being perhaps valuable personal ventilation, what is needed is a "map to action", if you know I am trying to express. What should be done next?
What could be more effective in accomplishing the goal? This should be the direction of discussions presented here. ..Maurice.
Dr B,s favorite motto is SPEAK UP! I think one important way of doing that would be to make other people aware of this blog. Especially young people who aren't aware of what can happen.
Otherwise WE won't be who resolves this issue because WE are law-abiding. Corporations are untouchable. Individuals who work for corporations are not.
How about this?: "Modesty would not exist if we weren't afraid of judgment. It's that feeling that someone will judge us to be more or less than someone else, or in some way failing to adhere to our cultural beliefs that embarrass us, and makes us afraid of exposing those parts of our bodies that we are afraid will cause negative judgment."
From https://www.verywellhealth.com/patients-medicine-modesty-healthcare-2615000 ..Maurice.
Dr B, I don't see how anyone could benefit from Trisha Torrey's article. The only thing different about her and other providers is that she acknowledges that patient modesty exists. But only if the patient feels he or she may be judged. Medical doesn't have to provide privacy. Has never done wrong by not providing privacy. But patients shouldn't avoid care because of it. I'd say that article was a step below worthless.
Does it occur to these people we haven't told ourselves some version of that mindset? Does she think other people haven't tried? Maybe she thinks that she have unapproachable wisdom that only she has!
It isn't correct in assuming it is all about modesty. It is the right of every human being to decide how, to whom, when, etc. any part of their is exposed. Way back when it was decided that certain parts of the body were to be covered. It is a human's right for this dignity to be automatically afforded. Yes, some people are modest but modesty and dignity are different but the same in some ways. It is belittling to people anyone to say there are afraid because of body image. Then all those medical providers too must be afraid because they are wearing scrubs that hide their bodies from the patients. They could wear see through plastic coverings to put them on equal footing but they don't. They generally go elsewhere for their own medical treatment because modesty and/or dignity are real issues. My husband didn't have issues because his modesty was violated as he had had numerous other encounters with female providers in the past. It was rather his dignity was violated in such a vile manner. He would have been fine at that time if the nurse would have asked him if she could help him with the urinal and then asked the others not needed to leave and to provide him privacy. He would have been fine if she had kept his genitals covered and she examined his groin punctures without leaving him exposed for 5 hours. It has nothing to do with modesty but everything to do with what is appropriate and what is not. Because this same nurse felt she didn't have to protect her patient's bodily dignity, she also felt she did not have to do anything to keep him from possibly choking on his own vomit when she should have given him prescribed meds to prevent it. Modesty had nothing to do with being put on display for whatever reason. Trisha Torrey does not know what she is talking about. She is belittling every patient and helping add to the problem that patients are just being "difficult" if they demand dignity or have modesty concerns. There is nothing shameful about having dignity or modesty but there is something shameful about those medical providers who callously and cold-heartedly ignore every patient's basic right of dignity and modesty needs. If they were to treat an woman of a certain religion without any regard for her religious beliefs, they would be shame and probably fired. Why can't they not understand that all people have the same right to dignity and modesty? It really makes no sense to allow them to have such an ignorant belief they can treat the average person especially a male so sexually offensively. By the way, nursing oaths have in them to treat patients with dignity so what about them not obeying their oaths? Textbooks are written providing the same belief. What are they not practicing what they have learned? Certainly it would lead to the conclusion that they may also discard other practices that could actually endanger lives. Think about that. A shortcut here a shortcut there. Again, she decided not to protect his bodily privacy and not to protect him while he was laying flat on his back from possibly choking on his vomit. She knew better but decided not to for whatever reasons except she was busy torturing him. By not providing patients with their inherent right to dignity, staff is saying you are not important to us. How far will they let that not important attitude go to? Where does it stop? Providing patients with dignity is only the tip of the problem I think.
Considering the seriousness of the discussion in this blog thread, I found Trisha Torrey's article to be superficial to the extent of being just more medical community propaganda.
BJTNT
JF is correct about Trisha Torrey. She states:
A report in the Wall Street Journal reviewed a study that showed that only 54% of men get checkups, presumably the other 46% have modesty issues at least to some extent. About 74% of women seek preventive care, again, we can assume that some of the remaining 26% avoid care due to modesty issues...
Another reason some healthcare professionals don't regard modesty with any importance is that a patient's modesty may cost them time and money...
Some people believe that, as patients, they are "owed" this extra step by providers to be sure modesty is addressed. But no, they are not.
Many providers, perhaps even the majority, understand that patients wish to be covered, want someone to knock on the door, or in general are modest and embarrassed. Those practitioners will take the extra steps in the best way they know how to address their patients' modesty issues.
However, this is not true for all providers.
What about victims of sexual assault and medical abuse?
What about research showing that intimate procedures can cause PTSD? (Reference: PTSD in women who have undergone obstetric and/or gynaecological procedures)
This is insulting, abusive, and incorrect.
For give my brutal honesty and my feelings (being told this), and I am sure that I am not the only one who feels this way, but f**k Trisha Torrey. This is the equivalent to telling a sexual abuse victim to "suck it up" and have relations with their significant other.
-- Banterings
In varying degrees depending upon the person modesty does have body image and fear of judgement components to it, but being modest as concerns genital and breast exposure is a fundamental societal standard.
In warm climates people do not need clothing in order to stay warm but society insists that people be covered up in public regardless. Why? Because society sees exposed genitals and breasts as being sexual in nature.
Nude beaches are an exception but such places are generally kept physically apart from the general public. Several States have passed laws or had court rulings that allow women to be bare chested in public anyplace that men are allowed to, yet it is extremely rare that any women exercise these rights. Why? Because the societal standards say they can't no matter what the law or courts say. In Vermont public nudity, and I mean full nudity, is legal virtually everywhere, yet it almost never occurs for that same societal standards reason. It may be too cold for this most of the year, but it is warm enough for a couple months in the summer when it is in the 70's & 80's to be outside w/o clothes. It thus could happen but it doesn't.
Societal standards also dictate that genital & breast exposure can be OK in certain same-gender settings such as locker rooms, pools, & swimming holes. For males at least that was long an established part of standard socialization, though I believe it is no longer the norm for boys growing up.
A major disconnect then occurs when we enter healthcare settings and the staff expects patients to unilaterally set aside a lifetime of societal standards and socialization. This is especially so for men who have been socialized to accept exposure to other males but such male staff are rarely available or offered.
I thus posit that the issue isn't as simple as body image and fear of judgement.
This is to clarify my last post one one key point. Even the most modest patient knows that for certain medical exams and procedures that they must set aside normal societal standards as concerns their exposure. This is because the exam or procedure can't occur otherwise. The problem is that "necessary exposure" only includes the healthcare staff actually necessary to the exam or procedure. "Necessary" doesn't include non-necessary observers. It as well doesn't mean casualness in exposing more than was needed to be exposed or for longer than it needed to be exposed.
The other problem is that healthcare chooses to ignore the societal standard that dictates same gender exposure is generally acceptable whereas opposite gender exposure is not. Adhering to that societal standard may not always be possible in healthcare settings, but the larger problem is they don't even try.
Modesty is a continuum and as such many patients have no modesty concerns at all, but healthcare's starting point needs to be general societal standards as concerns modesty until such point as the patient says it isn't necessary. In other words, approach every patient as if they are very modest.
As our Modesty blog thread is coming (at this time in the United States) to its 1 and 1/2 decade of discussion but without much signs that "things have changed" within the professional object of the expressed concerns, I hope to see progression by those here and their family and friends to accomplish the goals supporting dignity and modesty of all patients within the medical system. This should be our goal and even though I, myself, am still a part of the medical system, I do look forward toward beneficent all patient changes as we move on to the next decade of patienthood.
Best wishes and the best of health and spirits to all who are now or have or had been participating or simply reading here all these years. ..Maurice.
Happy New Year everybody!
A lot of you picked up the same thing as I did about the Trisha Torrey article. She seems only focussed on the belief that being judged is the only reason for modesty. As we all are aware, there are many reasons for modesty. Biker hit the nail on the head when he discussed "fundamental societal standards." America is after all, a clothed society. Therefore, any medical professional will take into account this fact when approaching the issue of modesty, if they are truly professional.
I am reminded of a past girlfriend who was a nudist. She was also a nurse. She had absolutely no sense of modesty. As female patients do encounter modesty violations, she had a few such experiences of her own. Even as a nudist, she felt those violations were a sign of disrespect. It didn't bother her to be exposed, but the disrespect did bother her. Being a healthcare professional, she knew the walk and the talk and took care of the situation. While I was not able to tell her of my abuse experience, I did mention some inappropriate situations that I experienced and she agreed it was unacceptable. Even as a nudist, she was very aware of societal standards.
Dr. Bernstein, moving forward in the coming year, I am thinking of making contact with my elected representatives and begin discussion of legislation aimed at providing protection for not only male patients, but female patients too. In my mind I am thinking along the lines of a "Patient Protection Act" which would call for mandatory identification of healthcare personnel, a true chaperone rule, and limitations imposed on the scope of practice of medical assistants. Another area of concern is the consent forms, I would like to see a provision where any patient could "opt out" of being used for training or observation without any penalization.
I do wish a highly gifted writer could write a book on the patient modesty issue in America as that would get discussion going with the realization that there needs to be change in our healthcare system.
58flyer
Biker,
Well said 1st paragraph of second post. Perhaps to add one more thing that the patient has been given an explanation as to why, who, and how and they have received a clearly understood patient consent. Your 3rd paragraph addresses the issues of every patient being given patient dignity which would solve a lot of issues. They need to recognize that males have the need for dignity too. It would be interesting to know of those patients who say they have no modesty concerns if that is really the case or they don't want to acknowledge those concerns for fear of being belittled like those who do express concern? We need a survey but how would that be possible? Instead of spending all the money on stupid studies the government needs to be studying the dignity/modesty issue. I think I will address that in future communications with some legislators. Has anyone seen any recent studies on this? It also would be interesting to find out if the general public thinks male patients can be compromised by how medical care (mostly female) is delivered to them. There also needs to some studies done on how many medical workers use their facilities for treatment and why and why not? I think I will put together a sample survey to send so they have something to work with and have the direction in place that we need to study. Any takers on helping with the questions? I have done a few surveys in the past but it has been many years ago for college classes and my union column.
Picking up on a point JR made, is the reason healthcare staff reportedly avoid getting their own healthcare where they work due to body image issues and fear of judgement? As healthcare "professionals" do they not believe all patient exposure is purely clinical for their co-workers and that they wouldn't be judged? To what extent does fundamental societal standards concerning exposure come into play? Yes, why they choose to go elsewhere would be a great question to do a study on. It would have implications for the privacy and dignity of all patients.
I suspect a big part of what such a study would conclude is that there is a perceived difference between being anonymous and being known. That in itself then poses the question why if healthcare is purely clinical. It also has implications for small town/rural settings where it is very difficult to be anonymous.
As far as Consent Forms are concerned, a simple addition of " with prior consent from the patient or the patient's representative" to the offending sentences would suffice in most cases.
This would be applied to references to additional people in the room during an examination and to the photography clause. Both are fairly common language in the forms that I have seen.
I usually add this to the consent form myself with an initial and date.
Ed T.
I've been thinking about Trisha Torrey's article and have to admit being upset with her for writing it. It reminded me of an interview with a former female judge that I saw in TV one time.
The lady was commenting on people going further up when they were displeased with the verdict that was given. She said she didn't believe that people should be allowed to do that. She had a turned around version about what judges are for ( getting justice ) In her mind the title of Judge exists so that the person who gets that title could have ultimate control of other people. If good judgements happen. Good. If bad judgements happen , O well! Suck it up.
Towards the end of the interview,the guy interviewing her asked her if she ever saw a judgement rendered that she disagreed with. She said I won't answer that question. Which of course, if you won't answer that question, you have actually answered the question with a yes.
I have been posting elsewhere. I am very encouraged about the feedback I have been getting from Men. From where I've been posting oh, there are a lot of other men who feel the same way as others do on this blog site. Now we just have to figure out a better way to reach them.
Sorry about the above post but did it by Google microphone. JF made a good point in what she said in her last post. Silence usually means guilt.
Ed. T.,
I have suggested that certain areas of consent forms need patient signatures like video, people in the room, drugs used, etc. because it is too easy for them to skip those parts and then lie about having explained them. I think I have a consent form on my website. Also, many places are now using electronic consent forms on tablets & it is not easy to make additions to the form. What we had to do was to write in it in the only available space & that was the signature area. I think they thought the electronic would reduce the number of people crossing off or adding things to the form. Most would give up and let the items they don't agree with happen anyhow or get a verbal agreement which many of us know is generally not adhered to once you are drugged.
58 flyer,
I am not a gifted writer but I am working on such a book. I had to start over bc my year old solid state harddrive that replaced my old one died without warning and without proper backup. (Banterings don't say anything. As with the mechanic's wife, the IT pro's wife computer is not high on the list but now it is.) So I am slowing beginning again but I have changed my view. I am going back and reading stories that I want to include and reading info from a lot websites.
As I said earlier, from these other websites, I am sort of surprised about the number of men that have wrote in response to what I have said. There are others out there that feel abused and assaulted by their medical treatment. Now, I just have to figure out how to reach them so we have numbers. I have invited a good many of them to view this website, Patient Modesty, and of course my website. I want them to know they are not alone like we felt before we came here.
You may not be allowed to get numbers. I heard a rumour that when people in power see us communicating in large numbers, conflicting with what they want said and done, that your website would be shutdown.
There was an article in the local paper which in a roundabout way speaks to the trend towards female dominance of "provider" ranks. Now before dismissing the numbers as incidental, bear in mind that Vermont only has 625,000 people.
The article said that there is currently a shortage of 69 primary care "providers" in VT. These days when the term provider is used the intent is to includes NP's and PA's in the reference. Most NP's and PA's of course are women. The article then goes on to say that 36% of primary care physicians in VT are 60+. A significant majority of that 60+ group are male. Interesting that they define the current need in terms of providers but then shift to physician stats for who will soon be exiting the workforce. Lastly the article says that of 319 Residents in VT, only 18 are going into primary care. That I couldn't find an MD taking new patients a couple years ago within 1.5 hours of where I live makes a lot of sense in light of these statistics.
With NP's and PA's filling the void in primary care, and most of those NP's and PA's being women, the future of primary care is clearly female. Female NP's are the ones who will be doing sports physicals for teenage boys going forward, with their female MA and possibly their female scribe observing. Same with required employment physicals for men. And so forth.
In a conversation w/ a primary care physician, he said to me (he knew my attitude about medicine), "A primary care doctor is the jack of all trades and the master of none." He went on to say they are over worked, under paid, and the specialized doctors look down upon them as they are the lowest member on the doctor totem pole. Nowadays they are merely coordinators of where to send a patient for further tests. They do very little procedures in office because the hospital they are affiliated with wants most things done in a hospital and wants referrals to other doctors. Colds and such are about all they handle because times have changed for them. He said back ten years they were a dying breed. In order to make money as a the NP or PA doesn't get paid as much, the medical system itself has made this category extinct.
As I said earlier, I am truly shocked at how many men are silent sufferers of this medical system. Too many won't go to get treatment bc they know the system is not male friendly and many of the ones who do feel marginalized or assaulted. There is a receptive public out there so now I just have to figure out how to get to more of them.
JF,
May husband is my website host so he is friendly to the cause as he was a victim of the medical community. Yes, they do tend to shut down disagreements with them. That is why I think they advertise so much because they know their money buys them media silence. Really why would a hospital need to tell me they are compassionate? Shouldn't those caring for ill and injured be without saying compassionate. Even they know they are not.
On this dignity/ modesty blog: we're still getting started in a wrong place. EO calls it ( us being ) SHEEPLE. I tend to agree. We the people need to address our people in power exploiting us and silencing us like they've been doing.
JR,
To get the news out there on a wide scale that will reach a large audience, you will need a news platform that broadcasts on a national level. 60 Minutes comes to mind, maybe this an issue they've never considered. Maybe reaching out to them may produce some positive results.
58flyer
Good Morning:
There is another crack this morning in healthcare's dam wall they all hide behind.
A John Doe filed a lawsuit for abuse against a San Francisco hospital.
https://www.sfexaminer.com/news/patient-sues-sf-over-abuse-at-laguna-honda-hospital/
That's all for now.
May 2020 be the year healthcare sees the error of their way.
Regards,
NTT
Concerning the article NTT posted about the sexual abuse at that San Francisco hospital, it is yet another example of where it wasn't a single rogue employee abusing patients but was rather more widespread abuse, or at a minimum widespread non-reporting of abuse.
There are millions of healthcare workers in the US and even a very tiny fraction of a fraction of the total is still going to be thousands of offenders. What is hard to fathom is why the majority again and again are found to defacto condone such actions by looking the other way and not reporting sexual abuse when they see it. Granted many hospital systems take no meaningful action when it does get reported, but even then staff always have the option of reporting it to regulators or legal authorities.
Is the answer to what I am asking as simple as the majority at these institutions just don't see the kinds of sexual abuse these cases surface as being sexual abuse?
Reference: https://www.sfexaminer.com/news/patient-sues-sf-over-abuse-at-laguna-honda-hospital/
Quote: "Laguna Honda Hospital, a skilled-nursing facility located at 375 Laguna Honda Blvd., is operated by the Department of Public Health. Last fiscal year, the hospital cost $263 million to operate and served 1,107 patients."
That's an average of $237,579.04 per patient per year - just short of $20,000 per month per patient. Is there any integrity in the finances of medical institutions?
BJTNT
MedPage is running an article about MeToo in medical care. One example they gave was of a male patient harassing a female med student if I remember correctly. Of course, the female med student did not recount if the male patient was ambushed by her presence or if this was during an intimate exam which some men might do to relieve their embarrassment. Articles like that only fuel the fire that male patients are bad and deserve what treatment they get. I don't imagine MedPage would be willing to print an article showing how male patients are abused and assaulted. I think this MeToo will only cause more abuse to be done to male patients bc they feel justified.
Banterings,
I invoked the Trauma Informed Care today. My husband went for a checkup. The MA was new and instead of the usual 3 lead they are now doing a 10 lead. She told him to remove his shirt from the waist up and lay down. (I doubt if this is the same for women.) His normally low blood pressure w/0 rx drugs was already hypertensive just having a female MA. He knew better but he was upset so I spoke up. (I can really see how they terrify him now & can manipulate him.) I told her it should be in his file that he is a victim of medical & sexual assault that occurred at a hospital. She said it was not in his file. They lied when they said it would be. I said she needed to use trauma informed care with him and did she know what it was. You should have seen her attitude change. She apologized and was visually upset. She asked what she needed to do. I told her that female staff now traumatized him as they were the ones you assaulted him. I told her that she needed to explain, ask permission, and not used terms such as I need to, you must, strip, but rather he needs to be in control of the situation. I told her no intimate care was to be given by female staff and I always must be present. He told her this was his wishes so she could hear it from him. When the doctor came in and took his blood pressure about 10 minutes later, it was where it should be around 115/70.
Clearly these people just don't get it. They don't believe they can damage patients by their careless actions in injuring a person's dignity/modesty. They truly believe they are godlike and there are no consequences for how they treat a patient. Medical records are just BS. That certainly don't tell true stories about patients. You can tell them info. but if they don't feel like putting in they just don't. Anyway, we recorded the whole encounter like we have done for the past year so we actually have a memo of the event. It is a shame that seeking medical care has to be such a battle.
If I hadn't been there, they would have done what they wanted because he is truly scared of them but then he would not have gone. I think that is why so many men don't go for medical help because they are treated so badly.
After I lectured the doctor, I gave him the 2 brochures from Misty. I told him a person's dignity/modesty is a serious issue. I told him that although they as medical "professionals" don't see it as being an issue in how they treat patients, it is for the patient and it is when they are the patient. I told although what happened to my husband was more than a dignity/modesty violation, it is the ability for those infractions to keep happening that can lead to the more serious crimes of sexual assault/abuse. I told him it would be great if he put me in touch with the appropriate people at the hospital to have a discussion about these issues. He said he would. Let's see if he is a man of his word or he is just another doctor who doesn't say what he means or means what he says.
58 flyer,
Great idea! I will contact 60 Minutes. I also am going to contact Lara Logan as she is a real journalist who does investigative reporting.
Biker and JR perhaps you or others here could read the issue presented by mwhistler20@gmail.com who today wrote his story about his mom on our blog thread "Does End-of-Life, Hospice, Comfort Care Represent "Murder, Euthanasia, Killing"? Perhaps your comments written on that blog thread or additionally even directly writing to his e-mail address would be of his benefit..since he is asking for help with his emotional, legal dilemma.
Write the response there and you can present some pertinent points to our Preserving Dignity volume here.
The following is the direct link to mwhistler's posting today:
http://bioethicsdiscussion.blogspot.com/2012/04/does-end-of-life-hospice-comfort-care_16.html?showComment=1578447939289#c3601210450904057076
Let us know, also here, how you see his problem with the medical profession and how you would handle it. My view of blog thread contributors may have views of value to more than one blog thread topic.
..Maurice.
Biker, thanks for your supportive comments on the "end of life" blog thread for Mike (mwhistler). People may write to a thread not necessarily to present new, unrecognized information but to ventilate their feelings. Support by others is therapeutic. ..Maurice.
What this blog does is provide and disseminate information about patient dignity, rights, and how to get them.
There is a phenomenon called the hundredth monkey effect.
The hundredth monkey effect is a hypothetical phenomenon in which a new behaviour or idea is said to spread rapidly by unexplained means from one group to all related groups once a critical number of members of one group exhibit the new behaviour or acknowledge the new idea.
Based on this concept, there is a point when knowledge is spread to so many it becomes universal.
-- Banterings
Banterings, wouldn't it be great if one of our informational and directional contributors to this blog thread... turns out to be that "hundredth monkey"?
Think of the improvement of our medical system.
JR, based on your description of anticipated actions on your part..perhaps you might be the very "hundredth monkey". However, that very monkey could turn out to be some other contributor to this blog thread.
So..in keeping with the study example described in the literature Banterings offered.. keep "washing your sweet potatoes" and you may be the one! ..Maurice.
Thanks also to Banterings and JR who contributed their support to Mike on the other topic blog thread. ..Maurice.
On the hundredth monkey effect, it does support each of us individually speaking up in that if we can get one practice to change a protocol or staff training, it might result in such changes being transmitted to other practices as staff change jobs or as patients expect the same more respectful protocols when they go to different practices.
Similarly, each time I ask for a male nurse when making a urology appt. and then remind the person at the desk of it when I check in, it serves to normalize such requests in their minds (vs the kinds of reactions I have had in the past when the person responds inappropriately to such requests because to her it isn't normal). The same goes for any modesty/dignity based request we make at any stage of the medical process. Mighty oak trees were once single seeds seeking fertile ground.
Without the support of all the monkeys, change won't come. Everyone works in their own way. I am impatient so I have chosen a different route. I had a long period of anger and mourning about what happened but now I am ready to confront head-on the powers that be for what they put every patient through but especially for men because male patient care is barbaric and unnecessarily cruel, demoralizing, degrading, and abusive. Having said that, care for female patients has improved over the years but still is not as good as should be but women have collectively found a voice whereas men have not. What I am afraid of happening is since women have found a voice, they will go too far and punish all men for actions of some men. That is what I see happening now.
MWhistler's story of fentanyl and probably versed is a story that could be told over and over. I have consistently said those drugs and others like them are overused. They are used mostly to gain control. I can't imagine the sheer terror his mother must have felt trapped in a world she could not communicate with because the drugs render them unable to communicate thoughts but they still suffer the actions of what is happening to them. My husband can testify to that. What people don't understand about versed is you still suffer during the moment but it may or not erase all or part of it. That is why they tend to overkill in the amounts hoping to cause the memory loss. It is certainly an ethical question of whether they have the right to cause memory loss. It certainly is glossed over in consent forms if even addressed. Usually it is "just a little something to help you relax" which is a huge lie. Fentanyl is killing thousands of people every year so we know it is dangerous. For people who are in a weakened state, it is very dangerous. The use of drugs like these are another issue I will be addressing because drugs should not be used as freely as they without complete understanding and consent and especially for the purpose of control and loss of memory. This also brings to my point that every patient should have the option of having their own personal advocate present during procedures. This was fought for and won by women in L&D and applies even during emergency C-sections. If it is acceptable for this type of surgery, why is it prohibited during other surgeries?
I have a wide range of issues that I see need to be addressed. JF, I also think that nursing homes need to step up the pay for its real workers. Nursing homes should be not for profit and the pay scale needs to compensate fairly all of its workers. The residents pay too much money for not being a priority of management and the owners of the facility.
JR,
You may take some comfort in knowing that all those providers practice healthy lifestyles and will live to be a ripe old age when the body starts breaking down and they will be subject to the same compassion that they have shown.
When they say "I am a doctor, nurse, etc.," the response will be "then you know this is the way we have always done things..."
-- Banterings
Banterings,
That is the only downside to bringing about change is that they will not be able to suffer the effects of what they do to us. However, maybe they will visit a foreign country and be imprisoned. That should take care of that.
Going back to hospice care from the other blog, hospice care clearly lends itself to there is no dignity in death. Hospice care, at least around here, is all about having the person that is scheduled to die be drugged out of their mind. This enables hospice's other point of having intimate done by family members or even friends that person would have never have dreamed of them having such access. It is mind blowing there are no boundaries as it is as if the person has ceased to exist once they enter hospice care. My dad was fully alert in his mind before the hospice care but with the drugs it was different. He was then unable to communicate except when the dosage wasn't followed as they wanted it to be. The previous President was questioned about having "red and blue pills" for the elderly to determine who would live and who died. I believe the Medicare under him really made hospice that vehicle. Hospice certainly speeds up that process and it is done without allowing the one sentenced to death to have any dignity or even real good-byes as the drugs prevent much of any coherent thought. They just lay there, drugged, waiting to die. At the hospital from hell, families are railroaded into accepting hospice which saves Medicare a lot of money but makes the hospital a lot of money. It is just a racket that traumatizes those involved once they really think about what happened.
JR,
I will die with dignity. I will take the "long, cold walk."
-- Banterings
Doing research and just read the The Remedy says you should never call your doctor by their first name because "this is to familiar. This is about the doctor-patient relationship and maintaining boundaries." What it doesn't mention in the patient-doctor relationship is when the doctor oversteps their boundaries of calling you by your first name or when they don't ask explain and ask permission first. It seems to me those boundaries are more important as who is pay who. Being called by your first name is something that is too familiar and most of us do not want that familiarity with our medical provider. No wonder there is an attitude that prevails in the medical community they are in charge of us and can do no wrong and whatever they want. I don't care how long or hard they have worked for their title. I, too, have worked long and hard. I demand respect just because I am a human so if I am called by my first name by them, they in return get in back.
Biker,
As for employment physicals and sports physicals for men, the hernia exam should be eliminated. Hernia exam should be optional and only done when a man / boy has a hernia that is causing his problems. Any man can easily self-examine for hernias.
I understand your concerns about the increase in female NPs and PAs. The truth is they can do physical exams without examining genitals. I think that whenever a boy or a man has a problem that involve their genitals that they should have the option of a male doctor. I think those female providers should refer men and boys to a male provider since most men find genital exams less embarrassing with male doctors.
I encourage you to take time to read this article: Are Genital / Breast Exams Necessary For Sports Physicals?. Hernia exam does not help to ensure the safety of playing sports or most jobs. The focus should be on important health issues that could cause problems such as heart, kidneys, bones, etc.
Misty
I would agree that most (if not almost all) inguinal hernias are recognized by a self-attentive male adult or teenager and a routine exam by a physician is not an absolute essential procedure. Asking the patient about the presence of appearance or symptoms as part of the history taking should be routine as part of a general history-taking and symptoms, if presented, should be followed up with a physical examination for hernia.
It should be noted however, that the hernia may be hidden and asymptomatic until increased intra-abdominal pressure causes its transient but otherwise perhaps asymptomatic appearance in the groin.
The value of a physician requesting to perform an exam for a patient who gives no history suggesting inguinal hernia is questionable but worthy in picking up a totally asymptomatic (only present on Valsalva, the bearing down act) hernia but only with the understanding and permission by the patient for the examination. If a asymptomatic hernia is detected, watchful waiting for serious symptoms or changes is still a possible clinical route though many of these asymptomatic hernias later require surgical treatment.
But again, routine examination considering inguinal or femoral hernias (men or women) should be based on patient education of the issue by the physician and specific permission by the patient. This is what I have taught medical students and what I have practiced right up to the present. ..Maurice.
Misty, I have read that material before, and it is excellent. I also realize that it can be complicated as Dr. Bernstein describes and that sometimes such exams are in order.
My point is that with mostly female NP's & PA's taking over primary care given so few physicians going into that specialty these days, that boys and men aren't going to have much choice as to whether it is a male or female doing their mandatory sports & employment physicals. With physicians generally having as much business as they can handle, my guess is that few physicians are taking contracts doing sports physicals for schools or employment physicals for businesses anymore. NP's & PA's are likely doing most of them already.
Specific to genital exams, boys and men will only rarely know which parts of an exam are truly necessary and currently recommended. Most instead simply assume that they have no choice but to go along with whatever they are told to do. Even parents bringing a child for their 1st ever sports physical might have no idea what it consists of.
To make it worse, I know that some practices require a parent or guardian be in the room during examinations of minors. I understand the rationale but how widespread that is these days I don't know, nor to what age they require a parent's presence. At issue is it is usually Mom taking the kids for medical appts.
But the issue is that NP/PAs are going to be taking the place of doctors. That is the whole point. Hospital systems who own most doctors and/or practices are looking for ways to save money and their solution is to eliminate doctors who command a higher salary. For years, it has been a secret that pelvic exams are not needed for young women who are not sexually active nor are they needed for the Pill but yet they insist. For most men going in for their yearly exam that had been done in the past by their male doctor, slowly this option will disappear. They will now be attended by a PA/NP w/ a MA as a witness.
It is like during my husband's recent visit to the cardiologist. He was told to strip off his shirt by the MA. I could see her taking out an EKG that involved more leads than before. I first told her about his file should have been noted that he is a victim of medical/sexual assault. After we went through that whole scene again, I asked about the EKG. She said she had been there 3 months and that was all she knew they did. However, in the past they did just 1 3 lead. Why the change? Looking at the insurance EOB, I found out why. It is the difference in the billing. They couldn't bill for a 3 lead so they have switched to a 10 lead. Also, I asked her if the female patients were told to strip from the waist. Added to that I wanted to know if she stayed in the room while they stripped? Another point is I wanted to know if they were provided a gown which they are. So for men it is different. Strip without privacy, no gown, and while stripped move around to lay down. It is so clear that men are treated differently in something like this where genitals aren't exposed. However for my husband, it really traumatized him all over again to experience that sensation of not being in control of his own body. Yes, it was true it wasn't a sexual part of his body and he has been shirtless since the assault but it was of his choosing and he was in control. It is like Banterings has said, part of the issue is their language. Their choice of language is a language meant to be in control and power bc how this MA spoke after this was totally different. They know.
So I believe w/ the intro of more female NA/PAs, more males will cease to get exams. They can be assured there will be 2 females present--one to do the exam and the other just to watch and stare. For most, being the only naked person in the room, that is very unsettling. Sadly, many don't know they can refuse genital exams. This is probably especially true of young males because in the sports physical setting, they wouldn't want to have the unneeded attention of being made fun of for objecting.
You all may be interested in reading the blog thread and JR's contribution of today and my response. The thread topic is titled "I'll Forget All the Bad and Remember Only Good" and deals with the issue of whether or not purposeful elimination of "bad memories" is in certain cases (such as PTSD treatment) of benefit to the patient and/or society. Of course, JR is focused on
"Versed or like drugs" in her contribution. But the general issue of "tampering with another's memory" is certainly pertinent to what is being discussed on "Preserving Patient Dignity.." ..Maurice. p.s.-thanks JR.
Biker,
I find it sad that most boys and men are unaware that they can refuse genital exams as part of sports physicals or employment physicals. I am fed up with how medical professionals can bully you into having intimate exam that you do not want. I have heard that some medical professionals may tell boys that if they do not submit to genital exams that they will not be allowed to play sports. The same is true of employment physicals. The provider can just write on the form that the patient refused the hernia exam. This is wrong to force a boy to not play sports if he refuses to have a genital / hernia exam.
There have been numerous men and boys who refused to have hernia / genital exams. This is exactly why we need to educate boys about how they can refuse the hernia exams. I actually have some sports physicals flyers that can be distributed to boys to educate them. I’ve distributed some already.
I am also concerned about NPs and PAs taking over because it could limit men’s choice of a male doctor especially if he has a genital injury or a hernia that bothers him. I personally think that female providers should refer men and boys to male doctors and PAs for genital exams. I cannot help, but wonder how many NPs and PAs know the truth that a hernia exam is not necessary to ensure the safety of playing sports. I have noticed that some men have become Physician’s Assistants though.
Also, many unnecessary pelvic exams are done on women. For a number of years, pelvic exams were required for a woman to get a prescription for birth control pills. Only a blood pressure check and education of possible side effects is necessary for birth control prescription. Also, some virgin women (who never have engaged in any kind of sexual activity) have been pushed into having unnecessary pap smears.
Misty
I agree that "tampering with another's member" is pertinent to this discussion as too many times the use of these very drugs is what allows for providers to assault a patient's dignity or modesty. Granting it is proper for those in power to have the right to erase memories is there a point where they would unafraid to cross any line at any time? Would this make these drugs even more popular for everyday use by others wanting to harm?
I read the "Forget all the bad...." thread and added a response. What I added was:
"JR said it eloquently. Medical staff choosing to erase patient's memories without obtaining informed consent is about as unethical as it gets. Versed and the like are universally presented as helping the patient relax, not as an amnesiac. It is usually emphasized that you will be awake throughout the procedure which infers something very different than what really occurs.
I am fine with patients receiving versed if there has been informed consent. Some patients don't want to remember anything about the procedure and that's OK. Then it would be the patient's choice. As noted on a different thread, I know from personal experience that some procedures can be safely done w/o sedation w/o the patients being traumatized by the process. That's OK too, but it is not an option that is even offered."
JR's comments from yesterday about her husband's recent doctor's visit is interesting. Healthcare may not know what is in the background of any given patient and thus should be trained to use correct language in addressing matters involving touch or undressing.
For me I have never thought twice about taking my shirt off in a medical setting and admit I can't say for sure how I've been asked (or told) to remove it. When it comes to more fully undressing and donning a gown, I don't recall any staff person ever trying to stay in the room (undressing or dressing) but I do recall a couple times when the person (usually an MA or nurse, never a doctor) posing it in a somewhat abrupt command along the lines of "Everything off & into this bag, then the gown on opening to the back". I choose my battles and have just let such things slide, but there have been a couple times when I pushed back on the "everything" off when it seemed unnecessary as to why I was there, and it turned out it wasn't really necessary and my underwear or even my underwear and pants stayed on.
inguinal hernia exams are not necessary for sports participation physicals. on my blog, i show where NCCA took the requirement out.
furthermore, the screening can be done with a person wearing their underwear. the patient can move their penis and testecles out of the way. not only do providers not tell patients this, most do NOT know this. i am finding out that providers are not as smart as they think, they are parrots. there is no critical thinking. this is why they are being relegated to the position of retail employees.
-- Banterings
Biker,
In the past, my husband never had an issue w/ removing his shirt or even getting the prostate exams, biopsy, etc. with a female nurse present. His clothes were forcibly removed & he remembers it. He was extremely high at the time although the MRs state otherwise but the other medical provider made note of how much and when fentanyl was forcibly injected into his IV. He remembers vividly how he couldn't do anything about anything they did. Although fentanyl is supposed to give you a feeling of well being since he didn't know about the fentanyl and versed, he fought it bc he thought he was losing control bc he was dying. He didn't know otherwise nor did time matter for him at that point.
He had had a derm appt this summer due to the extreme radiation exposure of the cath., and the male dr asked him to remove his shirt so he could look at the areas affected by the radiation. But this dr explained and asked. (Dr. B. you may not believe what you will be hearing but this dr is one of the good ones. Even I recognize that.) He had his female nurse present but she didn't participate as she was talking w/ me about how medicine has changed for the worse. He had no issue then. However, this MA was forceful and right in his space & her demeanor triggered something & sent him into a tailspin. He didn't expect it but it happened. This MA might have resembled one of his assaulters or maybe her voice sounded like one of them. It is certainly an after effect of the versed memory erasure and the traumatic events that happened. He knows he cannot have any intimate contact with a female staff member again but he wasn't expecting just being ordered to unnecessarily remove his shirt to send him off the deep end. And yes, he has been told numerous times to drop his pants & underwear for the prostate/genital/rectal exam. No one has left the room while he did this nor did they clean while they made him clean up in front of them and retrieve his underwear and pants. You are lucky you haven't had to go through this. Also, his stress test, he was told to strip from the waist up and they didn't leave but he didn't freak out bc the tech who said it was male. He kept his shirt on but a female tech came & started to reach to unbutton his shirt but he pushed her hands away & told her to stop he would do it. You don't have to pick your battles & let things slide. Use is as a teaching moment to see what their reaction is as it will tell you a lot about that person and how they view their interaction w/ patients. As I said, this MAs change was instant but for my husband the harm had already been done & she had added additional trauma for him. PS. I gave her brochures from Misty too as well as the doctor.
Another issue I have thought about is how much does what we see on tv on how patients are treated make us more defenseless and unprepared for what really happens. I think I may have mentioned before that during a recent tv show the a woman was getting an ultrasound of her breast. Only the sheet was lifted over the one breast however, the breast could not be seen by the tech doing the ultrasound. Also, when they show mammograms, they show a woman in a gown only exposing the breast needing the mammogram. As 58flyer (I think I remember correctly)said, his wife wasn't given a gown for hers. This is pretty traumatic to be the one who is exposed having to walk around the room in such a state. For women who actually think they may have cancer, this adds to their overall stress. For men it is the same during the prostate exam of having to drop their pants in front of the audience and having to turn and bend in such a state. TV certainly does not show it as it is actually done so many patients aren't prepared for the cold, stark reality of what really happens. However, I did notice on that show tv I mentioned before the exam room had a glass window to the outside that was not covered nor was there a curtain for privacy. So if this had been real life, the woman would have gotten dress where anyone in the hallway could have seen her and certainly anyone in the hallway could see what was going on. In real life, it is this situation in the ER stalls as the curtains are not pulled correctly nor are the doors closed for privacy. It also seems that in real life the exam tables have the patient exposed so anyone coming into the door or passing by when the door is opened can see anything and everything. On tv, it is shown the drs. having a more compassionate, involved attitude than what happens in most real life situations. I think that having this type of media has made conditions for patients worse as patients may base what they think will happen off of what they have seen on tv so thus they are unprepared. What do you guys think?
JR,
I agree with your analysis that often people don't know what to expect in a healthcare situation. What baffles me is that people go back knowing what's about to happen. Maybe they are conditioned to think that this is just the way it is. Some won't go back after a mortifying experience.
As to the hospital ER stalls, you are quite right about the lack of privacy. I worked in law enforcement most of my life and when I would go to the hospital for a follow-up as part of my investigation, I would often see people exposed for everyone to see. It always involved major injury and an altered state of consciousness, but I still cannot believe the casualness of it all. The stories I could tell of what I saw during hospital follow-ups would bring many of us here to tears.
I will mention one of own experiences as an example. I was involved in a serious incident with a barricaded subject who was armed with a pistol. My partner and I were both injured, his injuries were apparent as soon as the dust settled and he was quite vocal about it. An ambulance was already posted on scene and he got a ride right away. My adrenaline had me quite pumped up so I wasn't feeling any pain at the time. Soon enough about the time I started hurting was when officers around me noticed the blood. When you are wearing a dark blue uniform the blood doesn't look red, it makes the uniform look wet, so it took awhile for anyone to notice. Another ambulance was called and I arrived at the ER about 10 minutes after my partner. As they rolled me into the ER I was sitting up on the gurney with my legs dangling off both sides. They had placed me in a sitting position so I was actually very comfortable. But what I saw as I entered appalled me. There was my partner in the bay next to me stark naked with his uniform having been cut off. The staff was trampling on his uniform as it lay on the floor. He was surrounded by medical staff but it's not an exaggeration to say that there were at least 2 dozen people gathered around with eyes wide open. I was stunned and a nurse looked over at me and said "you're next". I grabbed my handcuffs from the case and held them up and said that if anyone even tried they would be wearing them. An evidence technician arrived about the same time to try to get injury photos before they were dressed by medical staff. I told him to close the curtains around my partners bay and he said no. I said then I will do it myself and started to climb off the gurney. He stopped me and then went over and pulled the curtains closed to block the view of most of the voyeurs. I remember saying that only a W***e would want to watch this. I remember some people saying how inappropriate I was but I was very irritated especially after what I had been through. I don't know who all these people were but many were clearly not medical staff. I was attended by a very small all male crew. I had 2 injuries but would have had 3 more if not for the body armor. I did not need surgery and left a few hours later.
58flyer
58flyer
In talking with the people I have far too many of them say it is just the way it is. When asked if they like it They say no. They said when asked they don't stand up for themselves because mainly they don't want to make the medical staff mad. Why they worry about then getting worse med treatment or being fired as a patient. Some didn't know they have patient rights. It is amazing that as easy as it is to get info society as a whole is ignorant and willing to put up with such barbaric methods of healthcare is delivered.
JR, I still say we're all starting in a wrong place. Where I believe we need to get started is in how our laws are made. It's time to say that our lawmakers are silencing our voices and not living up to the responsibilities towards us in the way they are supposed to do. All this people writing letters,so those letters can be ignored and thrown away,( and other communications ) needs to come to a screeching halt. There needs to be a tracking system. Not vast numbers of people being told that they are the one and only person on the face of the Earth making such complaints.
58 Flyer. That story seemed horrible to me. I believe I would possibly rather die than something like that happen to me. The Administrator should have been made aware and given a very short amount of time to confront the issue. If he lacked a strong approach, then he needs to find new work. Multiple people should have been made to account.
When I hear stories like 58flyer's, I delight in the suffering and suicide that providers are subject to today. They don't get that it is Karma. How can a person behave in such a manner and NOT think that some justice of the universe will not befall them?
I saw a good article on MedPage Today: Informed Consent: Docs Should Ask Permission to Touch
It's 2020, and no, it's not implied by patient's mere presence in exam room
Read my comment!
I am sick and disgusted with the profession. I am also tired of hearing how this continues, fighting the system, and protecting myself those rare occasions that I must venture in the system. This has made me so bitter and has hurt me so (not only hearing about it but my medical abuse) that I take delight in the suffering of those human beings in the profession of medicine.
This is not me, this is what the profession made me. I believe that it has taken its toll on PT as well and that is why he has ghosted.
-- Banterings
JF
I don't disagree w/ what you have said. Yes, we do need legislation but it will not come if they don't have a reason to change it. They have to see and feel public pressure or otherwise the medical lobbyist's money and power speaks louder than one single person telling them what the issue is. This is why I am making it a point to spread the word however I can. I talk to any and everyone. I am working on my presentations to hospital clergy, patient advocates, church groups, and any other group I can possibly get before. I am also contacting national media and still writing to legislators as well as using Twitter, Quora, and other sites as well as my own. I have been directing all to read our very emotional story on my website. My thought is maybe something will stick on the wall and break it down. I went through my complaining about the system period and now I am trying things. Hopefully, I can see some results.
Banterings,
I was reading the article on Medpage bc this topic is one of my hot topics. I always read the comments and usually make one myself but today I didn't have time. I skipped past the writer of the comments name on my phone but as I was reading I was thinking to myself this person really knows what they are talking about as they gave an argument and the facts to back it up. I thought I needed to see who that person was and it was you. GOOD JOB!
The administrator in 58flyer's story probably wouldn't care anyhow. That is the issue. No one cares. They have their excuses for as to why they don't care about a patient's personal dignity. Everyone makes excuses for them. I have an attitude similar to Banterings and I believe what comes around, goes around but even that doesn't cure the damage they have already done.
Hello Everyone .
I have a question for Biker or 58Flyer . Sorry but I can't remember who posted the story of his nephew refusing to get his sports physical by a young female PA . You and the coach were going to talk to the school about it . Whatever happened with that . AL
Banterings, From the article you linked, the published response "Physicians are not veterinarians" I thought was a perfect point of distinction which I and other medical school teachers should remind their students. We really don't know for sure animals' views are about their "private parts" but we do know that they are living their life in a generally "naked" state.
An interesting but perhaps silly question to my readers and writers: Have you witnessed any evidence that your animal might object to a genital exam by a veterinarian? If the answer by all is "NO", then this would support to comparison: "physicians are not veterinarians" and physicians should treat human patients as humans and not just "animals". ..Maurice.
Sometimes PT leaving this group gives me hope. If he can let go of his rage and get on with the business of living his life, maybe I can put things in perspective to. But what is the best perspective? Dr B appears to think if we just ignore our feelings, they will quickly fade away. That hasn't happened though. It's been a deterrent to patients getting care and it can't be measured how many people have suffered symptoms over a long period of time because of their arrogance and abusive tendencies and sexual deviancy.
JF
Al, that wasn't me but I'd be interested in hearing any followups as well. I suspect that schools seemingly not caring how much they embarrass their young male athletes is a reflection of education having grown increasingly female-centric in their administrations and priorities.
All the veterinarians I have visited with my babies have been very kind. They always explain what they are going to do before they do it. They always try to calm and be as gentle as they can. The animals aren't real thrilled to be there and they certainly don't like their temps taken but the vet is always soothing and interacts better than a doctor with a human patient. I always feel that I being my furry children's advocate is kept well informed and consent is asked for before they do anything. Maybe doctors of humans should learn from the vets I have used.
Concerning Banterings comments on that other thread, I think that the process of becoming a physician does suck the empathy out of many of them. They are the serious high school students focused on getting into the right program at the right college, then the serious college student focused on getting into medical school, then the serious med student focused on getting into the Residency program of their choice, and then the serious Resident focused on their future career. The effort and sacrifices required of them is monumental with thousands of small goals to be achieved along the way. Seeing things through the eyes of the patient isn't what is rewarded and measured on that educational journey.
When Dr. Bernstein is teaching his students how to take a history and do an exam and trying to impart the humanity of the patient, many are mostly going to focus on learning the mechanics well so that they can move onto the next step. It isn't that they purposely choose to not heed his sage advice on the softer side of things, but they are under tremendous pressure to get the mechanics down pat and that's going to be their first priority so that they can move on to the next thing.
You can see this loss of empathy on the Student Doctor Network forum when topics related to what we discuss here come up. Apparently shadowing doctors and other relevant experiences working as a scribe or EMT or volunteering in an ER can be important when applying to medical school. These focused high achievers often begin that experience tally in high school. On that forum they rather coldly dismiss concerns over doctors outright lying to patients or purposely misleading patients in an effort to get these high school or college students in the room for patient visits, exams, and even into the OR. By lying I mean introducing them as student doctors so as to infer medical students rather than the high school or college kids that they are. By purposely misleading patients I mean giving the kid a white coat and simply stating Mary will be assisting me today, letting the patient assume Mary is a Resident rather than a high school or college kid. On the Student Doctor Network forum they see nothing wrong with these practices because their need for experience is more important than risking being truthful with the patient. Some justify it by deferring to the word "student" buried in consent forms.
These doctors-in-training at the SDN similarly are dismissive of patient modesty concerns as concerns their (the students) presence for patient exams or procedures. Again, their quest to become a doctor and their perceived need to see that exam or procedure or operation is more important than what the patient's modesty concerns might be. Towards that end lying or misleading the patient in order to gain entry is acceptable. Is it any wonder than some of them emerge from the process with little empathy for the things we discuss here? The system sucks it out of them.
Dr B, Animals aren't naked. They're born with their clothes on. And wear the same outfit everyday. JF
Hello Everyone .
Did you catch the article about the ob/gyn sexual assault of Mr. Yang's wife . Many news outlets left out a lot of facts that are posted here daily . https://www.cnn.com/2020/01/16/politics/evelyn-yang-interview-assault/index.html
I find it interesting that the article say's so many things that are discussed here . AL
JF, this long running (since 2005) blog thread confirms that I am not championing the concept of the individual "ignoring" their own feelings. What I have repeatedly stressed is that use their experiences to be the basis of an active attempt to create changes of value to all within the medical system if that is where the hurtful feelings are originating.
And with regard to animals not being naked.. why are some humans buying their friendly creatures clothing to cover their bodies? ..Maurice.
Because they are so cute in them. And also it is part of my business to offer pet clothing.
AL,
It wasn't me either, but I remember reading it. I just can't recall who the writer was.
58flyer
JR said, "Maybe doctors of humans should learn from the vets I have used."
Funny you say that. Way back when I was in my first year of college, which was about 1975, one of my professors pointed out that the GPA requirement to get into veterinary school was higher than it was to get into medical school. I didn't check on the accuracy of his statement, but I still get a chuckle remembering his comment about that guy who isn't smart enough to work on your cat is going to be working on you!
58flyer
In addition to 58flyer, chiropractors have more background in psychology than medical doctors. In my personal life I have found vets to be more informative that MDs and personally have had better medical explanations regarding my health situations from vets than my regular doctors and have even been warned of certain considerations never brought up by physicians. Personally, I would much prefer to have my dogs vet as my internist or cardiologist. He has declined saying people are too much of a pain and he prefers to practice humane care not lining his pocket or work for a profit making corp.
58flyer .
What your professor said is true . My daughter is a vet . They used to talk about the people that would drop out of vet school because it was to hard . The school would have high standards to try to keep the dropout rate low . A lot of the dropouts would then enroll in med school because it was easier . At graduation they told a joke . A vet and a Md arrive at a accident scene . The vet does a 2 minute evaluation and determines he has a broken leg . The Md asks where does it hurt . Animals can't answer your questions . They have to use their skills . I'm sure most Md's would disagree with this . AL
AL,
You are right. Vets have to figure it out because their patients don't usually tell them. They actually must use their skills. My most favorite vet helped with my mini schnauzer who had lymphosarcoma back in 1998. It was unheard of around here but Dr. S. took in on. I also treated my dog w/ natural remedies. I told Dr. S. that I disagreed w/ chemo shutting down the immune system. I gave him Chinese herbs to build it up. I also gave him an herb I use to this day. Dr. S. was skeptical but wanted to study it. So he did the chemo and I did the herbs. My dog went into remission. He was amazed that he did and also had none of the side effects of the chemo and other drugs. He would go to chemo and hold up his arm for the chemo. Dr. S. was amazed. We would camp and hike the next day after chemo. Dr. S. asked me if it was okay if he wrote a paper and used my dog's info in it for Purdue to publish. (Imagine being asked for your info to be used for research instead of signing a generic consent form allowing them to use your info any way they want?) He wrote it and 20 years later I was talking to another vet because we both love schnauzers and he said he had read an article about a schnauzer who had lympho. He said he had kept that article as he was amazed that a vet took on the treatment and had such results with the herbs. Of course, me being me whipped out my cell phone w/ my pics of my baby that I transfer from phone to phone, showed him the dog in the story and his professional pics that were taken one day after he had had chemo. He was amazed. Another local vet who I have dubbed Dr. Death (he should have been an md) said treating cancer here at the local level was impossible so again me being me had to educate him. I said he needed to talk to his partner who had actually read the Purdue article. Dr. Death had sentenced one of our cats to death when the cat was in acute kidney failure. He recommended death but we took him home and gave him our liquid herb 3x a day and he lived for another ten years. Of course, I had to inform Dr. Death of this too.
Over my many years of dealing with vets, mostly the experiences have been positive. They do have a different demeanor and way they deal with their patients and their families I do believe vets have more skills than mds as vets have to arrive at their conclusions through investigative skills more than mds. Vets are more likely to make that personal phone call too in checking up on a patient. They make you feel as though they really care. When my dog got lympho for the second time as a foster dog bit & popped his tumor a couple of years later, Dr. S. gave him a stronger chemo but he did caution the chemo could kill him. It did. Dr. S. gave up private practice bc he said my dog's death hit him hard. It was not his fault. I called Dr. S. at the ER clinic he went to when my dog had her schnauzer pups, and he stayed on the phone w/ me for over 2 hours. He did not charge. He had me bring them in to check the over--again no charge. When the dog I got after the one died got a shot which he had reactions to, Dr. S. called the clinic & told them what to do as they did not know. Again, he wouldn't charge. Dr. S. knew how I felt about killing a animal so when the one who died wife's became severely ill and was dying, he helped me w/ her. If only mds were like Dr. S. I have donated to animal funds in his name bc he truly is a good man who loves animals and truly wants to help them. If only human medicine had used this same compassion then I wouldn't be doing what I am. This is a long explanation of why mds should be like vets.
Not to begrudge veterinarians their due but I don't see the point in making comparisons to MD's. Different training for totally different patients. No doubt there are good and bad vets just as there are good and bad examples for every profession that exists, including MD's.
Currently being in the midst of a difficult to diagnose matter I am grateful for the MD's trying to figure it out, especially a young female neurologist who has gone above and beyond. Her thoroughness and concern has been exemplary. The flip side is the male internist who when I began seeking help a few months ago was dismissive when after a few minutes couldn't check off a box as to what the problem was. He was backstopping my usual primary care, a young female PA who didn't have time to see me. When subsequently seeking help again, but with her, she in turn knew what she didn't know, but rather than be dismissive did the referrals to get me to people who might. As I said good and bad in all professions.
Biker,
Hope everything turns out okay. You are in my thoughts. It sounds like you are on the right track.
It just goes to prove that there are good men and women like there are bad men and women. Although I might prefer same sex, I haven't automatically said no. It hasn't been a matter of modesty that motivates but rather I like for reproductive issues someone who has the same organs and in my way of thinking better understanding. For other things, males have been okay. For my husband, he felt the same until now. For both of us, we cannot trust female nurses/techs and any doctors of either sex and will always be second guessing their motive(s).
Yes, you are right. There are good and bad But I do think the comparisons are relative to what we are talking about because it does show the difference in attitudes. To me, my furry children are every bit as special as my human children. Maybe some would see that as wrong but I really don't care.
ATTENTION: AS OF TODAY JANUARY 18 2020 NO FURTHER COMMENTS WILL BE PUBLISHED ON VOLUME 107. COMMENTS CAN CONTINUE ON VOLUME 108. ..Maurice.
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