Bioethics Discussion Blog: Preserving Patient Dignity (Formerly Patient Modesty) Volume 109





Tuesday, February 11, 2020

Preserving Patient Dignity (Formerly Patient Modesty) Volume 109

JR wrote today in Volume 108 "Many man don't like how they are treated but don't know it should be done differently. Some are ashamed of what happened and thus remained silent."  and but this why "speaking up" both to the profession and to fellow patients is so important and has been stressed on this blog thread. Every patient, provided
valid information or witnessing improper professional behavior has every right to express a "No!". 

Graphic: From via Google Images



At Tuesday, February 11, 2020 11:48:00 AM, Blogger Maurice Bernstein, M.D. said...

JF wrote the following on Volume 108 after it was closed for further comments. ..Maurice.

The root of these problems are in the ability/desire of empowered groups/people to silence other people's voices. And while modesty and dignity is extremely important so are other issues that get glossed over. How many times have Republicans won the Presidency? And yet abortions continue on and on. They always will, until God destroys this world. Why are we permitting lawmakers to make our laws? Are they doing such a super job of representing our needs that we just HAVE to keep them around?
Do our letters and emails and other communications have anything close to visible results? Are these people so poorly paid that we just can't resist keeping them around?
Anything can happen unless/until we get our fair share of voice about how things are done. And JR , I'm not bashing Republicans in this instance. I used to be one. ( because of the abortion issue ) But we've been absolutely unsuccessful in getting abortion outlawed. Çhildren Services is a sham much to often. Although I know of two cases where they accomplished a successful outcome. More often they don't even try. Police brutality. Wrongful arrests and wrongful convictions.
All these injustices run together because we the people are made to shut up! JF

At Tuesday, February 11, 2020 3:29:00 PM, Anonymous JR said...

I am an equal opportunity basher so have at it. .

At Tuesday, February 11, 2020 9:42:00 PM, Blogger Maurice Bernstein, M.D. said...

Let's dissect the action of saying "NO" to your doctor or nurse. What action, words or behavior would you essentially say "NO" to your doctor's or nurse's words or other behavior. Does anyone here feel that you should say "NO" but you don't because it might be damaging to you either related to your underlying clinical condition or embarrassment or get into some legal or financial trouble?

If you say "NO" is that an expected sufficient response or must you follow the negative with some detailed explanation or do you feel in most cases this single word response is sufficient? Do you feel the need to "educate" your doctor or nurse or one word is enough and no further explanation is necessary? As the patient, what do you expect should be the response of the doctor or nurse?

If you were one of those medical professionals and a patient said "NO" to your advice or behavior how would you respond to that patient? Would you enter into an argument with the patient? Should the professional ever argue with the patient?

I apologize belaboring "NO" but I was impressed by my GIF graphic for this Volume and wondering if "NO!" is or should be the full and sufficient response by a patient. What do you think? ..Maurice.

At Tuesday, February 11, 2020 11:07:00 PM, Blogger 58flyer said...

On Monday I had my 3 month check with my urologist, then on Tuesday I had my appointment with my primary family practice physician. I had previously ordered some brochures from Medical Patient Modesty and I was armed with "Men and Modesty in Medical Settings" which I provided to both practices. On my last visit with the urologist, the medical assistant was unusually casual in performing my workup. She was new and it was the first time I had been attended to by a medical assistant in that practice. As I may have previously posted, she is the one who tried to open my pants for the bladder scan without asking me first. There were a couple of other things she did that were unprofessional and made me feel uncomfortable. Mainly, she was just too familiar and crossed some boundaries. I called her supervisor the next day and complained.

On this visit, I was called from the waiting room, and a female LPN who I had previously been attended to by asked me to do the usual go to the bathroom, provide a urine sample and then finish emptying into the flowmeter. Then I exited the bathroom and she asked me to sit and wait for a nurse whom I had previous experience with. That nurse brought me into the exam room and started the workup. I knew something was unusual about this. She told me that the medical assistant who attended me 3 months ago was unaware of my abuse history and that was the reason things went bad. She said the MA felt bad about what had happened but understood my anxiety. I said that my records should have been flagged with an alert and the nurse said that that was now the case but furthermore, she had been assigned to be my nurse for all my future visits since she was familiar with me and we had established a good relationship. This nurse was formerly an LPN but had graduated from an RN bridge program and was now an RN. I congratulated her on her accomplishment. My BP was 180 over 90 which highlighted my concern. But now going forward I am relieved she will be the nurse accompanying me in future visits since she is very aware of the abuse history and I am comfortable with her. In my previous procedures I had a male PA who did the intimate stuff during my urodynamics, cystoscopy, and TRUS with biopsy. The nurse was present for this but kept her back to me. So far, she has not seen my intimate parts.

The problem is the doctor has been unable to convince management to hire another male PA or ARNP since the departure of the last guy. My PSA has jumped from 4.5 to 7.4 since my last visit so the doctor recommended a new biopsy right away. I provided the brochures to him and asked him to have the female staff read them and to send them to management. He said he would. I brought up the matter of the procedure shorts and they said they would order them for me. I took it upon myself to order some from Prime Pacific just in case. I will have the biopsy next Wednesday. I am worried the cancer is getting aggressive, but it could be just an inflammation that's causing the PSA to rise.

When I went to my PCP on Tuesday, I gave him copies of the brochures and asked him to distribute them around the practice and give a copy to management and he said he would. My PCP is concerned about some other issues which we will address in the coming weeks.

We will see what effect Misty's brochures will have going forward.


At Tuesday, February 11, 2020 11:36:00 PM, Blogger 58flyer said...

Dr. Bernstein,

In response to your question of saying "No" to a doctor or nurse, I would say that should be enough of a notification for them to stop in their tracks to find out what the issue is. "No" is pretty much a universal denial to stop what someone is doing and to proceed anyway would constitute battery. My personal choice of words would be "Stop" as that gets attention also and it means the same thing.

I am past worrying what the medical person thinks of me and I am only concerned what is best for me as defined by me. I would expect that the words "Stop" or "No" would be shortly accompanied by an explanation of my concerns and I would be happy to provide an explanation. If I see something going wrong I feel I need to get it stopped right away and fix the problem and a short directive to stop is the best for all concerned. Then we can proceed with what my concerns are and if they will be able to meet them. Then I can make the decision to continue as is, continue with a change, or go elsewhere.


At Wednesday, February 12, 2020 5:27:00 AM, Blogger Biker said...

"NO" is appropriate to stop an imminent harm but otherwise it is not enough of a descriptive to convey understanding or move an issue forward. For example if a nurse or MA without asking permission starts to lift a patient's gown, NO is going to be the most effective mechanism to stop them, but then it needs to be followed up with the "what are you doing" type questions and/or expressing your wishes on the course of action to be taken.

In the absence of an imminent harm, explaining your concerns or wishes (rather than simply "NO") will provide the staff with input that allows them to possibly offer alternatives that accomplishes the goal in a more satisfactory manner.

In the end the choice is ours to proceed or not, but simply refusing a procedure w/o further explanation possibly denies us healthcare we needed and that was possible with some protocol changes if we allowed the staff to offer those changes. Just saying no doesn't give them enough input to react to.

At Wednesday, February 12, 2020 8:51:00 AM, Anonymous Anonymous said...

JR, I hope I didn't come across as making this about Trump. I was TRYING to make it about the common citizens don't have enough say about creating laws and doing away with laws that aren't working. I like hearing from you, regardless of our different reactions of politics. JF

At Wednesday, February 12, 2020 10:15:00 AM, Blogger Maurice Bernstein, M.D. said...

Thanks to 58flyer and Biker for their responses to my NO! question but one of my questions I don't think was answered:
"Does anyone here feel that you should say "NO" but you don't because it might be damaging to you either related to your underlying clinical condition or embarrassment or get into some legal or financial trouble?" Do you feel that every patient has the potential to freely and safely to themselves simply state "NO" and be confident that there would be no personal repercussions? This is an important consideration to the "speak up" advice to patients. ..Maurice.

At Wednesday, February 12, 2020 10:24:00 AM, Anonymous JR said...

I have said "No" to different situations like being trained on or having an observer. Most of the time as I have female doctors, they understand "No" means "No" w/ no explanation being necessary. The times I have gotten pushback are from female nurses. Obviously, they don't know or don't care that a patient $ only a patient only has the right to decide who, what, how, etc happens to their body. I don't feel I owe them an explanation but have retorted back if they think it should happen, then they should be first while I observe to see how it happens as seeing it happen could help change my mind. No takers. One was angry but as I reminded her my dr. was in the room next door as she had just had her baby. If a nurse was standing just looking during a pelvic exam, I would say move as that was just creepy & they'd move. W/ my reg. dr she knew my feelings & accommodated them. Even w/ a C-section, I was in & out of the hospital w/in 24 hours. For others I have talked to, some of the reasons they didn't say "No" were being afraid of making the med provider mad. In making them mad, their exam might be rougher (rectal), they could be dismissed as a patient, the medical provider might refuse to do whatever & the insurance would make them pay the entire bill, they didn't know they had the right to object, they were never asked but always rather told, & yes some were even to shy or embarrassed to stand up for themselves even knowing they had rights or something was being done they didn't like. However, the common thread is most feel upset after the encounter no matter what the reason they didn't say "No". Ones like me who do say "NO" have one thing in common is that we resent having to be put in the position of having to say "No" bc it does change the mood of the visit far too often. A medical encounter should not turn into a power struggle to maintain your personal dignity or beliefs. The issue of your health should be the primary focus & many have trouble remembering what is said so the additional stress of the adversarial situation of "No" add to this. In my presentation, I state common issues like chaperones, observers, etc should be advised upon the setting of the appt At the very least upon confirmation of appt or least acceptable upon checking in. No patient should be ambushed sitting on an exam table in various states of unaddressed as it automatically mentally puts the patient at a disadvantage. This is where many are put & they do not feel able to say "No" at that time and they know it.
I think "No" at that time is enough. However, I think after the exam education is in order. If it is an issue of dignity, perhaps a brochure from MedicalPatientModesty should be given to them. Let them know it is a real issue with more than you. The medical provider should not argue, try to persuade, etc. They should accept the patient's answer w/ a high level of professionalism. I think issues of conflict should only be discussed when the patient is fully clothed & is mentally the same footing as the provider. The mental pic of a gowned or disrobed patient gives the med. provider the idea they still have control over that patient person while also giving the patient person a disadvantage.

At Wednesday, February 12, 2020 10:33:00 AM, Anonymous JR said...

If it is about a procedure, medication, or something along those lines, a med provider has the responsibility to give info so the pt can make the best decision. They should never argue but they can try to persuade. I would expect them to defend what they feel is best. If they present enough facts, then I could change my mind about a treatment or drug but I would take their advice & do more research. It has been my experience that nurses are the ones who tend to want to argue or turn paternalistic. MAs just flat out say it is the way they were told it had to be done. They have no thinking ability of their own.
My husband was one who didn't like to confront or upset them in fear of retaliation but learned to speak up. During this last time, I did not speak up & everything went wrong but in that hospital I sensed something different & unfortunately I was right.

I used to be a Democrat and now I vote my conscience and what I think works best. I have changed my mind a lot over the years as I have gotten more info than I had when I was younger. I just wanted to let you know that I was not offended as everyone even the ones with "wrong" opinions have the right to voice them. The silencing of the other side is one of the biggest crimes in today's society and it spills into areas such as the silencing of patients who have been harmed by the medical industry.

At Wednesday, February 12, 2020 11:59:00 AM, Blogger A. Banterings said...


I brought this subject up with my friend up north. He said that he had a recent, bad experience. This was his response in an email to me (as always, used with his permission):

I said NO and it was ignored. My doc brought up the issue of PSA testing by saying because of my age he is ordering a PSA test. I said NO, and my reason was because the whole PSA screening will distract focus from my healthcare.

Guess what? It did.

I also had an X-ray for a pinched nerve. At the 2 subsequent visits, he was pushing that PSA snake oil, talking about the "new, modern era PSA testing" (which is utter BS), aND he never mentioned ANY harms of testing.

I knew he was in the cult of religious cancer screening.

Automatically I would get defensive, and forget about asking what were the X-ray readings. It has been OVER a YEAR and I still don't know what was found.

My the beginning of my next appointment (first thing), I am going to start off with "I am very disappointed in you..." Then I am going to tell him what happened (he does not realize that he never gave me results). He is one of the better docs in our area; old school. Saying that he disappointed me is really going to hurt him (emotionally). When I tell how, that will cut him to the bone.

Of course, in the back of his mind is the fear of malpractice that will further haunt him. I am NOT even bringing up the implication of malpractice, that would override the emotions of hurt and failure with fear. Fear makes us strong, it invokes "fight or flight." I want sadness, self doubt, and self loathing to be the emotions that he experiences.

I will point out how his zeal for the cult of cancer screening distracted from my health care as I HAD WARNED HIM OF SUCH. Does a recommendation for screening that guidelines do not consistently agree upon trump a complaint of (current) numbness in my arm? Is waiting one more year?

A screening test is done to detect potential health disorders or diseases in people who do not have any symptoms of disease... Screening tests are not considered diagnostic... Source:

I will point out that by continually pushing the issue of PSA testing, this served only to make HIM feel better and has caused me (emotional) harm. I am then going to ask him to reflect upon this and his zeal for the cult of cancer screening so that other patients are not harmed.

Finally, I am going to tell him that the subject of PSA testing is permanently OFF the table. I do NOT want it brought up ever again (unless I bring it up).

I am really hoping that he has the common sense and intelligence not to bring up the topic of the other (or any) cancer screenings that he has been pushing (colonoscopy). That will only elicit my ire and I will permanently take the issue of ANY and ALL cancer screening OFF the table.

My friend up north's email made me think about another potential harm of screening, that is the distraction from the rest of the patient's healthcare due to the provider's zeal for screening when the patient refuses. If providers truly respected patients' decisions, they would just move on.

I am going to say it again: power corrupts and absolute power corrupts absolutely...

This is why power is being systematically taken away from providers.

-- Banterings

At Wednesday, February 12, 2020 4:00:00 PM, Blogger Biker said...

Dr. Bernstein, in response to your question:

"Does anyone here feel that you should say "NO" but you don't because it might be damaging to you either related to your underlying clinical condition or embarrassment or get into some legal or financial trouble?" Do you feel that every patient has the potential to freely and safely to themselves simply state "NO" and be confident that there would be no personal repercussions?"

For me I am very careful with my use of use "NO" because I don't want to be the patient that is deemed never satisfied and thus not taken seriously. As such I carefully pick my battles and look past less important stuff that may have been less than perfect.

I also try not to forget that my thinking is further evolved on these matters than theirs. This is where I sort of am at with the dermatology practice I go to. They know I want my privacy respected and I'm coded that way in the EMR system. Despite me being clear that all I want is to not have any female LPN's & scribes just standing there observing the genital part of my skin exam, they're needlessly carrying it further than that.

To explain what I just said, for my most recent exam, upon check-in I say its been a year since I was here do you have any male nurses or scribes yet. I expected the answer to be no but I was curious nonetheless. The answer was yes they do have a male scribe now but he's currently working with a different doctor & maybe they can get him swapped for my visit. I say no need to do that I can I talk to the nurse when I get roomed; but she runs off trying to re-juggle the scribes anyway. I appreciate her effort but it wasn't anything I asked her to do.

I get roomed and I tell the nurse I want my privacy respected in terms of not having female observers for the genital part of my exam. She tells me she understands completely and will take care of it. Later she comes back after I have changed into a gown and tells me no residents or students will be with the doctor, she'll stay away, and the scribe has been spoken to. In her quest to accommodate me she too carried it a step further than I asked.

The doctor & scribe enter and I don't know what the scribe was told but she faces away from me for the entire exam. It wouldn't have mattered because the doctor skipped the genital/rectal part of the exam, instead asking me if I had any concerns in those areas. Their protocol is the patient leaves their underwear on if they don't want that part of the exam. Mine had been removed but presumably trying to respect my privacy he skipped it on his own initiative. Even worse, my gown never came off my shoulders down onto my lap so as to examine my stomach/abdomen. Not much of an exam overall but the parts I can't see (back, back of neck & head) did get a good exam which to me was the most important part. He inserted a higher degree of modesty on me than I asked for. All in all they're trying too hard I think because they're still not fully understanding this male modesty stuff, and perhaps not enough male patients have spoken up so as to make my kind of request just part of a new normal. Because they're clearly trying I'm being patient in bringing them along.

At Wednesday, February 12, 2020 10:19:00 PM, Blogger 58flyer said...

Dr. Bernstein asked,

"Does anyone here feel that you should say "NO" but you don't because it might be damaging to you either related to your underlying clinical condition or embarrassment or get into some legal or financial trouble?" Do you feel that every patient has the potential to freely and safely to themselves simply state "NO" and be confident that there would be no personal repercussions? This is an important consideration to the "speak up" advice to patients. ..Maurice.

There was a time when I was hesitant to say no and failing to do so had bad consequences. I was worried that I might offend or be retaliated against. With one hip injection procedure I did voice modesty concerns and was retaliated against. In that instance I failed to discuss the past abuse history as my therapist advised me to do. Now it is my personal protocol to discuss clearly with my providers the past abuse. As in Biker's experience, they sometimes go too far. With my last hip replacement, I found out upon departure that my room had been placarded "NO Females." That's not what I asked for, but I did have an awesome hospital stay. With my recent urologist visit I saw that my doctor had noted in my records "patient is frightened to be alone in a room with a female." Again, that is not the case. Maybe they are overreacting.

As to your question of should a patient be freely and safely be able to say "No" and be confident that there would be no personal repercussions, I would say absolutely yes, they should be. And why not? It is the patient who is in control.


At Thursday, February 13, 2020 6:10:00 AM, Anonymous JR said...

I don't understand why the burden is on the patient to say no? Shouldn't the burden be on the provide to know when to bring up these issues and what issues to bring up? Shouldn't these questions be part of a new patient on-boarding and be part of the patient file? Would that not be a better solution if healthcare is truly patient friendly?

At Thursday, February 13, 2020 9:04:00 AM, Blogger Biker said...

58flyer, thank you for sharing your experiences. It is interesting that you too have experienced the overreaction which I suspect is from their just not fully comprehending the issue. The big question is why it is so hard for them to understand that some men object to being intimately exposed to the female nursing & other staff, especially when that exposure isn't necessary.

My most recent summary from my dermatology visit includes near the top in bolded red lettering: NO RESIDENT/PREFERS MALE PROVIDERS

I have never requested no Residents. My very 1st visit there was with a Resident. The Resident's behavior was very unprofessional as concerns my modesty and I complained. Somehow the problem has been interpreted as a problem with Residents rather than with the behavior of that one Resident. I have a brief follow-up appt. coming up, surprisingly with a female Resident, and I will try to get that NO RESIDENT language removed.

As for the PREFERS MALE PROVIDERS, yes I want male providers, but only to the extent intimate exposure is involved. I have no concerns whatsoever that I am scheduled to see a female Resident because that visit does not include intimate exposure.

It'll be interesting to see if this female resident sees the note before my appt. and I suddenly get switched to someone else.

At Thursday, February 13, 2020 11:18:00 PM, Blogger 58flyer said...

JR says,

"Shouldn't these questions be part of a new patient on-boarding and be part of the patient file? Would that not be a better solution if healthcare is truly patient friendly?"

I totally concur. Patient preferences should be a part of the initial consult and be a part of the patient records going forward. Anytime the patient is referred to a specialist, the preferences should be relayed to that specialist. That way there is no need for the patient to continually make their preferences known. If the patient requests gender concordant care, that should be passed along to the specialist and that specialist should honor the request or advise the PCP of their inability to meet the request so the patient can be referred to a specialist who can. However, I think legislation will be the only remedy.


At Friday, February 14, 2020 11:26:00 AM, Blogger A. Banterings said...

JR & 58flyer,

Is that NOT part of the snake oil called electronic medical records that the public was sold?

-- Banterings

At Friday, February 14, 2020 2:26:00 PM, Blogger Maurice Bernstein, M.D. said...

My opinion which should be taught to all medical students: medical or surgical specialists have for a time in the patient's illness the patient's physician. Don't look at them as some "attachment" to the patient's primary physician. And in the developing relationship between the patient and specialist, that developing relationship demands (unless the patient has no capacity, at the time, to communicate or life or death emergency) communication between the two parties, if not simple review of medical/surgical history, certainly requests and attitudes of the patient toward the specialist. Yes, the primary physician may include some of the "patient behavior" to the specialist but I would look at that transmitted information as biased based on the primary physician's impressions.

My advice: Transitioning temporarily to the clinical management of a specialist still requires ongoing or previously experienced issues of the patient to, by the patient, directly communicate these issues to the specialist. The specialist skimming through computer notes about the patient, in this regard, may readily (in a few words) provide nothing or biased information. My advice: "speak up". And yes "NO!" should apply to your specialist as well as primary general physician.

And yes, I have said "No" to my own physicians, both general and specialist, and they have listened and responded to my personal satisfaction.
Don't explain this personal experience as VIP response. I would have reacted the same if my patient was not a physician. ..Maurice.

At Friday, February 14, 2020 4:31:00 PM, Anonymous JR said...

The EHRs just compound the issue. There are many notes contained in the EHRs that are similar to a sticky note that the patient will never see but other providers will. These are usually personal notes so there is a bias caused by the use of EHRs. There are things said about you that you will never guess in a million years. The EHRs are a very real invasion of privacy as you have no control over who sees your info and furthermore, you will never know as they won't be honest unless they are forced. Your personal info is treated as badly as your personal dignity is treated.


At the beginning of every school year, I would make it a point to find out what my students liked to be call, what subjects they struggled in, what subjects they wanted to learn, what their hopes & dreams were, etc. In order to better help them, I made/took the time. I did it bc I cared. The fact the medical community does not do this shows a very glaring lack of caring or compassion. Medical apps are sometimes stressful enough but to add in how badly healthcare is delivered compounds the stress. They don't seem to want to understand this by changing and indeed becoming patient friendly. It is smoke and mirrors. How they have handled yours and Biker's requests show they are not willing to take the time to really listen to what you are saying. I can't imagine what the sticky notes in your file says but I bet it is not good.

We told the dr's office in 2 previous visits my husband needed to a notation made he was a victim of medical sexual assault. For whatever reason, they didn't probably bc they didn't want to acknowledge it in writing. So they instead re-traumatized him by the MA assuming rights she did not have over him. The only assumed consent was he was there for a checkup. There was no consent given by him as to how it done nor did they explain or ask for permission. They assume too much and give too little in info and absolutely refuse to acknowledge patients have rights.


They still know you are a dr. Unless you go somewhere else & do not use your MD title, you will never know for sure if the title influences how you are treated. Really, as a patient, there is no need for your title to be used when you are seeking healthcare treatment. But I doubt some 20 something MA calls you Maurice like she calls us ordinary fold John or Mary? So just by using your title, you have built in respect whereas we don't.

At Friday, February 14, 2020 9:43:00 PM, Blogger Maurice Bernstein, M.D. said...

To All: Please, please go to this link to and read the brief but tabulated article "How to Talk So Your Doctor Will Listen" but then near the bottom please click on or click here to read "12 Signs You Should Fire Your Doctor". Follow the links. This series of two subjects should provide ample ammunition for discussion here and some handy hints on moving on with your medical care when you have decided that a change is necessary.

Have you learned anything of help to you as a patient from this documentation? ..Maurice.

At Saturday, February 15, 2020 12:16:00 AM, Blogger Swannie said...

Dr. Maurice,
In response to your question about saying no to medical staff or a doctor:

I said No when told to remove my underpants, but then the doctor told me i may get burned in case of a short circuit with the electric instrument she would be using.

Therefore who would not comply with an order to avoid physical harm ? Yes it was an order and not a request! Only through my research i found out it was a classic example of coercion.

And by the reply of the hospital, the reason changed. The electric instrument would not cause a short circuit, but if a male`s underpants may get saturated by alcohol during prepping, the vapors may cause a fire due to combustion.

Still wondering how much alcohol is needed during prepping to saturate underpants.

Therefore to avoid being burned i had no other option than to say yes.

At Saturday, February 15, 2020 11:55:00 AM, Blogger Biker said...

It is just anecdotal but I have noticed that doctors seem to be better listeners when you are the 1st patient of the day. I feel less rushed and the doctors seem less stressed. When you are amongst the last patients of the day the doctor is carrying the stress of whatever that day has brought. Just anecdotal of course.

If my appt. is delayed I don't let it stress me. When the doctor or the staff start apologizing I say no need for that, it is good you took the extra time for patients that needed it, someday I'll be that patient and will be glad if the extra time is taken with me. This serves to de-stress them a bit as it is not the reaction they expect.

I don't have much experience firing doctors in the context of what the article is talking about. I changed urologists because I was tired of driving 4 hours each way to Boston. I left a couple local doctors so as to consolidate all my care in a single non-local more full service hospital. I fired several along the way for causing needless extra appts so as to run up the bill. An example of that was a cardiologist that said I needed to come in for a follow-up after a test (which I already had the results of). I get to the appt. and a nurse comes in and asks if I had any questions. I said no, it was the doctor who wanted to talk to me. She didn't have any further questions and that was the end of that office visit. Never saw the doctor and it was billed as an office visit. Never went back there again.

At Saturday, February 15, 2020 11:17:00 PM, Blogger 58flyer said...

Is that NOT part of the snake oil called electronic medical records that the public was sold?
-- Banterings

Perhaps, if used as it should be, and the patient has access to ALL information, including physicians notes, then all is well. We know all is not well, big change is needed.


At Saturday, February 15, 2020 11:28:00 PM, Blogger 58flyer said...

As to the topic of EHRs, legislation should be passed that stipulates that the patient, as the one who is in control of his healthcare, should have access to all information contained therein. That would "sticky notes." So far my urologist has supplied me with a paper copy of the records he will submit to my PCP. On my next visit next week I will just have to ask if there are "sticky notes" from the urologist that I can't see. I think my PCP is quite honest with me. I will bring along my urology file to show him to compare what he was sent. I'm rather curious about this. I have no reason to believe my urologist would not be totally honest with me but I would like to know for sure.


At Saturday, February 15, 2020 11:49:00 PM, Blogger 58flyer said...

If I kept a file of "Thoughts that go bump in my head" this would be one of them.

I have observed that a lot of healthcare providers deliver their practice according to what their liability insurance carrier demands. I'm not an insurance specialist and I don't know anyone who is. I am sure that the insurance companies have standards and research that they look to to determine their liability exposure. And I believe they are constantly looking for ways to reduce their liability obligations. So much of the way doctors practice is determined by their liability underwriters. So, basically, a lot of what happens to us in the hospital or clinic is based upon the demands of the insurance carriers, not sound medical research. The notion that female providers must have a "chaperone" for male intimate exams is probably based on an medical liability insurance requirement.

The insurance companies could be our friend. If they could be made to understand that a female chaperoning a female with a male patient is just as liability packed as a male chaperoning a male with a female patient, they just might just mandate a change. There is plenty of data on female medical impropriety with male patients to alert the insurance carriers as to the possibility of liability claims. They might just rewrite their policies.



At Sunday, February 16, 2020 2:24:00 PM, Blogger Maurice Bernstein, M.D. said...

So much of what is written on this "Preserving Patient Dignity.." blog thread deals with a matter of "bad doctoring". So, with this in mind, I looked back to my 2008 blog tread title "Doctors' Bad Doctoring and the Their Penalty". The thread contains my review, at the time, of the quarterly Medical Board of California's actions taken against physicians which brought up a bunch of reader comments on the subject which, reading the thread now, brought up some issues pertinent to what is being described on our current thread topic.
Take a look and if you have a comment to make you can write it there or bring it up to our current subject thread.

I've had so many topics related to the ethics within the medical system published here over the years since 2004 that it is worth integrating them into the current threads as considered pertinent. ..Maurice.

At Sunday, February 16, 2020 4:38:00 PM, Anonymous JF said...

I don't know if anybody agrees with me or not, but I don't get why its regarded as so awful wrong for a doctor or nurse to become involved with a patient or at least a person who used to be a patient. Plenty of people meet through their jobs ( or one of their jobs ) As far as chaperons go, just male attend to male patients and females attend to female patients ( if its something that requires nudity ) but a lot of intimate care/exams shouldn't be happening. Swabbing for example. Patients usually could do that themselves and should be given that option.

At Monday, February 17, 2020 6:08:00 AM, Anonymous JR said...


Their stories didn't match bc the real reason is bc they want to do prep fast & for their convenience. If you had anything on, they would have to slow down & be careful as it they got it wet, you could get burned. There are garments made to cover genitals but even those they don't like using bc again they have to be careful and not just slap it on. Their need for convenience overrides their obligation to private their defenseless patient just about every time.


Since part of our issue is the falsification of EHRs, I have done a lot of research. What I have found is part of the "sell" is EHRs use cut & paste, or click a phrase. Adding items in your own words is discouraged bc if there is a malpractice suite, using your own words is more likely to show the wrong committed. Their standard, pre-chosen phrases limits this as there are prompts that show which phrases should be used for every type of procedure or care. This limits saying something that could be helpful in showing what went wrong. Oftentimes, they do EHRs way after a procedure so things become foggy too. As for one dr. sharing private info from another dr., I wouldn't count on it. There is a solid personhood of protection. Those sticky notes aren't meant for you to see. I talked w/ the insurance company about the sexual assault & they just seemed immune. They didn't care. In the medical world, this type of behavior seems to be acceptable as part of the risk of receiving medical care.


The reason I am so opposed to involvement is medical staff says seeing you naked is not something sexual to them, they're not check you out. If you throw in dating a patient, then the sexual aspect is very real & at any time, your medical provider could be for real 7 not just in theory, checking you out for that potential date. For patients to be in a more safer atmosphere to be naked, there must not be the accepted potential of physical involvement. This is how I see it.


Again, we're in total agreement.

At Monday, February 17, 2020 4:45:00 PM, Anonymous Anonymous said...

JR, Doctors and nurses don't always see their patients naked. And it should happen a lot less than it now happens. When it just can't be avoided then the male staff should attend to male patients and female staff should attend to female patients unless the patient requestes otherwise. As far as intimate exams/care being sexual to providers, sometimes it is. Everybody knows that. JF

At Monday, February 17, 2020 5:59:00 PM, Blogger Maurice Bernstein, M.D. said...

What I read and re-read here is about the stress of being a patient.. not just related to being physically sick but how one is being treated by others in the medical profession as their patient.

Now I just read today, and reminded or, in my case, informed that STRESSED is actually DESSERTS spelled backwords.

Yes, I know that PTSD has been attached to many of those who have written to this blog thread. Yet..
has anyone found a tasty (not sour) ending to any of your stressful experiences as a patient? Is there something "good" or "acceptable" to recover after being stressed? Maybe the dessert is "education" know what to expect and thus to be "on guard". What is your opinion about looking at STRESSED backwards? ..Maurice.

At Monday, February 17, 2020 6:25:00 PM, Anonymous JR said...

As a dr., you know that DESSERTS lead to weight gain that could lead to diabetes, heart disease, increases the chance of certain cancers, etc. so there is not much of a bright area in DESSERTS vs. STRESSED.

Yes, both my husband and I have PTSD. The "sour"ness of what happened, a rape, and battery will never fade or disappear. The feeling of deep violation is one thing that cannot be forgotten. I really don't know how you can recover from rape and captivity especially knowing the guilty parties are still there ready to do it again (not only the actual ones involved but also any medical encounter could end the same.)

However, I now have made patient rights a part of my life going forward. I want to educate others so they don't become a victim like my husband. I want to give them the info they need to retain their dignity and control. No one should be sexually assaulted especially during a medical encounter. No one should be forced to have a medical procedure. No one should be forced to anything they do not agree to during a medical encounter. Nursing homes must become safer places for older citizens. I have met a lot of nice people. I hope that our story will help some avoid being victimized. Doing research & speaking to others help me as maybe I can prevent them from the same awful fate. It is also depressing because change will be very hard to bring about but I won't stop.

At Monday, February 17, 2020 7:36:00 PM, Blogger Maurice Bernstein, M.D. said...

JR you conclude with "I hope that our story will help some avoid being victimized. Doing research & speaking to others help me as maybe I can prevent them from the same awful fate. It is also depressing because change will be very hard to bring about but I won't stop."

And as I look at what you wrote, your response and observing its effect to the benefit of others who have been or might be stressed within the medical system will end up being among your delicious but healthy desserts. ..Maurice.

At Tuesday, February 18, 2020 12:25:00 PM, Blogger A. Banterings said...

I have taught of something very interesting. If providers are trained to deal with the human body, they view body parts the same, they see no difference in males and females, then there must be a higher incidence rate of bisexuality among providers. After all, they are desensitized and do not see the naked human body as sexual, therefore they can be sexually intimate with both genders without any hang ups.

-- Banterings

At Tuesday, February 18, 2020 2:02:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, for years and years now, I have participated in the medical student physical exam workshops for both male and female genital exams (on plastic models and prior to the students moving on to standardized patients for learning) and in no way are the students trained to observe the anatomy by inspection and palpation of either males or females as having similar genital parts. The students see and feel the differences both from an anatomic, functional and pathologic point of view. This is later confirmed by examination of the alive standardized patients.

Sexuality is always a part of the students anatomic, functional and pathologic learning and, at least at the beginning of their medical training and I can't imagine it waning in the later years and becoming either personally or professionally asexual. ..Maurice.

At Tuesday, February 18, 2020 9:15:00 PM, Anonymous JF said...

Dr B, Probably he wasn't saying that male and female genitalia look and feel similar. Just that allegedly seeing and examining the different genitalia is a similar in how affected/non affected the medical workers are .
I don't know if I should speak for him or not but that's how I took that.

At Tuesday, February 18, 2020 9:43:00 PM, Blogger Maurice Bernstein, M.D. said...

There is much more than genitalia (which are usually hidden) to attract or ignore any sexual interest regarding a physician or nurses sexual interest. There is general appearance, words and behaviors on introduction, while taking a history or performing a limited or general physical examination. In this general regard (not simply inspecting or palpating genitalia) which may stimulate some sexual or love interest regarding their patient. There is more to "sexual attraction", if that is how one should call it, than the act of "clinically", if that is the appropriate word, examining the patient's genitalia. To all: think about why physicians or nurses may marry their patients---and it is definitely not related to having been involved in a clinical genital examination. Anyway, that is my opinion. Anyone want to debate this viewpoint further? ..Maurice.

At Wednesday, February 19, 2020 1:57:00 AM, Anonymous JF said...

It's true that people can/ are attracted to other people without seeing the merchandise. That being said though, genitalia is special. And sacred and shouldn't be displayed for no good reason.
And 99% of swabbing should be done by the patients themselves in the bathroom in privacy.

At Wednesday, February 19, 2020 2:44:00 AM, Blogger Swannie said...

Dr. Maurice,

I am not saying female medical staff are sexually attracted to every male they encounter as it would be a stupid idea.

BUT, i have a hard time to believe and it will take a lot to convince me when they touch a male`s genitals for a period of time ( like catheterisation), they feel absolutely nothing and it does not affect them at all ( excluding LGBT persons, OR a disease ridden genitals.) It is simply not in a human`s DNA to have no feelings, or emotions at all.

At Wednesday, February 19, 2020 3:12:00 AM, Blogger Swannie said...

Well, i received copies of my medical and hospital reports today which consisted of 4 PDF documents. WOW, what an expensive report ! Cost me exactly R101.00 per PDF document = R404.00 for the lot.( this morning`s exchange rate was $1.00 = R14.92)

I found a lot of inconsistencies as to what really happened. The surgeon had to tick a box to confirm i was introduced to all medical staff by name and occupation. I have TWICE requested that same info from the Quality Assurance Manager and got nowhere. Surgeon (female) said they were FIVE females and ONE male in the OR and the females would look after me. I counted only 3 names on the form.

Where the staff was supposed to sign the OR form, only their surnames were written in. No real signature.

On the form where the surgeon was asked to describe surgery, she started by writing "general anesthetic", then "Clean and draped" ...then wrote down step by step until closure of wound.

NO mention anywhere about the catheterisation at all !!

One should think if any surgery has a blanket consent once an operation is underway,( according to the Head of Surgery Dept.) that the doctor would at least mention the catheter.

A copy of my signed consent form was not included in the documents i received and now i am doing my best to get it - not succeeding so far.

At Wednesday, February 19, 2020 5:28:00 AM, Anonymous JR said...


I posted a reply but in the meantime, I have done a little Internet work and she is real as are hernia clinics.

Dr. B.,

Because a doctor/nurse can fall for a patient does prove the point that medical encounters do have sexual meaning for them with or without nakedness being involved. So with having said that, it does make sense that when a patient's genitals are being exposed, they are looking a them only in a clinical manner but also in a personal manner. I would say that is especially true for the chaperone who is not part of the clinical exam but is there merely to "look". Lookers tend to look and make judgment calls. So yes, in theory a medical exam shouldn't be sexual in nature but if we have doctors/nurses wanting to date patients with or without nakedness, then yes sexual feelings are present at all times. However, in our case, it was not so much sexual feelings as rapist act on different feelings. Those feelings are the need of power and control and to demean and humiliate their victim using sex to do so as they have a disturbing manner in which to attain their sexual gratificational (not a word) needs. But clearly sexual feelings exist in all medical encounters. You proved the point on the dating issue.

At Wednesday, February 19, 2020 5:58:00 AM, Blogger Biker said...

Of course those who work in healthcare are not asexual. They are human. Those who have been properly trained will maintain a professional demeanor throughout any encounter but just as all of us judge those we encounter, fleetingly and unconsciously in most cases, healthcare workers do the same. The primary difference is that they see more of the patient than society at large sees in everyday encounters.

What is missing in healthcare worker's "maintain a professional demeanor and all is well" thinking is that patients are also not asexual. Patients too are human and the imbalance of "I'm intimately exposed and you are not" is at the core of the general discomfort patients experience. I've been at mixed gender clothing optional settings a few times in my youth and was more comfortable with nothing on at all when everyone else was similarly not attired than I am in a mixed gender healthcare setting where I'm the only one in the room exposed. Same gender doesn't concern me given I've been naked with others in locker room settings thousands of times.

Of course patients sometimes need to be exposed in order to receive the care they need, but the question then arises as to whether that exposure is greater than was truly necessary and the extent to which staff gender can amplify the effect of exposure. The healthcare industry surely is fully aware of this but it is expedient and more economical to ignore what male patients may be thinking and feeling, and perhaps to not care that some men avoid healthcare altogether as a result. It is too easy to blame those men for being too modest given the female staff is comfortable with the exposure of those men. You see that attitude all the time when female nurses & others comment that they've seen it all a thousand times. It is always from their perspective that they see things and never from the perspective of what the patient might be thinking and feeling.

At Wednesday, February 19, 2020 11:23:00 AM, Blogger A. Banterings said...


You misunderstood my point. What I am saying, is that if providers are conditioned to see genitalia as just another body part, and they react the same to both male and female (just like looking at an elbow to me...), then when it comes time for a sexual encounter (I am NOT talking romantic, I love you and want to spend the rest of my life with you), then medical providers would just as easily accept male or female partners because they have been desensitized to the sexual stigma commonly associated with the genitalia; thus incidence of bisexuality would be extremely high (compared to the rest of society) among medical providers.

-- Banterings

At Wednesday, February 19, 2020 6:46:00 PM, Anonymous JF said...

Banterings . I don't believe people can turn gay or straight. Bisexual people are BOTH and they are who creates the illusion they people can change sexual orientation. And medical workers don't see genitalia the same as elbows.

At Wednesday, February 19, 2020 10:41:00 PM, Blogger 58flyer said...


I searched online and found facilities that do hernia repairs and some evidently specialize in that area. I just didn't think that a facility could survive on hernias alone but apparently there is more hernia business than I thought.

Either way, that so called nurse we discussed has probably done a lot of harm in her career.


At Wednesday, February 19, 2020 10:56:00 PM, Blogger 58flyer said...

Well, today I went in for my second TRUS procedure with biopsy. It was a no go with my BP at 220/110. The doctor did not want me to stroke out on him. He recommended that I contact my PCP. After a round of phone calls with my PCP he recommended that I get to an emergency room fast. So I did and found my BP still hovering at the 200/100 range. My ER doc prescribed Vailum to help me get calmed down once I described the past abuse history and how it related to the current urological situation. Even though I was comfortable with my nurse and the prior TRUS was no big deal, it still must have gotten to me in a way I did not expect. Maybe it's the worry that the cancer may be spreading. So far the Valium made my BP drop significantly and tomorrow I will discuss with my PCP whether we need to adjust the Lisinipril dosage.

I am just astonished that one incident with a predatory nurse from way back in 1973 could still have such a major effect on my life after all these years.


At Thursday, February 20, 2020 2:38:00 PM, Anonymous JR said...


I didn't say much but I see you didn't catch that nurse didn't actually say she was sorry but rather "Yeah I thought it was funny at the time but now realize how uncaring it must made them feel." Just uncaring? No, many probably felt violated, humiliated, assaulted, etc. This was done by a person in control who was using sexual power to violate a defenseless person in a sexual manner or in other words just like a rapist does. I am not surprised your reaction is still as strong as after almost 50 years or so. The feeling that you were left with doesn't disappear & you can't control when something could trigger a response. I have seen that firsthand.

What many don't understand is it how exposure is done and if it is necessary that makes the difference. We all understand sometimes medical treatment does call for medically necessary exposure. However, it is how it is done for most of us that defines the difference in how you feel about it. Up to the point of being sexually molested, my husband didn't have a problem with medically needed exposure that he had been explanation as to why and consent for having when he had his prostate surgery. The other times like the ultrasound he didn't like but the tech wasn't abusive. Other times he was able to direct onlookers out of the room. The hospital from hell time was different as they made him totally defenseless, give no explanation nor did they ever seek his consent and most importantly, they did the exposure unnecessarily and made it feel as if it was a group sexual assault on him. Therein was the difference. The one time I had a male doctor very briefly b4 my female dr. arrived as it was an life or death situation for my baby, he was very respectful, apologized, explained, and asked for consent. I thought nothing about him doing the job even with the exposure. So it truly is the difference on how healthcare is delivered.

Tomorrow I will have my chance at my State Senator as he is in town. I am going to hammer him about his inability to set up appointments as promised. I have a list of issues that I am going to publicly bring up in a setting in which he is discussing sexual assault. I think fate had part in this as the subject is a gift for my to present patient sexual assault as a silent crime especially if it involves male patients.

At Thursday, February 20, 2020 2:50:00 PM, Blogger A. Banterings said...


Freud said that the only unnatural sexual behavior was to have none at all. And after that, it's just a question of preference and opportunity. My point is that if you take preference out of the equation, as described as romance and the social hang ups (touching same gender genitalia is a homosexual act) via the medical education, then all that is left is opportunity.

Therefore, all genitalia would be equal and thus providers' prevalence of partaking in bisexual acts would be extremely much higher compared to the rest of society.

Perhaps the best example is the expression "a hole is a hole."

My point is that if providers are gender neutral, then a hole is a hole.

As to medical providers seeing genitalia the same as elbows, search previous volumes of this blog and you will see that (lie) has cast upon patients that genitalia the same as elbows. Here it is in an academic paper:

Section 6.3 The "Is the vagina different from the mouth?" objection

I can't remember which acquaintance had told me this story; a female provider trying to access his genitals, gave the "genitalia the same as elbows" justification when he refused. He asked to see her elbow. She complied. He said "the other elbow. Again she complied. Finally, he said "NO, your OTHER elbow." She walked away rolling her eyes.


Do not underestimate trauma.

I have never been screened for ANY cancer. I have NEVER had a complete physical exam. All through childhood into my late 30's, a relative (physician) signed all my medical forms. This was from trauma I suffered at a hospital when I was 5 years old. My entire family thought this was totally acceptable and was normal. My mind blocked out what happened to me and I do NOT want to ask my family what happened because I do NOT want to relive the trauma.

I have an idea what happened by somatic feelings that I have, reactions to certain touch and sensations, and my phobias (DSM F40.23, DSM F40.24).

My friend up north complained to my current PCP about my elevated BP being white coat syndrome and the side effects of Lisinopril for over 2 years. Finally I told him I have been flushing them for the last 6 months and he was off.

TRUS with biopsy: God bless you. I could NOT do it. No surprise of your reaction (BP elevated). I also get triggered on this blog, become obsessed with this topic, then the self destructive behaviors begin and I have to walk away for a little while. This is what (self described) compassionate providers do to patients. We are survivors of medical abuse.

-- Banterings

At Friday, February 21, 2020 4:56:00 PM, Anonymous JR said...

Today I was able to get my message across to my state senator. No meeting had been setup so I decided to take the matter into my own hands at a chamber mtg. I told him that I had spoken to his intern & that intern had said he legislative aide would call me. They didn't so by not keeping their word I was forced to do this in a public forum. He said he wanted my contact info so he can talk with me after the session is over. Which if he keeps his words, I understand now is not the time as they are winding down. We were limited to one question which was something like this: It is commendable they want to make healthcare available to everyone but what use is having healthcare if the way it is delivered to patients is in an abusive manner, a manner in which any & all patients may be sexually assaulted for staff convenience or entertainment and/or medical battery committed on them to force medications that have refused, have not consent to having, or forced to have a procedure done w/o consent. You can bet there was silence in the room. He gave the usual song and dance but said he would talk to me afterwards. I talked to him about patient dignity and respect, female patients having multiple pelvic exams by medical students while anesthetized & male patients mass rectal exams bc the consent is too broad & gives to much control to the dr. I told him the majority of times the patient will not even know this has happened. I talked about how the consent form & process needs to be changed to avoid medical battery. He asked several questions like which states have done something & even said he didn't know this was happening. We also talked about how patient's dignity is not being respected & I gave him the brochures from MPM. I talked to him about issues of EHRs. He is an attorney by education so I talked to him about the legal system being unwilling to take cases & that Indiana's malpractice law is outdated & cases such sexual assault by medical providers like what happened to my husband should not be malpractice but rather criminal. I will be sending him a packet to review before we meet.
I also talked to a state rep who was there about fentanyl and consent. He agreed that it should be pretty simple to give patients the absolute right they already have to refuse whatever. He said based upon what I described something went very wrong. He is also an attorney. He is going to get me in touch with some people he thinks might be a fit. I also gave him MPM brochures.
I again talked to the state rep my husband & I talked to before. She said she is still trying to find someone who would be willing to take this on that has the expertise we need. She says she agrees that people thinks nurses have angelic behavior but many really don't as has been her experience. She took several brochures to pass around.
And I made a huge effort. I talked to someone from the hospital from hell. I told them they are the ones that propelled me into becoming an advocate for patient rights & dignity and all the related areas I am focused on. This man said he wanted to put me in touch w/ the right people to talk with so they can hear what I have to say. I also told him that as a male if he had a prostate ultrasound he would most likely get a female tech as healthcare discriminates against male patients. I told him if he had surgery he would have a high chance of getting mass rectal exams. He was visibly shocked.
And lastly, I talked w/ a nursing administrator who basically defended the bad things going on in nursing as not being able to give one on one care to residents. We are going to continue our disagreement over coffee.
Hopefully these people will follow through but it they don't I will & I told them my history w/ previous governors calling me into their office frequently bc I was such a pain in the _ss so I think they know I mean business. I told them this is very personal to me so things need to change.

At Friday, February 21, 2020 5:40:00 PM, Blogger Biker said...

Wow JR, you are a force of nature. Good for you. I look forward to updates as your conversations unfold.

At Friday, February 21, 2020 6:18:00 PM, Blogger Biker said...

Based on some observations these past couple months I am wondering to what extent is where we find male nurses, or not finding them as the case may be, the result of self-selection on the part of those male nurses vs their being purposely excluded.

In recent months my wife was an inpatient at the local hospital twice. The 1st time was for 4 days following surgery. The wing she was placed in was for surgery patients only. Between the length of her stay and her room having opened onto the central nurses station for that wing, it was easy to see that 100% of the staffing there was female.

The 2nd time started with a day in the ER, her room again opening onto the central nurses station making it easy to see the staff coming and going. My guess is that 50% of the nurses in the ER were male. Her time in the ER spanned a shift change enabling me to observe two shifts worth of staffing. She was then admitted for what turned into another 4 day stay. They put her in a different wing that is deemed for oncology patients, but they also place non-oncology patients like her there as well. You couldn't see anything from where her room was but I had to walk through the entire space to get to her room and so I saw plenty of staff with my comings and goings. Here there were some male RN's, maybe 15 - 20%.

Why would a surgical patient area not have any male RN's whereas an oncology & medical patient area have 15- 20% and the ER 50% in the same hospital? Could such a thing be random self-selection, or would there be some other factor?

Anyway, just some observations that gave me pause to think.

At Friday, February 21, 2020 10:06:00 PM, Blogger Maurice Bernstein, M.D. said...

I am wondering, after all these Volumes, how the visitors here can summarize the current health care system in literally a word or two with regard to the main objective of providing healthcare to the nation and the world. And can you explain your word or words?

From what I have read here, I might think of a word like "sloppy". "Sloppy"(careless, unsystematic and excessively casual). Yes, correct diagnoses and treatments are made for some patients but there is "carelessness" in attention to the concerns and desires of some patients within the system which then leads to a tendency for the members of the medical system to act excessively "casual" to these concerns. And because the medical system seems, faced with a multitude of issues, new methods based on requests or business demands there is the element of lack of patient-directed proper systemic behavior, in fact, suspected frank misbehavior.

So "sloppy" is my one word description ..and now yours? ..Maurice.

At Friday, February 21, 2020 11:26:00 PM, Blogger 58flyer said...

Dr. Bernstein,

My word would be "Discriminatory."


At Friday, February 21, 2020 11:48:00 PM, Blogger 58flyer said...

"And can you explain your word or words? "

I should have read a little closer before my last answer. I say "discriminatory" because of the way females are treated (generally) with a higher degree of professionalism and respect for their dignity than males. That female medical personnel are regarded as at a higher degree of trust than their male counterparts, who are frequently looked upon as "suspect" when they are in an intimate care situation with female patients. Discriminatory because males have distinct limits placed upon their ability to care for female patients in an intimate situation, whereas their female colleagues are free of such limitations. This is despite that they receive the exact amount of training and education. Discriminatory in that females work extensively with male patients in all aspects of intimate care, whereas male medical staff are mostly absent in the fields of OBGYN, mammography, and female urology. Intimate care of the opposite sex should not be considered wrong when it's males providing the care for females, but right for women providing the care for males. It's either right or wrong for everybody. Discrimination and professionalism cannot coexist.


At Saturday, February 22, 2020 4:48:00 AM, Blogger Biker said...


At Saturday, February 22, 2020 6:03:00 AM, Anonymous JR said...

"Sloppy" might be one but I think here are some others: Darkside, cavalier, controlling, retaliatory, paternalistic, uncompassionate, abusive, assaultive, offensive

But for sure, no one word can describe all the things that happen except maybe criminal because many of the things do fall within that category: unconsented for procedures, drugs without consent, pelvic/rectal exams without consent, exposure without medical necessity, failure to properly care for patient and I am sure there are others.

Yes, there are some true cases of unforeseen "accidents" of care but overall most things are done in a purposeful manner. Not allowing or protecting a patient's personal right to dignity is a purposeful act. Usually it is not an "oops" moment. It is the way they have agreed to deliver healthcare to the patient. My example of the girl from the hernia clinic demonstrated a purposeful action on her and the others part of assaulting their male patients. It was telling that she didn't say she was sorry but rather she said the patient might think it was "uncaring". Uncaring is not the term most of us would use when having experienced sexual assault. When we are in these positions out of our normal comfort zone and we are ill, we count on the medical staff to protect and do what is in our best interests. The medical community is failing at this. "Cure (not really a cure)" the present illness but we reserve the right to cause other harm" should be a warning to any medical encounter.

At Saturday, February 22, 2020 9:47:00 AM, Blogger Maurice Bernstein, M.D. said...

Biker, can you defend your selected word "misandry"? Do you really think that the underlying basis of the medical system is to purposely "dislike of, contempt for, or ingrained prejudice against men"? According to Wikipedia, "misandry" is define as "...the hatred of, contempt for, or prejudice against men or boys in general. Misandry may be manifested in numerous ways, including social exclusion, sex discrimination, hostility, gynocentrism, matriarchy, belittling of men, violence against men, and sexual objectification. " Is the system primarily a "woman's care" system?

We teach many things to first and second year medical students but frank gender discrimination is not one of the "things". Yes, my expression "sloppy" (which I feel I can defend that description) could lead to inappropriate gender discrimination but I wonder whether intended and generalized "misandry" is an appropriate characterization of the behavior of the medical system. ..Maurice.

At Saturday, February 22, 2020 10:11:00 AM, Blogger BJTNT said...

"Bureaucracy" when it comes to the bosses rather than management, particularly the lack of continuous training of caregivers and the poor enforcement of policy with real penalties for violations by caregivers.
"Perfunctory" when it comes to sanitation for patients, not for caregivers.
"Self-centered". How many caregivers say "I need to...".

At Saturday, February 22, 2020 10:55:00 AM, Blogger Biker said...

The definition of misandry has many components to it. Yes there is discrimination against males as was just defined by 58flyer. There is hostility towards men who request same gender care such as a number here have recounted and I myself have experienced. Some men have been belittled for asking for same gender care as has been described by some here. I see the perpetuation of the "men have no modesty" meme as an ingrained prejudice. Certainly men have been sexually objectified in healthcare settings. Been there on that one.

Medical, nursing, & technical training programs don't teach students that males are 2nd class patients, but that is the net effect of the female-centric nature of healthcare. Female patients are celebrated and empowered when rejecting intimate care from male staff. Men are deemed sexist if they ask for the same. Last year I recounted how a friend who as an inpatient at the local hospital got the "you don't have anything I haven't seen" when he hesitated letting a female LNA assist him with a shower. Male staff simply don't do that to female patients, at least not if they want to stay employed. A while back I also shared another friend who as part of his assessment at a rehab facility following hospitalization for guillain-barre syndrome was told by a female therapist "we have no modesty here" when he hesitated undressing, dressing, using the toilet, and taking a shower while she observed. Again, male staff would never say that to a female patient, yet it is deemed acceptable behavior by female health "professionals".

Of course not everyone who works in healthcare is a misandrist, but for the most part they tolerate the ones who are. The system does not treat male patients as the equals of female patients.

Ask your students how they see themselves as conducting exams and procedures. If they are honest they'll admit they would never have male MA's & scribes in the room for exams and procedures when female patients are intimately exposed but that its OK to have female MA's & scribes in for their male patient exams and procedures. Or advance their careers to the point that they are in the executive suite for the hospital. Do they then see themselves are making sure there is at least some minimal male staffing to handle male patient catheters, showering/bathing, cystoscopy preps, testicular ultrasounds etc. Assuming the answer is no on account all of the staff are assumed to be professionals, then ask the reverse, would they be OK if the only option for female patients was male staff for all these things. Of course such a thing would be unthinkable to these future healthcare executives.

My point here is that your students likely already see male patients are being lesser than female patients.

At Saturday, February 22, 2020 12:01:00 PM, Anonymous JF said...

DR B, I think it's more that the female workers don't have accountability. It's automatically assumed that the female staff are unaffected and professional. And that males are more inclined to be sexually abusive. But that doesn't account for the Denver 5 or Twana Sparks or that piece of shit who ripped away Rick's sheet as a practical joke on a new co-worker.

At Saturday, February 22, 2020 2:12:00 PM, Anonymous JR said...


I think you have the right word that encompasses what 58flyer said so well and I said. Your post clearly explained your choice of misandry.

The male rep I talked to yesterday agreed that healthcare is discriminatory towards male patients & it needs to be looked at and see what can be done. He also agreed there are many issues that need attention. Now to get some action & break the stranglehold the medical community has on our government's ability & desire to protect us from them. He agreed that the patient should always have autonomy unless they are unconscious & no next of kin can be found but agreed that is not what seems to be happening. It is no wonder that as a patient we cannot get our personal dignity respected because they really have no respect for the patient in any manner. With some simple fixes, I think even the medical industry would have to agree things would go smoother if patients felt respected in all aspects of care. Patients who understand, have consented and are treated with personal dignity are less likely to sue and/or to be unhappy with care.


I agree. When I was talking to the another female yesterday (a lawmaker) she recognized by situations in her life that "society thinks of female nurses as being angelic but they are not". Her statement surprised me.

At Saturday, February 22, 2020 6:47:00 PM, Blogger Maurice Bernstein, M.D. said...

JF, how do you explain the assumption "that the female staff are unaffected and professional"? Could it be that the long, long history of female nursing was tied into various religions and the moral and behavior cleanliness (or as JR noted "angelic") was embedded into their activities and this has persisted over the years even to our generations to those who haven't suffered directly from their "nursing"? ..Maurice.

At Saturday, February 22, 2020 7:11:00 PM, Blogger Maurice Bernstein, M.D. said...

BJTNT, I find "self-centered" expressed as "I need to.." an excellent contribution to my request for "one-word descriptions". Unfortunately "We need to.." may not represent inclusion of the patient in decision-making but represent the medical system itself expressing "needs" and changes for the benefit of the system rather than directed specifically to the benefit of the members of the profession or their patients. Example, of course, is the electronic medical record keeping and its challenges to the healthcare provider and the provider's patient. ..Maurice.

At Saturday, February 22, 2020 7:27:00 PM, Anonymous JF said...

Why is it assumed that females are unaffected? Probably because women are more active in early childcare. Also there seems to be more male sex offenders than female sex offenders. And females , expecially young girls will actually CRY about some of the harm the.medical staff dishes out. In time many females will tell other people about her upset. Males have a better ability to hide their feelings. Also males are generally speaking less modest.
( or passing off as less modest )
But mostly, the root of these problems is no patient voice. Letters are ignored. How many of the guys in this group have written multiple letters? And they were talking to a wall. Too many patients. Not enough doctors. And so there isn't enough concern about the large numbers avoiding health care. More of the numbers are male but there's plenty of females who avoid care also. Some because of our issue. Others because of the costs.

At Saturday, February 22, 2020 8:48:00 PM, Anonymous JF said...

Nurses are considered angelic???? I've worked with nurses for many years and some actually are angelic but a large number are @#$ holes to the core.

At Saturday, February 22, 2020 11:46:00 PM, Blogger 58flyer said...

Quoting JR
"But mostly, the root of these problems is no patient voice. Letters are ignored. How many of the guys in this group have written multiple letters? And they were talking to a wall. Too many patients. Not enough doctors. And so there isn't enough concern about the large numbers avoiding health care. More of the numbers are male but there's plenty of females who avoid care also."

I may have posted this before but it comes to mind again. In speaking to a retired urologist, he said there is a general shortage of doctors. Many medical practices turn away new patients because they are full. I've been turned away. The mighty $ is the bottom line. They just don't care that there are patients who avoid care. As long as the waiting room is full and even overbooked, there is no financial incentive to improve things. The clinics and doctors offices are working at full capacity in many areas. In most businesses, more is better, but not in healthcare. There is this happy little status quo, so nothing is going to improve.

I have noticed at many practices, including my own PCP, there are a number of Nurse Practitioners and Physician Assistants, both male and female. There has been talk for a long time to allow them to practice independently of a physician. Of course the doctor lobby screams "No" loudly. Why? Because it's competition, but that's not the reason used. The doctors claim patient safety. I feel the real reason is that the doctors will lose patients and the result will be a lot of people will turn to the NPs and PAs for the most common of primary care matters with less cost. I would think the insurance companies would be in favor of this. If the PAs and NPs could practice independently, that would create a competitive market where the medical consumer would benefit. There's nothing like strong competition to increase the quality of any consumer commodity, including healthcare. Maybe then medical practices would start listening to the real concerns of patients and addressing them. The traditional doctors offices would have to step up when they start seeing gaps in the schedule knowing that is lost $.

Competition drives excellence. Remember the ho hum cars of the late 1970s and 80s? That's when the Japanese car makers jumped in and took the American Auto manufacturers to school on how to build a car that the American consumer wanted. Not only did Japanese car makers establish a strong American market, the American car makers had to step up also if they wanted to stay in business. Look at the really awesome cars we have nowadays that resulted from the competition.

Maybe the NPs and PAs could take the doctors to school on how to deliver better quality care. I'm not trying to sell NPs and PAs as the way to end all our concerns, but I am a believer in marketplace competition as that frequently results in a better consumer product. And we are all medical product consumers. Of course, I am also a strong believer in legislation to protect the consumer.


At Sunday, February 23, 2020 4:20:00 PM, Anonymous JR said...


I wanted to thank you as I have met someone on Twitter from Indy & we are going to work together on the consent form overhaul. She has the one from her hospital assault & I have the one from my husband's assault. We are going to pool our ideas and make the suggestions on the form so we can present it to some of the legislators so they know from patients who have suffered medical battery over lack of consent what needs to done.

Of course, we are already supposed to be given Informed Consent but it is not working out that well as hospitals have found ways around it. There needs to be an agreement what those forms say--no more broad coverage that actually allow for pelvic/rectal exams, no more you must have this drug, no more blanket you can do anything you want type of thing. It needs to be buttoned and zipped.

At Monday, February 24, 2020 8:29:00 AM, Blogger BJTNT said...

Reference: Bugle Blasts March 2020 Vienna VA 22181 Volume 11 Number 7 Cell: 703-861-0726 Email: This Newsletter is dedicated to serving and former members of the Armed Forces of the United States and to their families and friends.

VA Caregiver Program - Should Someone Else be in the Room Initiative – source Military Times.

In coming months, physicians at VA hospitals will start their patient visits with a seemingly mundane but potentially radical question: “Should someone else be in the room too?” The move is part of a new initiative by VA leaders and the caregiver-focused Elizabeth Dole Foundation to make sure that spouses, parents and loved ones providing direct care for injured veterans are included in every step of their medical planning and treatment, something that happens inconsistently today.

At Monday, February 24, 2020 4:27:00 PM, Blogger Maurice Bernstein, M.D. said...

If the VA hospital initiative, reported by BJTNT is carried out fully (every step) and regularly, does anyone see harm to the willing patient or to the Veterans Administration hospital and its function? Should family members be allowed into the operating room from start to finish, as is currently and commonly carried out with some pregnancy deliveries or even during cardio-pulmonary resuscitation? Any views here about "every step of their medical planning and treatment"? ..Maurice.

At Monday, February 24, 2020 5:36:00 PM, Anonymous JR said...

It is my opinion that a relative of the patient's choosing should be with them at all times during an medical encounter. Of course, that is with the patient's consent. If the patient has no one, there should be an outside organization they could engage if they wanted but only if they wanted. The advocate should never be a hospital employee because when push comes to shove the hospital employee will the majority of times protect their employer. ORs can be made to accommodate an advocate so they can be within viewing distance but not in area that would cause issues to the procedure. However, it is the advocate must be close enough to question or stop issues such as unnecessary patient exposure or having gender care not authorized by the patient. This would also eliminate patients getting pelvic or rectal exams without consent. The advocate would also be able to sound the alarm if any areas of the patient's consent was being violated. I think it would be a positive for both the patient and healthcare as it would make them more honest and compassionate towards the patient. They would not have the we're are totally in charge of this patient and can do anything to them we please attitude. I had 2 emergent C-sections and nothing bad happened with my husband being present. It made the whole less scary as I knew he was there for me. Isn't it supposed to be about what is best for the patient? When will the patient actually be asked what they think is best for them and when will the medical community actually follow through with the patient's wishes instead of following their own agenda?

At Monday, February 24, 2020 6:19:00 PM, Blogger Biker said...

If the patient agrees to the presence of family members, and the patient is properly informed as to what the procedure entails, then I'm OK with it. In an emergency scenario where obtaining proper consent is not possible then the only people who should be allowed in is the patient's spouse and for minor children, the parents.

Part of being properly informed must include whether the patient is going to be intimately exposed. The fact that someone has been brought into the ER unconscious does not mean that person's exposure should be open to all of their extended family & friends who might be present.

At Monday, February 24, 2020 7:45:00 PM, Anonymous JR said...


That is why every patient should have a detailed health directive telling what they expect during a medical encounter. Not only what they expect but what they would refuse. A health directive needs to be much more than just flipping off a switch type of thing they are now. Ours say exactly what we will allow and what we won't. It also says for my husband he will not allow female intimate care under any circumstances even ER. He states he does not want ER services without his advocate present, air ambulance as he clearly states he has been a victim from these services. He names which hospitals. He names drugs. He is very clear. He wants me present. If he has been given any painkillers or like, the POA takes effect. I am his POA. Nothing is to done w/o my consent and the same for me. This is on file, carried, on phones, and copies. He also wears a medic alert stating there is a directive along w/ some other items. Everything is spelled out and the consequence of expecting to be sued if the conditions aren't met. That is a direct result of the former care nightmare. As I said everything is explained and clearly stated.

At Monday, February 24, 2020 11:03:00 PM, Blogger 58flyer said...

I see the conversation is going along a different path but I have to get something off my chest. Early this Monday morning I see a message on my cell phone from my urologist asking me to return his call. This is unusual since the staff makes all the contact, but this was from him personally.

So I call back and when he gets on the line he wastes no time telling me he is withdrawing as my urologist. The reason he gives is that at my last visit my BP was no high he was concerned that I might have a stroke or a heart attack. I am baffled, I didn't know what to say. He's dumping me because my BP was high? I told him of my going to the ER and working on a plan with my PCP to get the BP under control. He wasn't interested in hearing that. He had made no attempt to contact my PCP to inquire what was going on with my care. His mind was made up. The call was short and he advised he would be sending me a registered letter advising me of the termination. To say I felt like crap is an understatement. I got on the phone with my PCP and his nurse was as astonished as I was. She verified that there was no contact between my PCP and the urologist.

With the cancer diagnosis I have to admit I was stressing over the TRUS but I didn't realize how badly. I took an extra Lisinopril that morning but clearly it wasn't enough. I'm not trying to play the cancer feel sorry for me card but where is the compassion when I really need it? I do feel the doubling of the Lisinopril and preloading Valium for a couple of days prior to the TRUS would keep the BP under control. But my urologist was having none of that. I have tried to avoid being labelled a difficult patient, but no doubt in his mind I am.

My wife has experience as a legal assistant and paralegal in the field of medical malpractice. She says he cannot just dump a patient without arranging for another provider to step in. I just hate for it to come down to a legal issue. Going forward I will just have to wait and see. My next PCP appointment is in 2 weeks.


At Tuesday, February 25, 2020 6:18:00 AM, Anonymous JR said...

I really advocate everyone especially those of us here on this blog who all have suffered somehow at the hands of the medical community to have this more detailed type of health directive. Your healthcare directive should deal with more than end-of-life issues. It should deal with how you want healthcare delivered to you. Most spouses would not have an issue of being exposed in front of their spouses but to be exposed in front of other family and friends may be different. That is why all should have the directive to spell it out. You don't really have a choice to whom the healthcare community exposes you to as they consider anyone employed in the healthcare industry has the right to see any patient naked at any time for any reason including non medical reasons. We took a template and edited it and then we took it to an attorney who went over it. When then had it properly witnessed, notarized, and filed. As I said it is carried with us at all times. There is a copy of our phones. His medic alert necklace alerts to its existence. Having suffered sexual assault once through a medical encounter, we have done all we can to protect from another occurring. You never know when you will experience it again as we never expected this one to happen. We have proactive in not wanting to be victimized again without a fight to have this done.

At Tuesday, February 25, 2020 6:57:00 AM, Anonymous JR said...


I am so sorry you having this additional stress placed on you. It is not fair or right. Certainly there is no compassion. If I remember correctly, you have been satisfied w/ the care you have received from this urologist? You're certainly not the first man to have multiple issues going on. If a urologist were to stop treating all men or women w/ high blood pressure, they would have no patients. They are supposed to coordinate care with other specialists is what I was led to believe. I think it is something else. I think he realized who have lingering issues from the sexual abuse of your past medical encounter and he doesn't want that to affect how he practices. In order words, he may think he is protecting himself from you. Far too many as we have found do not want to admit men suffer from sexual abuse especially at the hands of medical providers. He probably thought your extremely high blood pressure was setting the stage for some type of legal action. He is apparently uneducated on how to deal with victims of sexual assault especially male victims. Having no male rns or techs in place does add to the stress of having such a procedure even for a "normal" person. My husband had cancer before the heart attack so he can relate to the stress these prostate procedures cause. Put on top of the stress of having been a sexual assault victim, it really compounds things. He remembers how they were not real concerned about what now he recognizes as personal dignity. He remembers just shoving his feelings down as they didn't cross the line into assault but rather not showing compassion or concern for his personal comfort.
I don't know exactly how the law works on being fired as a patient but you are better off without that jerk as he really is showing his lack of skill as a doctor. He probably didn't believe you had really been sexually assaulted before he saw it manifest itself and now he knows he has no interest in delivering healthcare to you or anyone in a compassionate and dignified manner.

At Tuesday, February 25, 2020 8:14:00 AM, Blogger Biker said...

58flyer, I am so sorry for you being dismissed by your urologist. Given your prior comment about your records having a note about you being afraid to be in a room alone with a female, or something to that effect, my guess is he just didn't want to have to recognize your past abuse and the need for some reasonable accommodation. Either that or his female staff complained about their rights being violated or some such.

Just as doctors choose specialties that meet their interests, nurses and every other category of healthcare worker also choose areas of healthcare that meet their interests. This includes all of those women who choose to work in urology. Some might just might find urology interesting, some might go into it for the view, and perhaps some modern era feminist types enjoy the power imbalance over their exposed male patients. It is that latter group, if your urologist has any on his staff, that could have protested you asserting your needs above their "rights as professionals". How dare any man say he doesn't want to be exposed to them.

As has been discussed, just about all physicians have as much business as they can handle. There is no incentive to be accommodating, unless they personally want to be empathetic to patient needs. This is why I choose my battles carefully and let certain other things slide.

Good luck with your search for a new urologist.

At Tuesday, February 25, 2020 8:40:00 AM, Blogger Maurice Bernstein, M.D. said...

58flyer, what I see missing here is communication between your urologist and your general physician especially if there is a general medical issue (such as uncontrolled hypertension) which may affect some surgical procedure. Both parties should be wanting such clinical consideration and discussion of management to permit the necessary surgical procedure. Your general physician should be the one to help you control your hypertension and bring you to a state where your urologist would feel comfortable following up with your procedure. There always has to be communication about their common patient especially when problems or conflicts arise. Anyway, that is my understanding and what I would say is the way clinical problems involving two specialties should be handled. ..Maurice.

At Tuesday, February 25, 2020 8:54:00 AM, Blogger Biker said...

As I think of 58flyer's urology situation, I again am thinking of a recent discussion about the good old days when patients had a primary care physician who was the center of their healthcare experience. The PCP coordinated care, on occasion using specialists as might be appropriate, and was the person who oversaw the big picture. I had described growing up that way with the family doctor that delivered us also being the one to tend just about every aspect of our care. The doctor that delivered me was the same one who filled out the required health forms when I was going off to college. In the old days 58flyer's PCP would take charge of the situation and hopefully that will prove to be case this time, but it is no longer the norm.

Now it seems patients are on their own to find their way through the healthcare maze. Over the course of the past two months for what is still an undiagnosed problem I have gone from my PCP to getting an MRI of my head & appts with physical therapy that she ordered in what felt like "throw a couple things against the wall and see if anything sticks", then to a neurologist at the recommendation of the radiologist reading the MRI, then to a carotid artery ultrasound & half a dozen blood tests ordered by the neurologist in the "throw something against the wall" manner again, to a cardiologist & a wearing a heart monitor for a couple weeks, again more of the same with seemingly nobody in charge. My PCP hasn't contacted me to go over everything done to date. She gets copied on all of my test results and visits. Over the next couple weeks I'll have another cardiology appt. to get the results of the heart monitor test and then a follow-up with the neurologist for reasons unknown. If anything the problem has gotten worse over the course of the past two months. The physical therapist and the neurologist had suggested maybe I'll need to see an ENT for a theorized inner ear problem being the source of the problem but no referrals have been made. Yesterday I called the ENT dept to see if I could make my own appt. and they said they need a referral, preferably from the person who is overseeing my care and familiar with everything done to date. I'm thinking the answer is nobody fits that bill.

I have grown to understand people paying for concierge primary care. There are two doctors doing that locally and I'm thinking of signing up. The only problem is they aren't associated with the hospital where all of my other providers are.

At Tuesday, February 25, 2020 9:57:00 AM, Anonymous JR said...

Dr. B.,

58 flyer is taking meds to control hypertension. You are missing the issue. It went up as a reaction to the medical abuse he had suffered long ago. You cannot control those surprise trigger flareups with a blood pressure medicine. It could have been controlled if he had been given more compassionate care as they knew he was a medical sexual assault victim. At the risk of bringing wrath down, my husband has no high blood pressure issues nor does he need or take meds for it. However, every doctor visit it is extremely high when he is faced with a female staff member even with me present. Once they leave and while he is waiting for the male dr. it returns to normal as the dr. takes it so confirm what is happening. 58flyer had a reaction out of the blue that triggered the response. As far as I have read from him, this is the first time this has happened so there was no way he knew he needed to prevent it from happening.


I disagree. All dignity infractions need to be addressed as they will build up to the point of overload especially for victims of sexual assault. You don't have to be combative but you have to make it known you have a right to dignity in care and they have an obligation to make sure you are respected while in their care.

At Tuesday, February 25, 2020 10:23:00 PM, Blogger 58flyer said...

Thanks all.

I spoke to my PCP by phone today and he is also concerned as to why the sudden action especially when the urologist had gone out of his way to being accommodating in the past. My PCP said he would direct the question personally to the urologist as to why this action without any attempt to resolve the issue by involving the PCP. I will be interested in hearing the answer to that question.


At Wednesday, February 26, 2020 11:59:00 AM, Blogger A. Banterings said...


PCPs don't even do sutures any more. Honestly, I would NOT even know where to get them is it was non-emergent (other than an urgent care. You would probably get sent to an ED and wait 24+ hours because you are not critical.

For those reasons, I have ordered suture kits online and keep an ample supply of super glue on hand.


I dealt with this for years until I finally told my PCP that I was flushing my lisinopril. It was white coat syndrome. I backed that with home readings.

You are a victim of medical (sexual) abuse OR sexual abuse under the guise of healthcare. That is how you need to phrase it.

I am sorry to say, but most people are idiots. Something triggered you.

Having a counseling degree, I would suggest that a sexual abuse survivors support group may offer some benefit. Counseling will be useless; providers will only gaslight you. You will be surprised that you will find people in these groups abused by providers and the stories of their encounters with healthcare.

-- Banterings

At Wednesday, February 26, 2020 9:04:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, the role of the patient's primary physician who should bear internal medicine skills is to be the one who interacts with each and all consultants to formulate a differential diagnosis and then discusses with the patient approaches to any further workup or beginning therapy. It seems to me, by your history, you were experiencing specialty chaos. ..Maurice.

At Thursday, February 27, 2020 5:36:00 AM, Blogger Biker said...

Dr. Bernstein, it isn't in the past tense but rather ongoing. My guess is that the billing codes don't allow time anymore for primary care providers to coordinate with specialists in other depts. reviewing test or examination results, and then proactively contacting the patient to chart a course of action.

In my case I moved all of my care (except for my dentist & eye doctor) to a single hospital so that everyone could see my entire record and coordinate as needed. Each person I see is looking at my records; it is just the central coordination piece that is missing. I don't truly fault my PCP for this given it is easy enough to see she is rushed trying to get through the volume of patients being crammed into each day. I would add that being on Medicare the shockingly small amount being paid for office visits is certainly part of the problem. It is understandable that they have to compensate for it with volume.

Fortunately for me I am capable of seeing myself through the maze to an eventual solution, but I can see how others can get lost in the system.

At Thursday, February 27, 2020 6:39:00 AM, Anonymous JR said...

That is one of the issues of PCP is they are not coordinating care as there is more $$$$ in actually seeing more patients. Rarely do they look at the files of patients until that patient is sitting in front of them asking for results. That is one of the pitfalls of how big and corrupt the medical field has become. Corrupt meaning they had been bought and paid for by big pharma and allow the abuse and assault of patients as a standard to having healthcare.

I just received a comment from an older man about how care he received as a teenager was so traumatic it shaped his view forever. He was talking about when hospitalized for surgery as a teen, he and his roommate suffered by being physically restrained. I of course said that "sedation" is not the choice of restraints because it basically causes the same to happen. Fentanyl causes a paralyzing feeling, heaviness in the limbs and a feeling of well-being while versed cause an erasure of memory, submissiveness, and lack of inhibition. So while they had to discard using physical restraints, they have a found a better way of just simply saying, "We're going to give you a little something to relax you" that in essence is no different than the physical restraints of the past only as an added bonus not only do they physically control you but they have mental control too.

At Thursday, February 27, 2020 9:24:00 AM, Blogger Maurice Bernstein, M.D. said...

Biker et al, it is interesting that there are cases that our hospital ethics committee has experienced where the problem is conflicts of approaches to diagnosis and therapy as set by different specialists on the case directly to the patient and family and there is no primary general physician who knows the patient and family, discuss with the consultants and provide his or her view of the clinical approach to further diagnostic tests or final therapy. Getting as many of the participants into one ethics session to talk to the family and/or patient has helped resolve conflicts and uncertainties set my the prior individual specialty consultations. It isn't so much an ethical issue to debate but it is the gathering together of as many stakeholders as possible for a acceptable to all resolution. As I have previously mentioned, it is the ethics committee who doesn't make the final decisions but provides the education and mediation necessary for all the stakeholders to leave the session satisfied with the approach finally made.

By the way, I know "of what I speak" since, as I may have mentioned previously I was chairman of two different hospitals' ethics committees and currently a member of one of them. ..Maurice.

At Thursday, February 27, 2020 1:26:00 PM, Anonymous Anonymous said...

Hello Dr. Bernstein,

Your recent post begs the question of the necessity for the use of the ethics committee (or any other resource) to resolve communication problems which should have never occurred. Why aren't the "medical stakeholders" communicating? The patient is not involved and, therefore, cannot be faulted in any way. Where is the much-touted medical professionalism? I don't expect answers to these questions. They're purely rhetorical; albeit, the basis for many of the posts on this blog.


At Thursday, February 27, 2020 5:08:00 PM, Anonymous JR said...


So true!

At Thursday, February 27, 2020 5:50:00 PM, Blogger Biker said...

I've commented in the past about how it is near impossible to be anonymous in rural areas. It is wonderful in that it gives one a sense of community and belonging that just isn't possible in urban settings. It can also be not so great in circumstances where you'd of preferred to be anonymous.

Today my wife had day surgery at the local hospital to have a large kidney stone broken up and removed. Clearly a very intimate kind of surgery. We live in a little hamlet of just a couple hundred people. The OR nurse and the Post-Op nurse she had both live in our hamlet. The OR nurse takes walks and we'll briefly talk if I'm out and we pass each other, or if I bump into her elsewhere in town. I've been to the post-op nurse's house in my official town capacity and I've interacted with her in the context of a non-profit group I volunteer with.

Had it been me having that surgery I've of been there exposed to two women who live in my neighborhood. In my case I'd go to the larger hospital in NH for such a procedure but most people don't do that and could find themselves exposed on a table with a neighbor as their nurse. Yet another reason to drive 75 miles each way such as I do for all of my healthcare, except for ER scenarios of course.

At Thursday, February 27, 2020 10:10:00 PM, Blogger 58flyer said...

Today I got a certified letter from my urologist terminating our relationship. I will quote it here if it's appropriate.

Dear Mr. (58flyer),

I have thought about your situation all weekend and have been trying to come up with a plan. I spoke with my boss and at this time we cannot accommodate your needs of only having males present in the room for procedures.

I was really bothered by your spike in blood pressure when you were here last week for your prostate US and I imagine that was due to stressors you feel regarding having females in the room. I read the material you presented and I know your condition is real.

That being said I do not think my practice is a good fit for you. I cannot assure you that no ladies will be present during procedures nor can I guarantee you that if you have a problem I will always be available. My nurse practitioner Emily sees my patients in my absence.

So I think it best that I withdraw from your urologic care. If you recall, you do have a history of a small amount of prostate cancer that was diagnosed when your PSA was 5. Your PSA is even higher at this point, that is why I was planning to re-biospy you. We have even discussed the Rezum procedure to help you with your urinating.

I hope you will find another urologist as soon as possible to address your needs a well as has male nurses, etc. to make you more comfortable.

If you have an emergency problem within the next 30 days I will try to take care of you. After that period of time I will no longer be available for your care.

Take care and best of luck to you.


So there you have it. he said at the beginning that he was trying to come up with a plan. Funny how he never reached out to my PCP to coordinate that plan. I will respond to him in writing once I get my thoughts together.


At Thursday, February 27, 2020 10:38:00 PM, Blogger Maurice Bernstein, M.D. said...

58flyer, thanks for your appopriate posting...Maurice

At Friday, February 28, 2020 8:55:00 AM, Anonymous JR said...


As I said earlier, you are better off without him as he absolutely no effort to talk to you or your PCP on possible solutions to this issue. Up to that point, you have not had a reaction to the females being present so he is acting in a very uneducated manner & may be violating the ADA for dealing with victims of sexual assault who have PTSD. So does he fire all patients who have other issues he is not able to control? It is very telling the skills of a doctor of apparently which this man has none.

Dr. B.,

As this was not an incident in the hospital setting, it is unlikely that an ethics committee would even look at this issue. Quite frankly, many hospitals like the hospital from hell do not even give the issue a chance to be heard or have an ethics committee like the one you have described. They and their patient advocate director just shut down the conversation by saying we refuse to acknowledge anything or even discuss it because we are always right. What should happen and what does happen are generally very different. If there was a dispute, too many hospitals use the court system to gain the upper hand legally. Most patients would not even know an ethics committee existed. It is not mentioned in the Patient Bill of Rights or how to complain in their literature.

At Friday, February 28, 2020 8:57:00 AM, Anonymous Anonymous said...

Hello 58 Flyer,

Again I marvel at the lack of creativity of the medical profession. Where are the Louis Pasteurs or the Marie Curies? Future residents of this planet will consider our age as the Dark Age of "Modern Medicine". I don't know in what area you reside; nevertheless, how difficult would it have been for your urologist to have advertised for a part-time male nurse - one who could be available for your care? Certainly there's a local nurse registry with a male nurse looking for work; or, a retired military male nurse who'd appreciate part-time work. How difficult would it have been for Emily to have researched this for him? I'm utterly astounded that the urologist could recognize your need for care (in a closing paragraph) and not say, "I've got to find a way to help this guy. I've got to find a solution." He's certainly not a medical researcher, is he? Unfortunately, your situation demonstrates how a male asking for accommodation is viewed as a problem and not as an opportunity to relieve suffering - suffering on many levels. How can a "professional", dedicated to the care of others, be so cruel?
Notwithstanding the above, what's to stop you from being creative? Maybe you could find a male nurse who could accompany you to the urologist to assist with your care - provided you find a urologist who would accept this. Maybe you'll find a "bold" urologist who'll go where none have gone before. Advertise in your local paper. I donate a few hundred dollars a year to a local hospital foundation with a memo that the money is to be used to hire male nurses. There are many ways to affect change and to be accommodated. My motto is that perseverance pays. Get creative. There must be a compassionate urologist out there somewhere. Keep searching. I'm confident that you'll find one.
Take care.

At Friday, February 28, 2020 9:47:00 AM, Blogger Maurice Bernstein, M.D. said...

Actually, when 58Flyer's urologist wrote the following to him "I hope you will find another urologist as soon as possible to address your needs a well as has male nurses, etc. to make you more comfortable", the urologist may be missing an important ethical and even legal personal responsibility when the physician terminates the professional relationship with a patient because of conflict with the patient's request for management. The urologist wrote the following "If you have an emergency problem within the next 30 days I will try to take care of you. After that period of time I will no longer be available for your care" which is ethically and legally appropriate BUT what is missing is a statement by the urologist to the effect that over the following 30 days, he will be making an effort, himself, along with you, to find a urologist for you who will meet your gender requests. This requirement is "standard operating procedure" for other requests by patients or their families which are rejected by the professional. Within a limited time period, the physician must assist in finding a resource for the patient who meets the patient's request.

"I hope you will find.." is an insufficient termination statement. The "hope" should be "I hope WE will find.."

This is the professionally ethical and most likely also legal response by the physician to the termination of a doctor-patient relationship due to a conflicting issue.

This is one aspect of a developed doctor-patient relationship which is often missed by both parties. ..Maurice.

At Friday, February 28, 2020 11:14:00 AM, Anonymous Anonymous said...

Hello Dr. Bernstein,

Thank you for your explanation of how 58 Flyer's urologist SHOULD HAVE RESPONDED. However, where does this leave 58 Flyer. What can he do rather than just "get over it"? The problem has been identified. What's the treatment protocol?


At Friday, February 28, 2020 11:29:00 AM, Blogger A. Banterings said...


JR beat me to the punch. I would respond with a letter to the practice saying "...dismissing me as a patient because of my PTSD and my request for a reasonable accommodation...

-- Banterings

At Saturday, February 29, 2020 4:14:00 AM, Blogger Biker said...

I wonder if 58flyer's urologist would similarly dismiss a female patient who wants only female staf fin the room given when his female NP is out her patients would need to be seen by him. I'd say the chance is about 0%.

At Saturday, February 29, 2020 8:15:00 AM, Blogger Maurice Bernstein, M.D. said...

Reginald, in answer to your question
"What can he do rather than just 'get over it'? 58flyer should return to his primary care physician whom I am sure was involved in selecting and communicating with his
"current" urology consultant. It should be his primary care physician to attempt to assist in referring his or her patient to a consultant more in keeping, if possible, with the patient's concerns. The primary care physician's duties has always taken the professional lead to direct and assist the patient to the consultation by a specialist which the primary care physician has established was the appropriate consultant for the patient's suspected illness.

As a primary care physician, I have never said to any patient of mine "You need a urologist, go out and find one and then let me know who you selected so that I can respond to his request for my information about you." Abandoning the patient to deal with a consultant without the information and support of the primary care physician is not in keeping with the primary care physician's responsibilities and duties. In 58flyer's case, his primary physician should have previously be informed and aware of the professional gender requirements of his or her patient.

As a primary care physician for years and one teaching medical students for years, I am fully aware of the responsibilities to bear the title of "primary care physician" and one of those responsibilities is the appropriate selection for the patient of a consultant to attend to the elements of the needed consultative care.

Primary care physicians do not abandon their patients after a specialty referral. They are still "in the game". ..Maurice.

At Saturday, February 29, 2020 11:41:00 PM, Blogger 58flyer said...

JR, Reginald, Banterings, and Biker,

Thanks for your creative commentary. I will consider all your input while I formulate a response to the urologist.

Dr. Bernstein,

During my last conversation with my PCPs nurse, she said he fully agrees with me but he did not want to confront the urologist as it will just lead to a counterproductive argument. My PCP feels strongly about this. Last year my PCPs nurse personally called as many urology practices as she could find in my area trying to find one who could accommodate my gender preferences. She was unsuccessful. I found the urologist when I saw an ad in the local Ocala Style magazine when they showed a male PA in the staff picture. That was fine until the PA left the practice. I really wasn't stressing over the lack of a male nurse, it was just the PSA jump and my concern that the cancer was possibly becoming more aggressive. The urologist just jumped to the conclusion that it had to be the lack of male personnel. I had the US done previously with the same female nurse who was to be in on my most recent US. She really didn't expose me, she just handled the biopsy specimens. I was using the procedure shorts then and had a pair with me when I went in for the US. I wasn't stressing at all over the female nurse. She is a great nurse and I feel she genuinely understands my situation and does her best for me. The urologist just failed to understand what was my greatest concern.

Come to think of it, at my most recent visit prior to the US, the urologist said "the older I get, the more I worry about liability."


At Sunday, March 01, 2020 4:55:00 PM, Blogger A. Banterings said...


Get a lawyer and sue the practice for Americans with Disabilities Act (ADA) violation, gender discrimination (women afforded this request), patient abandonment, malpractice (causing you more trauma, unable to meet accommodations), assault (coercing you into accepting female providers with threat of dismissal), and anything else that the lawyer can come up with.

You may also want to take a look at laws dealing with natural disasters. There are laws that deal with not only price gouging, but coercion when people are in a vulnerable position (usually due to natural disaster). Depending how your state words the law, it may apply to you as a cancer patient.

There are also laws that specifically protect "vulnerable populations." These are generally children (minors), seniors, and the disabled. Depending on your age, you may have additional protections as a senior and disabled (psychological trauma survivor, as noted in your medical records).

You sue for damages, that is having to travel a significant distance to find care. It may include concierge care because your dismissal created a prejudicial profile of you as a patient. You may need to do overnight trips (bringing someone with you) so you now have per diem costs.

There is also the costs of delayed treatment with your elevated PSA and dismissal.

You need to find a lawyer in a large city in your state, one who is not afraid to go to trial. Most attorneys look for quick settlements so they do not have to work. You want one not afraid to fight. If you know any attorneys, ask them who they would recommend that meets your criteria or call your state bar association.

-- Banterings

At Sunday, March 01, 2020 9:59:00 PM, Blogger Maurice Bernstein, M.D. said...

Banterings, your thorough description of legal avenues for 58flyer to take is worthy of considering but is something for future action but what is most important at present, for immediate attention is diagnosis and management of the patient's pathology and symptoms. Legal actions take time to resolve. Repeating: diagnostic and treatment actions are for immediate attention and action and legal responses later.

Repeated: Search first for an effective physician working in a patient-hospitable environment and then legal repercussions toward the urologist can follow.

Nevertheless, Banterings, your potpourri of legal response was great!

At Monday, March 02, 2020 10:02:00 AM, Anonymous Anonymous said...


Relative to 58Flyer's situation (and, possibly, ours in the future), whatever happened to medical "Jen"? That is, a compassionate love for humanity (or for the world as a whole); or, also interpreted as human-heartedness and kindness. This is a Chinese (Confucian) concept predating Hippocrates by about 150 years. In my previous posts, I obliquely referred to the medical profession's loss of Jen. Is there any reason why medical training cannot stress this (now apparently lost) concept? This is a virtue that distinguished a person who ethically rises above the masses, one who is motivated by great empathy for others. Shouldn't this define the physician? Isn't this what we hope for approach medical personnel for help? Dr. Bernstein, is there any place in your curriculum for instruction in human-heartedness and kindness?


At Monday, March 02, 2020 11:22:00 AM, Blogger Maurice Bernstein, M.D. said...

Attempt of medical students (and later as physicians) to find true empathy with their patient and the patient's experience rather than simple and often relationship trivial sympathy is and has been an important teaching point. Sympathy ("I'm sorry to hear that") is much different than true empathy ("I feel and understand what you are going through because I have experienced...")

Unfortunately, empathy could be expressed to patients more often but that action of communication and behavior is often limited by the time available for self-description to the patient or the false hesitation of physicians to describe to the patient their own experiences and emotions.

But I have no doubt that from a true enhancement of relationship and therapeutic point of view, an expression of true empathy far exceeds the value to the patient and the doctor-patient relationship then some incidental, automatic expression by the medical student or physician of sympathy. And, incidentally, I do recall medical students who have told our 6 student group discussion upon their just completed student-patient experience their introduction of supportive self-experience which, in my opinion, amounted to expression of empathy toward the patient's story. Reginald, it's there in medical education but unfortunately in later clinical practice time limitations and distractions limits the delivery to the patient of the physician's own experiences and the expression of true empathy and true expression of "Jen". ..Maurice.

At Monday, March 02, 2020 2:24:00 PM, Anonymous JR said...

You hit the nail on the head when you said, "the false hesitation of physicians to describe to the patient their own experiences and emotions." We as patients are expected to bare everything to strangers but yet these strangers cannot do anything to appear human to us. This is a big issues as it allows them to view and treat us as objects. Objects we own and have authority over is how many patients are seen by healthcare providers thus is why making sure to protect a patient's dignity or modesty is not even on their radar. We are expected to allow them access to us without them ever giving to us a part of them.

As I have said before from reviewing medical textbooks and such, I know that protecting a patient's dignity is part of the teachings and expanded upon by nursing education. However, when it comes to practicing what they have learned, it disappears for far too many. Surgery pre-op & post-op are prime examples of them not allowing a human being to keep their personal dignity & their failure to protect it. They know they don't have to completely expose most patients for surgery but they do. Why? It is a power trip, they don't care, convenience, entertainment, and list could go on. This is an absolute human rights violation & needs to stop. If there is a lack of time then

Just bc you need medical treatment does not give them ownership over your body. The use of MAs, surgery techs, chaperones have completely eroded the patient's ability to limit access of their body. Even clerical hospital workers can see a patient naked at any time. There is something very dehumanizing happening when seeking medical care. Why is this allowed?

In short, I can answer the above question. Because they do and can get away with it.

At Tuesday, March 03, 2020 6:34:00 AM, Anonymous Anonymous said...

In response to some of the comments:

58 flyer

I have never been to a urologist. Never had the pleasure. I think the urologist that you were seeing hasn't been straight with you. He said over the phone that he was dismissing you as a patient because of high blood pressure. That seems pretty weird. Then he said in a letter that he was dismissing you because he could no longer accommodate your male nurse urology needs. Somehow I think he should have told you that and asked you whether or not you wanted to continue. You stated as I recall that you were working with a male nurse at this practice who left. What happened with this guy? Did he move to another urology practice or quit the profession altogether? Even though you are no longer on the best of terms with this practice it seems they could find out for you. It seems that if you wanted to find a urology practice with a male nurse you could do it if you were willing to travel although only you would know whether or not that would be worth it to you. This doctor stated that part of the reason for the break was because he couldn't always be there. He could find a way to coordinate that. I had a couple of instances where two different doctors cancelled, one the day of and the other the day before and we just rescheduled. I live in a large metropolitan area so if there was a doctor who no longer wanted to see me there are always other doctors. I would do what you talked about and send him a letter or find out what happened to this male nurse and then just find another doctor.


You said that you wanted to meet with a state or federal representative. What law would you have them pass? Somehow I think that this issue should be discussed on mainstream TV somewhere even if it's only a short segment. They do talk about problems in medicine from time to time but I cannot recall them discussing this subject. Perhaps on Dr. Phil who is after all a doctor but I don't know if there is enough material to support an hour long program.


You said that you were trying to find out the names of all the people who were involved when you had your unfortunate occurrence. I still don't know who the two tech/nurses were when I went through the previously mentioned procedure. I asked the director point blank "Who are these people?" but she would not say nor did the Department of State say although I did not ask them. I suppose it would not change anything but I would have liked to have known. Any assistance would be appreciated. Thanks PA

At Tuesday, March 03, 2020 9:06:00 AM, Blogger Maurice Bernstein, M.D. said...

This may seem a bit silly.. but after hearing "Medicare for All" ("All" referring to patients), I was wondering if a more ideal title based on what has been written to this blog thread should be "Medicare by all. The "all" specifically referring to the potential professional gender selection available to every patient. Got it? Have you heard from Sanders describing his medical system with the title "Medicare by all provider genders"? I haven't. Maybe he should be informed about the discrepancy in his selected medical practice goal title.

This is my suggestion on this Voting day. ..Maurice.

At Tuesday, March 03, 2020 4:29:00 PM, Anonymous JR said...

Why in the world would we want our healthcare to be managed by the government? They already do a horrible job. CMS basically told us to be satisfied he didn't die. They told us they only review what is in the MRs even when the patient is telling them the MRs are not correct. They don't even bother to investigate. But on the other hand when there is a glaring mistake like talking about a 67-yr old man's pregnancy or his TAVR procedure he didn't really have, their tone was they do make mistakes. CMS is completely worthless at protecting seniors from abuses. When a claim of sexual assault has been made, shouldn't they be taking that seriously? Shouldn't they be concerned when even they agreed there was a lack of consent but said it was okay bc he didn't die? They weren't concerned about fraud or overpaying for 2 patient rooms on 1 day or drugs that cost 200% more 5 minutes later that were identical. Why would anyone want Medicare for all? As it is administered now, seniors are the only group of citizens having to pay the govern. insurance AND carry private insurance. Now Medicare is dictating that drs won't get paid/paid less if patients w/ certain ailment don't get certain tests. They are trying to take away patient rights. Anyone would have to be insane to want government to be in total control of your life like that. As it is, countries like Britain stop care on older folks whom they have determined do not have much life left so they only offer palliative care. It is said the US spends too much on end of life care so they would stop under this new healthcare system. NO THANKS.

At Wednesday, March 04, 2020 12:15:00 AM, Blogger 58flyer said...


Thanks for your input. My wife is a paralegal and a legal assistant who has been in the business for 35 years. She spent 10 years with the best law firm in the SE USA and another 10 years with a highly regarded mediation attorney. Her most recent experience is at a defense firm. She knows plenty of lawyers. However, at the moment we are focussed on getting into another urology practice to get this cancer under control.


The male PA at the recent urology practice left for reasons unknown. His employment history was that he would work in a place for a couple of years then move on. The urologist was not happy that he left since they had just poured a ton of money into expanding the office into another building with an eye toward ED and just a general building of the business. He was to be an integral part of that plan. Then he up and left for New Mexico with short notice. The urologist was not pleased with him and had no problem venting with me on that incident. To be honest, even though I was pleased that he stepped in and took the place of a female nurse or MA, he seemed rather distant and cold. He treated me just fine, but I got the impression that he didn't want to be there. Maybe he was in the hunt for greener pastures at that point. Believe me, I will be sending that doctor a letter letting him know how I feel about his conduct. I have sent a Thank You to the female nurse who was involved with me. She went out of her way to make me as comfortable as she could and I honestly feel she is an awesome nurse who truly cares for her patients and I wanted her to know that I was not stressing over her. Also, Dr. Phil is another great avenue of opportunity to get the message out, in my opinion. There is plenty of material for an hour long show, if not more. Great Idea!

I have to add this. Last week I attended a Aviation Law Enforcement convention to keep in contact with my pals in case I decide to continue my career in that field. I ran across an old friend whom I had not seen since last year at this time. He revealed his prostate cancer journey which I was not aware of. He opted for the Da Vinci robotic surgery to remove the prostate. He is doing well by this time but several months ago he was not doing so well. I am glad to hear he is doing well as he is no longer incontinent and his ED function is improving. Without any prompting on my part he said that the worst part of it all is the female involvement in his care! He described a session where several men were in a discussion with a female nurse young enough to be his granddaughter who took questions from the guys on how to deal with their private issues. She insisted that she is a professional and while that may be true it does not take into account that men may not be comfortable discussing such a strictly male issue with a female. After she presented her dissertation she asked if there were any questions. Nobody raised a hand! By not taking into account how men would feel about her presence she completely failed her patients.

Going forward, I have found 2 urology practices in my area that show a male PA at each of them. So there's hope! I am quite willing to travel, but it's great to know that I may not have to.

Cancer is a bitch.


At Wednesday, March 04, 2020 9:09:00 AM, Blogger A. Banterings said...


My prayers are with you.

-- Banterings

At Wednesday, March 04, 2020 2:44:00 PM, Blogger Biker said...

58flyer, for the past 3 years I have had a male RN do the prep for my annual cystoscopy. I ask to be scheduled with a male, then upon check-in I remind them again, and the female schedulers & check-in staff accept my request w/o any fuss. I am scheduled for this year's procedure in two weeks so hopefully they still have a male RN. NH is a long way for you but thus far I find this teaching hospital to be a class act overall.

Good luck to you in your quest.

At Wednesday, March 04, 2020 10:05:00 PM, Blogger 58flyer said...


Thank You very much.


I also hope for your comfort that the male nurse is still available for your prep. Let's hope they don't try to pull a switcharoo on you at the last moment if he is not available. I mean, what do you do if you get there and the male nurse has moved on?


At Thursday, March 05, 2020 2:33:00 PM, Blogger A. Banterings said...


A dirty little secret that offices do not disclose is that they can bring in a nurse from another unit or they can bring one from a staffing agency for that specific patient/procedure. These things are already in place in the event that something happens to staff members now.

Simply call at least 2 weeks prior, remind them, make sure there is a male nurse, if not, simply tell them they need to procure one for your visit or ask that the doctor prep you.

-- Banterings

At Thursday, March 05, 2020 6:12:00 PM, Blogger BJTNT said...

This is my attempt at a list of requirements for the lawmakers to pass into law. So feel free to "add, change, and delete". My rationale is that everyone is a critic, but few are artists. So, here goes nothing [stream of conscience]

Phase 1 is for us to develop a list of requirements. Phase 2 will be to cut the list to a TBD number of items and then prioritize those. The requirements will be presented to politicians running for the first time, with an appropriate donation. Forget existing politicians since they know the AMA will pay them well to maintain the status quo.


1. [Arbitration] Arbitration is illegal unless the patient can select the arbitrator. Mediation is acceptable if the medical institution pays the patient's out-of-pocket expenses if the location is not the medical institution itself.

2. [Consent] All consents by patients must be in writing and a copy given to the patient before any routine touch labor, even if forms were completed over the Internet. Consent forms must be written in the vernacular, only one consent per page, and no other verbiage on that sheet.
Consent forms for signature must be given to patients 36 hours in advance of medical appointments and for hospital admission except for emergencies and Urgent Care. See emergency.
Since consent forms for Urgent Care must be signed in the moment, patients can return any form with a change for future care giving. Urgent Care must accept this change.

[See next posting for definition of emergency]


At Thursday, March 05, 2020 6:13:00 PM, Blogger BJTNT said...


1. Arbitration
2. Consent

3. [Emergency] An emergency is defined as the determination of the involved caregivers based on their education, training, experience, and judgement. Emergencies must be attested by three caregivers that it was an emergency in the following priority. First by a paramedic if one is involved, second by the triage nurse if involved, third by the involved doctor, fourth by the attending nurse, fifth by an involved nurse. The attestation must be at least three sentences in the author's words describing the emergency and include identifying data for both patient and attestor plus date and times.

4. [Benzo] Benzodiazepines and similar drugs can only be administered with the written consent [see Consent] by the patient or an advocate selected by the patient, emergency excepted [see Emergency]. This law applies to, but not limited to, benzos used as an anesthesia, to mollify anxiety, and as a convenience for caregivers.


At Thursday, March 05, 2020 7:51:00 PM, Blogger Maurice Bernstein, M.D. said...

To augment BJTNT's dissection regarding how to maintain patient's dignity, you may want to read the study from Iran (which is reinforced by studies from other nations) identifying what patients in Iran understand as maintaining the dignity of patients.

What I get from the patient study in Iran is not much different than what has been described on this blog. ..Maurice.

At Friday, March 06, 2020 8:06:00 AM, Anonymous Anonymous said...


You'd like your facial wrinkles removed or your lips enlarged? Sure. We have Botox for that. You'd like your nose straightened? No Problem. Breast enhancement or reduction? Of course. We've improved our silicone. Too much belly fat? Liposuction to the rescue. A butt lift? We can happily make you higher. You'd like to change your sex? We can certainly help you change your pronoun. You'd like a male nurse to preserve your dignity? Are you crazy? Do you think we're here to satisfy your every whim? Get over it!!!



At Friday, March 06, 2020 8:44:00 AM, Blogger Maurice Bernstein, M.D. said...

Yep Reginald, providing the patient's desired male gender professional is one medical procedure which appears to be of disinterest within the medical system or beyond the studies and skills of their leaders or workers.

I think the title "Medicare for All" should be "Medicare provided by All Genders for All". ..Maurice.

At Friday, March 06, 2020 10:11:00 AM, Blogger A. Banterings said...


Here is my issue with emergencies: in the case of emergencies, the law expects the provider to do what the average person would want them to do. The problem here is that providers define this as the preservation of life at any cost. That is why the issues of POLST, DNR, etc. have come up.

I would argue that in this modern day and age, in light of past abuses, the patient would expect that they NOT be rendered unconscious, and their wishes (even if contrary to the standard of care) be RESPECTED.

Furthermore, as I pointed out previously, most providers lack common sense and critical thinking skills. Take the PR/DRE in trauma.

Other patient experience is far more controversial and led to assault and battery in the alert and aware trauma patient. Is there that much clinical value in the PR/DRE that wrestling and eventually intubating a patient to perform a PR/DRE is necessary? Have clinicians forget alternatives to diagnostics that have limited value in the ED/trauma setting? Source:

What happens when we look at the science? For trauma, the eight edition of advanced trauma life support (ATLS) recommends that "DRE be performed selectively before inserting an indwelling urinary catheter." Currently, its utility as the screening exam ATLS intended it to be is not supported with current data.

So alert patients expect their wishes are RESPECTED even in emergencies. Source:

-- Banterings

At Friday, March 06, 2020 5:05:00 PM, Anonymous JR said...


You are brilliant! You bet me to the emergency part. There are emergencies and then there are real emergencies like someone is coding. However, all patients should be given choices if they are conscious. If family is available, a family member should be consulted. There is no real need to consult 3 medical workers because it is a done deal they will all cover for one another and all agree with the first. That is the nature of what they do--cover and protect one another. Patient rights be dam-! What the medical worker and the patient wants varies as in our case. We have always held the principle of the least method of invasive procedures and no RXs. Yes, they knew that but yes they ignored that so doing what they thought was best was in a direct conflict of what the patient thought best.
The consent forms themselves need much change. They actually need to protect the patient. Too many of them may give verbal okays but once the form is signed the verbal agreement is no good. Most forms give total authority to the doctor to do whatever he thinks is in the best interest for the patient and do have whoever he feels needed to help or actually do the procedure. This how they get by with the pelvic/rectal exams as the consent form vaguely alludes to anything being allowed. Morally this is not right. What the dr thinks is right may directly conflict with the patient's view of right/wrong. I have the consent form proof if anyone questions that the consent form does not give a blanket consent. So in other words, verbal agreements may not work as you doctor may not be as ethically as you thought they were. After the fact, is the only way this is usually discovered. I am on Twitter and Facebook and believe me, there are plenty of victims that can attest to this.

At Friday, March 06, 2020 6:03:00 PM, Anonymous Anonymous said...

"Rape is a type of sexual assault USUALLY involving sexual intercourse or other forms of sexual penetration carried out against a person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority, or against a person who is incapable of giving valid consent, such as one who is unconscious, incapacitated, etc"



At Saturday, March 07, 2020 10:08:00 AM, Blogger BJTNT said...

Banterings and JR,

Your point is well taken. My musings are simply a quixotic exercise. JR was correct, there is no real oversight of the medical community. If our requirements became law, the medical community would simply fudge the laws because they can.

Caregivers aren't going to extent respect and dignity with the exception of some caregivers with a value system that overrides the culture in the medical community. The "bosses" see patients as just a source of revenue. Within this environment, the caregivers know that if they do their assigned tasks they have the power to not only control, but retaliate, with impunity. This culture is so pervasive and universal that it attracts caregivers who get their jollies controlling people.

Of all the entities that provide a service to people, only the medical community [+ dentistry] has patients. Every other entity that provides a service to people has customers, clients, consumers, et al. Although, as an aside, the CA Medical Board now calls patients "consumers".

Probably the only effective way for beneficial change would be to legally establish an all powerful agency with absolute powers to change the medical community. But, we don't want that power in our Republic.

When you frequent any entity that provides a service to people, other than the medical community, do they have a Bill of Rights? You laughing at that. They don't need one because they treat you with respect and dignity.

The 2-4 page Patient Bill of Rights is proof of the medical community culture. No other entity that provides a service to people needs to sell the public that people are to be extended respect and dignity. The Bill of Rights is pure marketing - just another propaganda vehicle by the medical community to sell fiction to the uninitiated.

Sorry to be negative. My believe is the only way that the medical community will change is from a grass roots effort [like this blog thread] that will take 15-25 years to reach critical mass, Then the lawmakers will effect change. Who in the medical will like the changes, certainly not the MDs?


At Saturday, March 07, 2020 5:46:00 PM, Anonymous JR said...


Your last post was really great. That is why I am doing Facebook to increase the numbers of people I reach. I have joined several groups & have almost 200 friends from everywhere who are listening. I am tweeting daily and growing my numbers there along with Banterings. I am writing on my book. I am contacting media and politicians. I am setting up meetings. In my opinion, what needs to change is the so-called Informed Consent process as it is not in its current form any protection for the patient. I have written a lot about this on other sites. I will be working with another surgery victim here in Indiana to get this changed. The other area is actual patient rights and not that garbage that is currently passing itself off as Patients Bill of Rights as those are worthless and may in fact lead to patients being harmed as they believe what is on the print to be true when mostly it is not.
None of this is going to come easy but I am involved with some real fighters. We will not stop until we are heard. This fight is much too important not to win.

At Saturday, March 07, 2020 7:54:00 PM, Anonymous JF said...

BJTNT, Maybe medical are the the only ones with PATIENTS but they're NOT the only profession that victimizes people they serve. There's a number of cops murdering people, raping women. There's judges that render bad judgements. There's Çhildren Services who aren't anything close to what they should be.. I'm sure there's others that I'm not thinking about. Maybe we should link up with other groups and besides modesty violations many people will have problems with the extortion of medical care. I know everybody should be paid their rightful hourly wage but SOMEBODY is being paid MORE. And how many people are dead or harmed because of their greed? We need to be a greater part of creating our own laws.

At Sunday, March 08, 2020 10:39:00 AM, Blogger BJTNT said...

It might help our campaign in a small way to inform "strangers" that the medical community is for the caregivers and you are just a patient. It's a delicate proposition since who wants to believe that when your health and even your life may be at stake that you're going to be treated as a "patient"?

On a recent plane trip across continent, my seatmate was a young nurse. I couldn't resist, but made only a few points about the medical community for two reasons. Who wants to be talked to when you're a captive audience? Also, I thought that more than several points would be too much and be counterproductive.

Two female volunteer theater ushers [retired from their jobs] initiated conversation about my health when they saw my cane. After I made a few points about the medical community, one said that she was a retired nurse and what I said wasn't true as she walked away. The other one stayed for several more points until I ended the conversation.

How much should we say? Unless you have the people skills of Biker, less is probably better.


At Sunday, March 08, 2020 10:39:00 AM, Blogger Maurice Bernstein, M.D. said...

Anonymous wrote the following today, unfortunately on closed for further publication Volume 96. Maybe he will find our current active Volume here and will participate further. ..Maurice.

Was seen by a male urologist ( I am male). Was to have cystopscopy done and yes female nurse as there weren't any male nurses working there. She gets me prepped for the doctor and we chit chat while we wait. I asked about how long she has worked in her profession and asked several questions in regards to issues I had. I am not sure why she doesn't go on to be a urologist instead of being a nurse. Anyhow the doctor comes in and he starts procedure and explains things and has the nurse confirm what he is talking about. So as the doctor is finishing up he has the nurse to leave room. Then he started getting rude and his voice raises as he is talking to me. He was saying I didn't need to keep coming here as my case was minor (I have lump in prostate that needs to come out). The nurse comes in room to find out what was going on as he is yelling at me. I never said a word during his rant. He snapped at nurse to clean me up and put me in another room so he could talk to me. He started his ranting again and I promptly left the office. I had two other appointments with two other male doctors with them getting on me also. The nurse said I should change institutions because of this. She reccomended a doctor from another town. So I went and found it to be a female doctor. Very intelligent and talks to me like a human being. Let's me make my choices after giving me options. Also explains what happens if I let my conditions go versus surgery route. I for one am happy where I am now than the hostile environment that I was in. Thanks to a nurse who cared about my health situation.

At Sunday, March 08, 2020 7:16:00 PM, Anonymous JR said...


You cannot say too much in defense of what you believe in. I get bashed and beat up all the time by medical "professionals" especially nurses on other boards. To the credit of some, they have admitted there is indeed a problem. Some of have even offered us the names of several attorneys they know are good. What I try to drill into them, even if they aren't dismissing a patient's right to dignity out of a criminal, evil impulse it really doesn't matter to the one who has lost their dignity. It hurts no matter it was done. I drill into them the concept they are the protectors of patients especially when the patient is defenseless. Speak up say something if you see something being done wrong. No job is worth losing your set of values over especially given there is a shortage of nurses. There needs to be changes and those changes are coming so be a positive force.

At Tuesday, March 10, 2020 9:25:00 AM, Blogger Maurice Bernstein, M.D. said...

Biker, best wishes on your upcoming cystoscopy and its participants, performance and results. ..Maurice.

At Tuesday, March 10, 2020 12:48:00 PM, Blogger A. Banterings said...


What we need is an entity to POLICE, INVESTIGATE< and APPLY CURRENT LAWS to healthcare providers. They would NOT have absolute power over the providers, they can NOT impose new regulation, but they would enforce current laws such as those of assault and battery.


You may want to attack your claim as a breach of contract. You can say that you took the facility's posted Patient Bill of Rights as an implied contract.

As to your nurses comment:

If you are NOT part of the solution, then YOU are a part of the PROBLEM.

-- Banterings

At Wednesday, March 11, 2020 4:01:00 AM, Blogger Biker said...

I recently shared the wildly varying gender mix observations from my wife's recent 4 day stay at the local hospital in the surgical ward following knee surgery and day in the ER followed by a 4 day stay in a general population ward for a kidney stone. At the time I wondered how much of the very different gender mixes in those 3 areas comes from self-selection and how much by design.

I again have some observations, but this time of staff behavior from the early days of what has been a two week stay thus far for sepsis following lithotripsy to remove that kidney stone. They surprised me as it wasn't what I expected, thus why I am sharing it. This was in what they call the progressive care ward which is for very sick people that are not quite at the ICU level, but sicker than those placed in the general population ward. It is 12 rooms, some with 2 patients, that surround a center nurses station making it easy to visually observe what is going on. Being there 12+ hours a day I was able to observe a lot. All of the patients were Medicare aged so nobody young and fit, and of course all were very sick or they wouldn't be there.

Each shift had at least one male RN and one male LNA. Some had more than one but all in all the staff was mostly female as you would expect. Patients were assigned specific RN's and LNA's but my observation was this unit worked as a team and any RN or LNA would jump in as needed with any patient. I did not observe any purposeful assignment of staff by gender. Females might be assigned male staff and males female staff. When catheters needed to be placed or assistance needed with incontinence type issues, whoever was available went in to do it without regard for gender.

My observations were as well that with the exception of one rather creepy middle aged male RN, the staff was all totally professional and clinical in carrying out their duties. I have no concerns with any of the staff in how they dealt with my wife. The creepy guy was the charge nurse for his shift and never directly interacted with my wife. He instead flirted with the young nursing students there doing their clinicals and also with the younger better looking female staff. I suspect he will find himself in a world of #metoo hurt one of these days.

Anyway, just some observations that surprised me in how male and female patients were seemingly treated equally.

At Wednesday, March 11, 2020 9:39:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, thanks for your "on the scene" description of one "cluster" of medical staff dealing with the care of your wife and other patients in their occupational domain.

You know, though I realize this may be unrealistic, it would have been interesting if you could interview the patients regarding how they themselves evaluated the behavior of the nursing staff. I know that was not possible..but..maybe you could tell us about your wife's observations about how she herself was treated or those patients she was able to view from her bed. ..Maurice.

At Wednesday, March 11, 2020 10:25:00 PM, Anonymous JF said...

Sometime in the near future a victim/patient unnecessary embarrassed should begin coughing vigorously and cry out I HAVE THE CORONA VIRUS!

At Thursday, March 12, 2020 4:43:00 AM, Blogger Biker said...

Dr. Bernstein, my wife's thinking is not representative of the general views held by me or others who post here. She has by choice only had female primary caregivers for many years but when a surgical patient and as an inpatient she has been comfortable with male & female caregivers for intimate matters. Her attitude has been there is no modesty in hospitals. She thus simply accepts whoever comes into the room to tend her issues. However, were anyone to be less than fully professional and clinical she'd complain. To date she has not had problems with how she has been cared for or by who.

I should add that though male and female patients were seemingly treated equally in that unit, the fact that the majority of staff are females does give female patients an inherent advantage in that the odds of them having female staff are greater than them having male staff.

At Thursday, March 12, 2020 7:51:00 AM, Anonymous JR said...

I agree that not all nurses/doctors are an issue. Even during my husband's stay, he had male nurses and some other female nurses that provided care that was acceptable. The difference was he was not heavily under the influence of sedation and they knew it so they did treat him differently. The general opinion of providing care to patients who are sedated is that the patient doesn't know, isn't aware so therefore it won't hurt them. They count on if the patient is "awake" for the sedation to erase or cloud their memories. Granted there are some who still view sedated patients as deserving of dignity but I imagine that number is far less than those who do not.

Also, when family is present the they do tend to act differently because there is a witness and an able person. When family is present their workload is often times lessened as family provides some of the basic care. Sick people are less likely to argue bc of the power/position of the caregiver.

None of this still addresses the some of the vital issues as there being too much unnecessary exposure. Unnecessary exposure is more likely during pre-op, post-op, sedation, office visits, to name just a few. I also feel the bigger the institution the more likely it is to happen as bigger institutions have lost the need to provide compassionate, dignified care. They think advertising takes care of that need. They focus on money and ways to get more money.

At Friday, March 13, 2020 7:40:00 PM, Blogger Maurice Bernstein, M.D. said...

Biker, I appear to have had and still have the same viewpoint as you describe referring to your wife. Whether I am considered by the medical staff as a VIP or not my own personal attitude is that as a patient I have not entered into some environment with any goal of the staff of promoting sexual misbehavior or worse. I have never witnessed sexual misbehavior and despite what has been written on my blog thread here don't await for that to happen. But that's me and that's your wife. That doesn't mean that I have, all these years with this blog thread been ignoring what has been written here by others who have had a different experience as patients. And that doesn't mean I would not be on the alert and not document such an experience here. ..Maurice.

At Sunday, March 15, 2020 4:04:00 AM, Blogger Biker said...

Dr. Bernstein, we can't lose sight that there is a difference between sexual misbehavior and needlessly embarrassing patients. The hospitals and practices that hire only female sonographers, nurses, MA's, scribes etc know that they are embarrassing many of their male patients but they prioritize operational efficiency and the comfort of female patients over basic human considerations for their male patients. Those female staff members may perform their jobs in a totally professional and clinical manner but many of their male patients are embarrassed nonetheless.

The other aspect of this is in seeking maximum operational efficiency, hospitals and practices also know that patients are often exposed more than is necessary, be that the actual exposure, the duration of exposure, or the audience being exposed to. They continue to do so however because it is slightly more efficient. It serves their interests even if at a cost to the patients.

As has been documented here numerous times, actual sexual misconduct occurs as well, even if it what I describe above is far more common. This occurs not out of efficiency efforts but rather out of a societal norm that it doesn't matter if the victim is a male. Male staff would be fired for what female staff get a pass on. That minority of female staff that do demonstrate sexual misconduct know that they will almost always get away with it. There is little risk to them.

At Sunday, March 15, 2020 10:18:00 AM, Anonymous JF said...

Biker, I also think they are too quick to display exposed patients to the patients family members. Some won't care. Other times permanent damage is done. And for no good reason.

At Sunday, March 15, 2020 2:07:00 PM, Anonymous JR said...

Your last post pretty much said it. Yes, male patients as a whole are exposed more often but it can happen to female patients too. This is done routinely as it really does not matter to them if a patient is exposed as it is more convenient or some even thrill in the power and control. And then, there are the ones who go beyond just unnecessary exposure that is actually criminal in conduct. Male healthcare staff will more likely to be eventually called out but female staff can be pretty certain they will get away with their crimes. I think female staff committing criminal sexual acts will become more widespread as more men will start speaking up. Right now, it is a silent crime because most men are silent victims because of the shame and knowing no one will believe them.

Banterings posted a really good article other day on Twitter:

The Understudied Female Predator by The Altantic

It echoed what I have been saying here for over a year. It does happen. Many do not believe it can happen in such a criminal way but women do have and act upon sexually inappropriate desires.

There are many issues in healthcare that needs address but Patient Dignity and REAL informed consent are the big ones I am going after.

At Monday, March 16, 2020 5:02:00 PM, Anonymous JF said...

JR, I think probably male patients do retaliate on female staff who medically/ sexually abuse them, if and when the opportunity presents itself.
It just doesn't pass off as retaliation. It's comparable to a job termination with the reasons stated on the termination papers being completely different from the real reason for the termination.

At Monday, March 16, 2020 8:03:00 PM, Anonymous JR said...


I hope there is somehow some justice for their actions. I know I have enough bad thoughts karma should be heavy around them. It just in not fair they can harm so many people. I have talked to so many who have suffered great harm and not just in dignity issues. So many having procedures done on them without consent or having thing done to them in a procedure they never imagined would happen. It is really bad. But the systems allow for those who do harm to continue and flourish.

Parents have lost their children. One young lady had her healthy muscle cut out with no medical necessity and no lab pathology report to back up the need. And to boot, he carve and burn into her leg, a square design. She was a fitness trainer and he ruined her leg. There are so many who have been harmed and so many have died. Why is going on? Over 250,000 people die a year from medical negligence that we know of and probably more go unreported. Is this not also a pandemic but there is no media coverage as the media has been bought and paid for as well as the legal community.

On June 27th, I am going to participate along with some others here in Indianapolis in a Medical PTSD day of picketing. CS has the details. It is a time for everyone to show the medical world that we are going to stand up and let the world know. We will no longer be silent. We are going to have change.

At Tuesday, March 17, 2020 1:18:00 PM, Blogger A. Banterings said...


Send me info on the June 27th Indianapolis Medical PTSD day and I will post it on my Twitter.

-- Banterings

At Tuesday, March 17, 2020 5:17:00 PM, Anonymous JR said...


I will get it from CS. She may already have the info on Twitter. It is a nationwide effort. Felicia and I are doing Indy. I want to have on my sign that loss of patient dignity (Medical Sexual Assault) and lack of consent (Medical Battery) can cause Medical PTSD. I belong to several boards on FB. CS is also on Twitter. We are starting to make some movement. I had to delay my speaking engagement but I am using this time to write and do social media.

At Wednesday, March 18, 2020 10:26:00 AM, Blogger A. Banterings said...

Has anyone noticed that we have a shortage of ventilators, masks, and hospital beds? Yet there is no mention of a shortage of doctors and nurses. If there was a shortage would now not be the time to speak up? The country is ready to act and be prepared so changes will be made.

Maybe there is no real shortage or the profession is keeping their mouth shut because they are trying to keep the supply low...

-- Banterings

At Wednesday, March 18, 2020 2:13:00 PM, Blogger Maurice Bernstein, M.D. said...

I am pleased that Banterings has moved the area of discussion to the current nationwide and planetwide clinical dilemma. What is being discussed and what is happening currently within the medical profession with regard to the COVID-19 pandemic also deals with its impact on the preservation of patient dignity.

In this regard and with respect to what VOICE patients should be given with regard to their treatment, I present here a Comment written to a bioethics listserv by a physician-ethicist. It is, of course, only an example conversation and is presented as such for discussion by the other physicians and ethicists. However, I think as potential patients, I would like to read what my visitors think about this example.

As you know, we are in the midst of a very challenging and unprecedented situation. During this pandemic, some people in your situation, with your chronic conditions, survive an acute downturn, and some don’t.

We are committed to doing everything we can to help you recover, and in this very unusual time, with many of our normal services in shortage, we may face some tough choices if you become critically ill, so it is particularly important for us to know your priorities and values around your care if you were to get much worse.

This is an extraordinary time. We are trying to use resources in a way that is fair for everyone. And this is a very difficult question to ask, but we are in a very difficult time so I need to ask it. I’d like to hear your thoughts, if things took a turn for the worse and your lungs were failing. Knowing that there is/will be a current shortage of life support machines/breathing machines, would being placed on a breathing machine, if an option, be in line with your wishes or would you prefer to not be placed on life support machines and be allowed a natural death, where our number one priority and effort would be on your comfort and relief of suffering during the dying process?

Again, the thinking about how the healthcare provider communicates with the patient who arrives in the hospital with the virus infection, in this time of limited resources, is essential in considering patient autonomy and dignity.



At Wednesday, March 18, 2020 5:52:00 PM, Anonymous JR said...

They are not going to consider patient autonomy and dignity. It is rare that a patient is allowed those two things. Those patients will be isolated and no one will be able to defend them from medical harm. If either my husband or I get the virus, we both have said we will simply die at home rather than suffer the abuse, assault, and harm he did when he was hospitalized. This is the lasting consequence of the severe, criminal abuse/assaulted they did of which they cared not about the consequences. Is that what is called successful medical treatment?

At Wednesday, March 18, 2020 6:02:00 PM, Anonymous JF said...

Dr B, I don't know if this is what you're talking about or not, but many of us in this group are Baby Boomers. I suspect that our leaders may want to help us die easier and quicker so we don't have to be paid social security. They look at that fund as theirs more than ours. I kinda want to donate my body to science. But I really would like to live for another 14 to 15 years. Depending on what my health is.
I don't think the Corona Virus is going to help our issue any. If anything it'll make things worse. Hospital staff will be constantly working overtime. Tired hungry and pissed off. When there are a large number of people applying for jobs at the hospital, then the bosses become even more bullying than usual.

At Wednesday, March 18, 2020 9:18:00 PM, Blogger Maurice Bernstein, M.D. said...

I read that hospitals will be calling for retired nurses to participate in the care of patients in view of the increased patient load. How will the population of now working retired nurses affect the issues being discussed on this blog thread? ..Maurice.

At Thursday, March 19, 2020 4:24:00 AM, Blogger Biker said...

Dr. Bernstein, retired nurses came of age in the era of men and boys not having any expectation of or entitlement to privacy. They are as well the ones that trained the generations of nurses that followed them. I don't see them somehow advocating for male patients on the matters discussed here.

At Thursday, March 19, 2020 10:31:00 AM, Anonymous JF said...

I think those nurses are needed like crazy. Thank God for them and their willingness to step up to the plate for their country.

At Thursday, March 19, 2020 11:17:00 AM, Blogger A. Banterings said...

Patient dignity is only convenient to free up ventilators for providers who need them. If there was no shortage, then I GUARANTEE you patients would NEVER be asked these questions.

I am surprised that there are no genital or rectal screenings required. Government mandated genital/rectal exams on ALL patients would be fun for all providers.

SERIOUSLY, the reason is because the profession of medicine is under such scrutiny, that if they tried pulling these shenanigans, the full force of the federal government driven by the wrath of the American people would be brought down upon the profession of medicine.

-- Banterings

At Thursday, March 19, 2020 11:34:00 AM, Anonymous JR said...


I just remember that night my husband's medical team was called in and they complained of wanting to be there and the result of them not wanting to be was that he was medically and sexually battered. I remember how vicious those women looked when they wheeled out their prize trophy of sexual abuse. Many patients will suffer at the hands of medical staff because they will use this "crisis" as a means to defy patient autonomy, rights, and dignity. I would rather die at home than be mistreated and abused by any of those medical workers. You have no way of knowing what type of medical worker you have until they have harmed you. I really cannot find anything noble about the medical workers. What was done will forever form my opinion of the not so noble profession.

At Thursday, March 19, 2020 9:43:00 PM, Anonymous JF said...

JR, This is different. The retired nurses don't HAVE to work! And they are making the workload much easier for the staff already working. Also its a survival issue for the staff also. Its like in a forest fire, animals will gather together on a hill. The animals who would normally eat the smaller animals and the smaller animals will be huddled together.
Maybe if this Corona Virus continues on for awhile and its 6 months later and the retired nurses are still working THEN maybe.


At Friday, March 20, 2020 9:29:00 AM, Anonymous JF said...

JR, I thought more about what you said. First I want to say that I believe what you have said about your husbands treatment. There's nothing in place to prevent anything like that from happening.
But your husbands so called care givers were in all likelihood told to come into work or find another job. These retired nurses already don't have jobs and are putting themselves in harms way because that's the kind of people they are. That's not saying they might not unconsciously violate a patients dignity but they're not of the same mindset of those hospital workers who attacked your husband.

At Friday, March 20, 2020 11:06:00 AM, Anonymous JR said...


I understand what you are saying but in some of my other communications with others not on this board, the nurses of the past who most likely make up this retired population being called back are some of the very ones who have committed patient dignity violations in the past. Yes, they don't have to come back but coming back to help doesn't change the fact they commit the violations and are most likely the ones who taught the present generation to disregard patient dignity and rights. Far too many of them think if they cure or help someone the manner in which they go about it is fine. They give absolutely no thought about how their callous, uncaring, disrespectful, etc. actions will affect a patient's mental health thus endangering the patient's overall ability to physically come from the illness.
And I don't care for the reason what was done to done as there is no acceptable reason for harming a patient. I am making it my goal for those nurses to loose their jobs, licenses, or whatever. There is absolutely no excuse in the world for that type of behavior. I have no empathy for someone willing to harm another for because they are made to work or afraid of losing a job. I have self-worth, integrity, etc. and I will not compromise my beliefs as a person. No job is worth that type of compromise. It is like Banterings have said that many lose their humanity when become a part of the medical world. All know it is a part of their job to protect a patient personal dignity. It is in their schooling, their oath, and they also know how they or their family should be treated.
I appreciate caregivers like you who do what you can to protect your patients from harm. There needs to be more like you.

At Friday, March 20, 2020 4:27:00 PM, Anonymous Anonymous said...

This Coronavirus pandemic must be like Christmas for all of the predators in the medical world. CL

At Friday, March 20, 2020 7:31:00 PM, Blogger Maurice Bernstein, M.D. said...

CL, whatever or whomever "predators in the medical world" are present now in the medical system which is becoming devoid of instruments for their own illness self-protection, it will certainly be "no Christmas" for them as it is becoming for all the others, humane "non-predators" currently directly participating with patients in the medical system. ..Maurice.

At Saturday, March 21, 2020 4:40:00 AM, Blogger Biker said...

My wife has come home from the local hospital somewhat earlier than she really should have, let alone not even going to the rehab center as had been planned. The hospitalist and others caring for her purposely did this in an attempt to better protect her from getting covid-19 either in the hospital or at the rehab center. In part the doctor trusted that I'd be able to care for her at home in at least a minimally adequate manner. She likely wouldn't survive it if she does get covid-19.

The hospital will send someone (the same person each time) to the house to take blood samples and the hospitalist gave her his cell# with instructions to call him everyday to report her condition. The guy is a hospitalist who technically is only her doctor when she is in the hospital and he is on duty, yet he is acting like her primary care provider.

The hospital had banned visitors a couple days ago so I missed these past couple days. She tells me that the staff has grown nervous and afraid of what they may soon be facing, yet they are there everyday doing what they have been trained to do. The closing of schools has caused staffing shortages due to childcare issues which has added to their burden. Yes there are bad actors in healthcare as has been documented here many times, but there are many more good ones putting themselves at risk to care for others.

At Saturday, March 21, 2020 9:19:00 AM, Anonymous JR said...

I understand there are good ones in the system. But this crisis will also allow those who are bad better chance to abuse patients. Why is there no crisis when over 250,000 people a year die from medical malpractice. No doubt there are countless others who have died from medical malpractice that it has not been identified as the issues. And then there are scores of others who have been harmed by medical malpractice, medical battery, or medical sexual assault. Where is the media, government or public alarm over this crisis? Why is nothing being done? This is a huge problem that kills or harms more individuals yearly. Where is the concern for those victims?

At Saturday, March 21, 2020 10:37:00 AM, Anonymous JF said...

CL, Probably testing for the virus wouldn't include intimate exposure. However it might be an opportunity for some to call on the phone saying My husband/ father/ father in law is deathly ill but is refusing to go be tested because he's had bad experiences with having to depants in front of female staff. Say whatever you think they need to hear and be concerned about until you feel like you're losing control of the conversation. Then hang up. Maybe if enough people do that it might get the needed concern. And YES Dr B. I do think it's justified because I think more Healthcare gets avoided because of this issue that can be measured.

At Saturday, March 21, 2020 3:39:00 PM, Blogger BJTNT said...

We have "no extraordinary care" signed paperwork in a red folder on our frig per policy of the paramedics in our city.

If we didn't have the folder, I would ask the caregiver if I don't accept the LIMITED RESOURCES who would benefit? Would it be a person under 40 years old who would receive the resources? Would it be a person years older than I and/or in worse health? Of course I wouldn't ask any questions because the answers would be the propaganda of the medical institution.

I have never asked a question of anyone in a medical institution, except for an MD, that ever said "I don't know". They always give an answer. Years ago I quit calling my MDs with medical questions because every time the receptionist would give me the medical answer. I've changed PCPs because of the staff, not the MDs, but to little avail.

It's understood that the non-touch labor in the medical community lacks integrity. Except for a minority of the touch labor that has their own value system that overrides the culture, where's the integrity in the touch labor? This minority of caregivers receives the letters of appreciation. The administrators, being bureaucrats, believe the letters validate their bureaucracy. If only real managers ran the show. If only.


At Monday, March 23, 2020 10:17:00 AM, Blogger Maurice Bernstein, M.D. said...

Doesn't the major risk of Corona virus infection from sick patients because of inadequate provision of self-protection garments and masks for healthcare workers represent an issue far more extensive (how many overall transmittal occurrences could occur), and potentially more lethal to both the patients (both already infected or not) and hospital personnel than the occasional professional misbehavior (or worse) which has been fully documented on this blog thread? Thus some situations in life trump others as one looks at the entire picture.

I think so and that is why I think, at this time, such concern should be dominant in the consideration of patient dignity (bodily protection from unnecessary injury or death.)

Our government should get and actively provide all the necessary tools to protect patients and their healthcare providers.


At Monday, March 23, 2020 10:45:00 AM, Anonymous JR said...

No, it does not trump patient dignity. It will be used as an excuse to even worsen dignity. Certain occupations come with certain risks. A healthcare worker must just as easily die from flu which at this point has killed more. Patients at this point are more likely to die from medical harm than the corona virus but nothing is done to stop that.
I have witnessed many healthcare workers not taking the proper safety precautions in the past to protect patients from germs such as entering a patient room gloved and not changing them before touching that patient. Some care little about patient harm thinking the purpose of the gloves is only to protect them not the patient. I have seen them get out supplies and lay them on an unsterilized part of the table without thought to the patient. But now they are complaining they aren't safe? Welcome to the world of how patient care works! I have no sympathy for them until they start showing some sympathy and respect to the patients. Whatever I had was lost when they decided to make someone I love their victim. Given the stats on how many patient are killed or harmed a year by medical negligence there is not much consideration ever given to bodily protection from unnecessary injury or death. When will there will an outcry over all of this and the white coat/scrub worship will get a hard does of reality?

At Monday, March 23, 2020 12:13:00 PM, Blogger A. Banterings said...

CL, Biker, et al,

You will see the abuses of dignity drop at this time because of the scrutiny that medical staff is under. The CDC, Johns Hopkins, and others are analyzing EMR in real time looking for any clue, especially transmission patterns. The risk to ANY medical staff of acquiring COVID-19 is much higher than the general public. When medical staff becomes infected, admin interviews EVERY patient that they were in contact with, thoroughly. The last thing that a medical predator wants is to test positive (even if not work related) and having their prior 4 weeks' patients interviewed and a pattern of abuse emerges.

COVID-19 has been shown to be acquired through fecal-oral route. So you unnecessarily exposing repeated patients and you test positive. Admin reviewing notes, reports, etc., hospitals at capacity, and a provider doing unnecessary genital exams? Procedures that are not critical are being cancelled; that is removing the opportunity to be "prepping" patients for surgery, thus removing opportunities for abuse.

Admin is no longer turning a blind eye when county and state health depts, CDC, and others are scrutinizing their records if not physically at their facilities.

Patients being discharged as fast as possible, no "I need to watch you urinate on your own before we can discharge you"...

Hopefully this incident will bring about some reform, especially for unnecessary procedures.

-- Banterings

At Monday, March 23, 2020 12:48:00 PM, Blogger Biker said...

It isn't an either/or.

The covid-19 situation is putting an extreme burden and great risk on healthcare workers and anyone who doesn't recognize that isn't paying attention. Anyone who doesn't care what harm they might incur themselves, or bring home to their families needs to take a deep breath and think about it.

On the other aspect of this, there is nothing unique about covid-19 as pertains to respecting patient privacy and dignity. Covid-19 isn't going to cause healthcare to do a better job or a worse job on that front.

At Tuesday, March 24, 2020 1:08:00 PM, Blogger A. Banterings said...


COVID-19 is making providers do a better job in terms of dignity.

First off, the hospital is lessening the number of people that do not have life threatening conditions. This includes urodynamics, cystoscopy, and TRUS which gives the opportunity for dignity violations.

Second, there is no need for intimate exposure (other than chest/breast) and no need for genital or rectal exams to diagnose COVID-19.

Finally, there are many people scrutinizing what providers are doing with patients. Whether in person or statistically, there are many eyes on each provider. The risk for their gratification is very great at this point in time. If a predator provider tests positive, the COVID-19 responsive team will contact EVERY patient that the provider has come in contact with, and there is likely to be a question of "what treatments did this provider did. Even if the patient accepts what happened as normal, they will still feel this is a good time to vent their frustrations if not outright accuse them of abuse.

-- Banterings

At Tuesday, March 24, 2020 4:34:00 PM, Blogger Biker said...

Banterings, my annual cystoscopy that was scheduled for this week was postponed indefinitely by the hospital. It not occurring obviously eliminates any possibility that someone would have been inappropriate or unprofessional, but it doesn't change the nature of any staff person that would have been inappropriate or unprofessional. It just postponed that particular opportunity such a person would have had. I don't consider myself better off because covid-19 caused my procedure to be postponed.

When investigating patient contacts of clinical staff that become infected with covid-19, yes it is an opportunity for patients to speak up if that staff person had behaved inappropriately but my guess is those investigating are not going to specifically probe for inappropriate behavior.

At Tuesday, March 24, 2020 5:50:00 PM, Blogger Maurice Bernstein, M.D. said...

To all: don't you think that a worker in the medical profession may be more concerned about his or her own health safety at this time than to, by intent, "fiddle" with the patient they are attending to satisfy their own personal sexual or non-clinically pertinent other interests? Concern about self-danger may be a factor at this time which may stimulate "appropriate (as considered by those writing here) professional medical behavior". ..Maurice.

At Tuesday, March 24, 2020 7:05:00 PM, Anonymous JR said...

I believe there will be more dignity/sexual assault offenses as they will be able to justify by saying they are tired, not enough help, they're in a hurry, pre-occupied with their own health safety concerns, etc. Also, those in isolation will have no one there to be their advocate. Sexual assault is not "fiddle" with a patient or something to make light of or makes less important as there is a "crisis". It is a very serious criminal act that leaves deep mental scars and trauma. Making light of such acts is what allows this behavior to grow and flourish. Sexual assault is a crime of opportunity, power, and control and all of these elements will exist during this virus crisis. I don't think you recognize the seriousness of sexual assault.

At Tuesday, March 24, 2020 8:20:00 PM, Anonymous JF said...

Dr B, JR and Banterings both make really great points but HOPEFULLY this Corona Virus crisis will be in the past and BEFORE it trashes our economy. If it hasn't already that is.
My thought is the virus won't make any long term impact regarding our issue. I just hope massive numbers of us don't DIE!

At Tuesday, March 24, 2020 8:42:00 PM, Blogger Maurice Bernstein, M.D. said...

By the way, JR and others here, I am not sure whether the advocate group of 25 years duration titled RAINN (Rape, Abuse and Incest Nation Network) has been noted our thread topic previously. It would be worth looking at their website. Particularly pertinent to the topic of our thread is their description and advice regarding "Sexual Abuse by Medical Professionals"

JR. had you been aware of this service organization with regard to your virtuous attempts to "spread the word"? ..Maurice.

At Wednesday, March 25, 2020 6:27:00 AM, Anonymous JR said...

You're right in saying the virus won't make any long term impact on dignity issues as they are & still will continue to disregard patients as people who have rights.

There are over 250,000 to some accounts 440,000 people a year in the US killed by medical mistakes making it the 3rd leading case of death behind cancer and heart disease. The number harmed may be over 20% higher than those numbers. Many go unreported but yet this is an not epidemic. It is not even important enough for an investigation. Why? The media and government has been bought and paid for by the medical industry. We can't even get them to stop killing us so how do we think we can get them to cover our genitals covered?

Is that sarcasm I'm hearing in saying "your virtuous attempts to 'spread the word'"? But yes, I am spreading the word. I am talking/working with legislators, doing interviews, building up my social media presence on both FB, Twitter, Quora, networking, building another website, whatever to try to make sure what happened to my husband and us does not keep happening. No human should be able to be tortured, abused, assaulted or otherwise harmed by having healthcare delivered to them. Healthcare is a service industry and therefore should be consumer friendly not hostile or ran like we are inmates in a POW camp.

At Wednesday, March 25, 2020 2:51:00 PM, Blogger A. Banterings said...


I am merely speaking to the here and now that JR brought up as COVID-19 allowing more abuses and violations of dignity. Once things are back to normal, so will be the risks to our dignity and autonomy.

There may be a silver lining to all of this; that is it has shown weaknesses in our healthcare system. Perhaps we will see hospitals incorporating better tracking and patient contact in EHRs. Some hospitals use RFID badges that track employees throughout the hospitals. I would like to see more of this as it is the "leash and muzzle" that I advocate for on providers. Not only does it actually track them, it also is a constant reminder that big brother is watching.


The excuse of overworked will not fly. What the predators will use is the view that providers are saints putting themselves in harms way, without proper PPE, they could NEVER ABUSE patients.

"Fiddle" is a very good term. It emphasizes the lack of medical necessity of such actions, describes the providers as teenagers.


I have posted this link to the RAINN article before,

-- Banterings

At Wednesday, March 25, 2020 4:59:00 PM, Blogger Maurice Bernstein, M.D. said...

In JR's posting below, a hospital was specifically named in a description of sexual misbehavior of its staff as originally written. Since it is my policy not to identify specific institutions unless they have already been identified in the news media, I have edited out the name in the reproduction of JR's posting which follows. ..Maurice.

At Wednesday, March 25, 2020 4:28:00 PM, Anonymous JR said...

This was a post left for me by some who wrote a really good post about sexual offenses of male dignity that involved the Denver 5.

"A SR. citizen male heard me referencing one of those situations and responded by relating an incident he said took place at .He claims to have awakened from being anesthesized to discover that one nurse was penetrating him with the other handling his penis.They quickly moved away-My guess is that they were attempting to discover if they could cause an erection and orgasm while a patient was sedated. He didn't report them because it would be his word against theirs."

It is interesting that many nurses who initially are mad in responding to my posts most of the time come around when we have a discussion of what is happening. They know.

At Wednesday, March 25, 2020 6:31:00 PM, Anonymous JR said...

Dr. B.,

So sorry I knew that but in haste forgot to delete it. Thanks, JR

At Thursday, March 26, 2020 4:40:00 AM, Blogger Biker said...

JR, in reaction to that last post, the man not reporting it because it would be his word vs theirs is the standard male reaction to inappropriate (felony sexual assault in that example) actions. The female staff know the odds are heavily in their favor that it won't be reported and that if it is, that they'll likely get away with it with only a "don't get caught again" kind of reprimand.

At Thursday, March 26, 2020 9:51:00 AM, Anonymous JR said...

You're right that know most men will remain a silent victim as most men know even if they reported it, they'd be laughed at or be ignored. For men, there is no justice. Even for females, it takes hundreds and hundreds of victims before anything is done. The medical system knows but refused to do anything as they like having a secret society that is above the law and oversight.
There currently is before Congress a 250,000 cap on malpractice which is ridiculous as most deaths and injuries are worth more than that. Add in the costs of legal representation and then the 33% legal fee after the expenses and the victims get nothing. That is probably the aim of this bill is eliminate patients from filing malpractice claims. Malpractice deaths is the 3rd leading cause of deaths in this country. And that is putting in or the not reporting of cases that should be criminal but bc they are medical they get a pass on criminal charges. And they know there is no consequence. That is why patient dignity is not important because they know they don't have to treat patients are people bc there is no consequence to their actions.

At Thursday, March 26, 2020 11:25:00 AM, Blogger A. Banterings said...

We all want the system to be better (even if that means destroying them and starting over). My friend up north is donating a bunch of nitrile gloves to local fire/EMS departments in his area. He wants to remain anonymous and since no one knows his name or where he limes, he remains anonymous. Again, my point is that we are not just filled with hatred (it is actually HURT that we are filled with).

-- Banterings

At Thursday, March 26, 2020 4:19:00 PM, Anonymous JR said...


We may be filled with hurt but for those who are the ones who hurt my husband, we are filled with hate. We despise them and hope in life they have nothing but misfortune and grief as they had no compassion or thought about the harm they did to him and us that night. They are the lowlife form of human beings or slugs as I refer to such. This is not the turn the other check thing because it will only be slapped again. Lesson taught, lesson learned.

At Friday, March 27, 2020 11:34:00 AM, Blogger A. Banterings said...


I said:

...we are not just filled with hatred...

Yes, there is hatred there too.

-- Banterings

At Friday, March 27, 2020 12:04:00 PM, Blogger Maurice Bernstein, M.D. said...

To those whom we say we hate, there should be a need and sense of providing them "therapy" to attempt to restore them to appropriate, proper behavior. Sure, criminals are locked up in prison as punishment, but isn't there for many programs set up for rehabilitation and hopefully finally accomplished by time of release.

JR, do you ever consider the concept of rehabilitation of those who misbehaved and mistreated your husband (and also yourself, as his wife)? As a doctor, I look to a beneficial treatment beyond simply providing some diagnosis. ..Maurice.

At Friday, March 27, 2020 3:40:00 PM, Anonymous JR said...

Dr. B.,

Yes, for those who expose because they "don't have time to cover" or even those who expose bc it hasn't occurred to them that even "patients" should be allowed to dignity. Those people might be salvageable with the right intervention but there should be harsh consequences for that behavior to help remind them it is not something that will be tolerated. I have suggested they need to use some of us to tell them what it feels like to be a patient who has been disrespected and made to feel like a victim of sexual assault. They need to understand & to have recurring learning experiences in how to deliver healthcare to patients without mentally harming them.

However, the ones who did what they did to my husband--no as they did it for malicious reasons. It could even be considered a hate crime as they thought he was gay. Do consider child molesters to be salvageable? Society doesn't as they assault the very innocent and defenseless just as does a medical person who assaults a patient who is at their most vulnerable and defenseless stage. It is an illness deep inside of them. Sex offenders forever are on a list & have severe restrictions on their freedom once they leave jail. Sexual criminals are the only ones that supposedly cannot be reformed which is interesting to me as to why someone thinks a murderer can be reformed? So a hard no for ones like harmed my husband and Mr. Kirschner. Those were intentional sexual crimes/battery. Those belong in criminal court as their intent was criminal not malpractice or simply bad behavior. Those people who commit those types of crimes should be forever banned everywhere in participating in patient care meaning they should loose their licenses and be on a sexual predator list.

Banterings found a good article last week in the Atlantic Monthly about the Understudied Female Sexual Predator. It tells that females committing sexual crimes are less likely to be investigated. Over 90% of most hospital staff is female. It is the perfect place for them to hide and be protected as the medical community does protect its own rather than protecting their patients.

You may not like my answer but that is the way I see. It wasn't an "oops" situation but a situation where they meant to harm him and did. It wasn't a situation where previously he objected to female care for modesty reasons. He is a survivor of prostate cancer and had plenty of female care before so he was well aware of the "oops" or "I don't care about exposing you bc I don't value you as a person" while is horrible is not the same as being sexually assaulted. Both are very damaging but one is actually a criminal act. One instance that night may have been the first but the second instance was definitely criminal. Hope this explains to you my hard stance on this & why we feel so much venom for those people. Some you might be able to reform; others a hard no. Why don't you talk to your peers about a pilot program for people like us to educate them on patient dignity? Or give us the info to contact them? That would be a very productive outcome of this blog. I am on Twitter, Facebook, and you have my email. I am very proactive in something done. Another victim from Indiana and I are working hard to get things done. I am going to be doing another interview soon for this time for PBS hopefully.

At Saturday, March 28, 2020 2:36:00 PM, Blogger 58flyer said...

After my urologist dropped me a few weeks ago I was able to locate a urology practice in my area which had male personnel at the assistant level. I verified this by calling around until I found them. So, I had my PCP do a referral to them. After some difficulty in getting the prior uro to fax copies of my medical records to them, one of the urologists in the referred practice declined to take my case. I was told this by the new patient coordinator and the doc gave no reason. This was last Wednesday. I asked the girl if there was another doctor in the practice and she verified there was. So I asked her to give the other doctor my referral. On Friday, she called to inform me that the other doctor declined me as well, again with no reason given.

No doubt my prior uro put something in my records that is scaring any new doctor from taking me as a new patient. I fear that will also be the case with any other new doctor. I am tempted to call the patient coordinator and ask to see what was sent to them. I did ask for and received a copy of my medical records from the prior uro. I didn't see anything suspicious in them, so that makes me think there is some kind of special notes that the prior uro wrote that I was NOT provided a copy of. I will have to run this by my PCP on Monday and see if he has any ideas. Maybe he can talk to the referred urologists as a physician concerned for his patient and maybe learn something.

I cannot ignore a cancer diagnosis as my life depends on getting the proper treatment, and BPH has to be dealt with too. That's a quality of life issue by itself. Maybe one approach is to just do a referral for rising PSA and not bother to mention the prior diagnosis. I don't like that idea but what else am I going to do? I can't believe that high BP is the deciding factor, there is just no way that something so treatable would cause a urologist to not take a patient.


At Saturday, March 28, 2020 3:41:00 PM, Blogger Maurice Bernstein, M.D. said...



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