Originally published in HCPLive.com
Physicians are increasingly bringing their views on healthcare reform into the examination room. Others are distributing flyers or taping up signs in the office. Given that healthcare reform has become such a contentious subject in the United States, it is not surprising that conflicts have arisen between physicians and patients who hold different views.
The St. Petersburg Times in Florida reported last month on an incident involving Jim Heltsley, a 67-year-old patient who confronted his chiropractor about a flier in the waiting area that he felt misrepresented proposed healthcare legislation. Heltsley, an acknowledged Democrat, said he had been a patient of Dr. Michael Moss, age 44, for 5 years. In recounting the incident, the two men disagreed over the tone of the ensuing discussion, but Moss admitted that he lost his temper. The argument ended when Moss threw Heltsley out of his office. Moss later sent a formal dismissal letter to Heltsley and says he will not apologize.
In an interview with the Times, Moss said he made the flier to address queries he had received from numerous patients. “I was like a mad scientist until 2 o’clock in the morning, watching this stuff on Fox News,” he said. The information from Fox and points from an anti-reform viral e-mail he received make up the bulk of the flier, which continues to sit in Moss’s waiting room.
Physicians against proposed reforms are not the only ones talking to their patients about the debate. Dr. Ari Silver-Isenstadt, a pediatrician, told the Huffington Post he placed fact sheets in his examination and waiting rooms outlining his support for health insurance reform. He said he also shares his views with his patients’ parents. Another patient recounted how his physician had taped a sign to the door reading, “Why is healthcare for all Americans a foreign concept?”
Some patients told the Huffington Post they were uncomfortable with their physicians’ comments on healthcare reform during office visits. Jim Dorsey, a 68-year-old man seeing an oncologist for the first time about his newly diagnosed prostate cancer, recounted how the physician told him, “If you were in Sweden today, they’d say you’re too old. They’d tell you to go home and die.” Other patients said their physicians told them reform would mean the end of Medicare or result in long waits “like they have in Canada.”
Dr. MJ Galceron, a physician with The Southwest Internal Medicine Specialists in Orlando, Florida, said his group avoids discussing the issue during office visits but did write to 6,000 of their patients to warn that the legislation “will harm American taxpayers and directly interfere with your healthcare.” The group also dropped its American Medical Association membership after the organization came out in support of many of President Obama’s proposed reforms.
Related posts:
- Patients still trust their doctors, and how that can influence health reform
- What doctors can learn from patients in the health care reform debate
- Not all doctors discuss the risks and benefits of prostate cancer screening to patients
- Will patients or doctors be the biggest obstacle impeding health care reform?
- Interruptions when doctors see patients and how that affects care
- Health reform ignores primary care doctors at its own peril
- Do patients trust doctors to bring about health reform?
{ 21 comments… read them below or add one }
Good God, people. We are adults. And why is free speech for doctors a foreign concept?
Physicians have the right to their opinion and to express that opinion. I don’t openly discuss my views on healthcare reform while seeing patients (and if I did, the newborns would sleep right though it), but if a parent asks me what I think about something, I tell them.
And I stopped pulling punches long ago.
The physician-patient relationship is NOT one-sided. We don’t live or practice in a vacuum. But emboldened by privacy laws, today’s patients increasingly think that they can say or do anything they want to (or about) a physician, and the physician is just supposed to roll over and take it – they cannot fight back.
As a Pediatrician, a long time ago, I found myself on the very wrong end of a parents’ bad behavior, In my case, it was slander and libel for which (in retrospect) I could have successfully sued.
But I stayed quiet and tried to honor all the tenents of professional behavior that I had been taught. Meanwhile the parent (ironically, a medical professional) publicly eviscerated me – in my office waiting room – to other parents – in letters to my bosses. She requested a transfer of records to another office – and I complied – discharging her child with the transfer. She interpreted this as an insult and raised even more hell.
And in the end (because in corporate medicine, the truth doesn’t matter and due process for doctors is a joke) she got what she wanted. The full story is on my blog in the sidebar.
I have to wonder now. What if I had been more like Dr. Moss?
Good article.
Doctors are the most trusted profession in America, and for good reason. They are seen as independent, and focused only on the science of getting you better.
As this article illustrates so well, they put this reputation at risk when they start to bring politics into the equation.
Some related thoughts here: http://bit.ly/4fmbVk
Cheers,
Evan Falchuk
Since at least Hippocrates, we have been taught to keep our own needs and wants, political and otherwise, out of the examination room. It is an excellent rule because it facilitates patient care and it helps us preserve our dignity. If we lose our dignity we are lost. This doctor’s political opinion might be exactly the same as mine, but my first impression is that he is a fool with a self-control problem. I’m sure many others have this first impression. As another poster said about nurses, self-indulgence is a poor quality in a doctor. There are other forums to discuss politics, like this one.
If a doctor wants to write and op-ed or go to a public debate, fine. Don’t whine to your patients. They have enough problems.
Respectfully, jsmith, Hippocrates was a very long time ago (most medical schools don’t even use his Oath anymore – a whole nuther topic).
And Evan, I thnk I speak for a lot of doctors when I say I’m not feeling nearly as a trusted or respected by the general public – or Federal government – lately.
I firmly believe that, as a profession, we’re in the boat we’re currently in because we’ve kept our own needs and wants out of the equation until we’ve gotten to the point we cannot anymore.
Patients often do not view us a human, but as some unrealistic being up on a pedestal – or a cog in their wheel of entitlement.
Like I said, I don’t openly discuss my political views with patients/parents. But if a patient/parent asks me what I think (and some do – as they want to hear & learn – it’s refreshing), I’m going to tell them. When I got my medical degree, I did not check my right to free speech at the door.
It’s not okay to slander or libel doctors – and then provide no mechanism for them to fight back. It’s not okay for hospitals to hide mediocrity and bad care behind confidentiality and privacy. It’s not okay for patients to make ugly scenes in offices or hospital – to confront or threaten doctors (for ANY reason – much less political).
I lost A WHOLE LOT MORE than my dignity a long time ago (and/so I suppose I’m more ready to roll up my sleeves and get scrappy). I was totally in the right. But the descendents of good-ole Hippocrates were nowhere to be found when I needed help.
You wanna really “reform” medicine? These are the things you need to be talking about.
I enjoy talking politics with my patients when the time permits as means of rapport and in sharing ideas. The patient sets the tone and if they wish not to engage then we move onto something else. Honest civil discussion is healthy so long as it doesn’t detract from the delivery of healthcare services.
When someone asks why a certain medicine or proceedure is not covered by Medicare I tell them to contact their Senators and Representative and ask them.
I represent their interests and my interests as healthcare recipients, providers and tax payers and the country’s interests from my perspective. It’s the only perspective I truly own.
“I thnk I speak for a lot of doctors when I say I’m not feeling nearly as a trusted or respected by the general public”
Dr J is right but imp, it is bcs drs allowed themselves to become a commodity. How does the public typical decide on a specific dr? If you’re in their network. If not, adios. So essentially, drs are valued like Walmart – if you’re relatively convenient + accessible – and if you’re in the network. Accessibility + pricing do not engender professional respect.
Who is to blame? Start with medicare and it all went downhill from there. Want less respect? Keep asking for medicare for all.
I am encouraged that some docs talk politics. Most docs i encounter “just want to practice medicine.”. It is frightening to me that a profession i respect could be marginslized & reduced to medical professionals that are interchangeable like any other commodity.
Physicians & surgeons must protect the integrity of their profession for both themselves & for us, the patients!
Discussing health system reform with your patients must be allowed (obviously, if it doesn’t interfere with their care) as they are our constituents. Educated patients are educated voters.
That being said, if you insist on discussing the current health system reform with your patients, be sure to be educated on the actual legislative language. While we may be pessimistic about the implementation of the current bills, at least educate yourself and accurately represent the legislation as it is written. (Or simply admit that you are relaying personal political philosophies instead of policy facts.)
Physicians will always advocate on behalf of our patients, and sometimes that entails educating them and ourselves.
*ahem* Encourage your Congressman to pass 3961!
I saw a new primary care at the VA recently, and as part of his unsolicited introductory spiel, he mentioned his credentials and that he had been a doctor in private practice but had been forced to retire because the insurance companies weren’t reimbursing him. I didn’t have a problem with this, but it did strike me as rather odd that he felt the need to elicit sympathy from me as part of his introduction. I highly doubt he would be so sympathetic if I introduced myself as a chronic pain patient who’s been forced into retirement from life because a doctor at the VA lied about me and sabotaged my ability to get pain treatment.
Beyond that, the patient is paying you for medical care, not your opinion on health care reform, or the weather, or anything else for that matter. Nobody wants to go to a doctor’s office and get barraged with propaganda from Fox News. The propaganda from drug companies all over your walls is enough, thank you.
“the patient is paying you for medical care”
Man, that is a loaded statement. But hey, mum’s the word;)
“the patient is paying you for medical care”
Man, that is a loaded statement. But hey, mum’s the word;)
Well, some in the medical profession apparently need reminding…
Hear hear Paynehertz,
When I talk about diagnosis and treatment, I’m an expert. When I talk about politics, philosophy, or economics, I’m just some guy talking smack. Of course guys have the right to talk smack, but whether they should while they’re wearing the white coat is another question entirely. I think it’s a terrible idea.
If you want to talk politics, go to a public meeting or give a public speech yourself or write an op-ed or start a blog. No one will fault you for it.
Reminded of what, exactly?
The millions of parents in this country who do not pay ONE DIME for their children’s medical care . . . people who don’t give it a second thought as they have as many children as they want?
That’s our biggest problem now. Entire generations who got free medical care as children growing up to expect a whole lot of expensive something for nothing.
That, and the politicians who feed upon it.
But God forbid a doctor share an opinion!
Reminded of what, exactly?
That you’re getting paid to do a job, not proselytize your patients. If you worked at WalMart and spent your time spreading your personal opinions rather than working, you’d be fired. What makes doctors special?
The millions of parents in this country who do not pay ONE DIME for their children’s medical care
You’d be hard pressed to find too many people in this country, including illegal aliens, who have never paid a dime in taxes. You seem to be under the delusion that the majority of people in this country have either never worked or are not currently working and therefore, have never paid into the system. Most people on Medicaid and Medicare have in fact spent years paying into the system and are now either retired, disabled, or temporarily down on their luck. Good to know “doctors” like you would prefer to see them denied anything for the taxes they’ve paid.
Speaking of welfare, the average doctor’s medical education is subsidized by as much as $300,000 in ebil gummint money by the very poor and working class people doctors like you despise. You are the last ones who should be complaining about welfare.
. . . people who don’t give it a second thought as they have as many children as they want?
Now you are psychic and know what your patients think. The God Complex is real. Who knew?
That’s our biggest problem now. Entire generations who got free medical care as children growing up to expect a whole lot of expensive something for nothing.
Our biggest problem is we have a whole generation of doctors who’ve been trained to nod their heads, scribble something on a chart, and then write out a prescription for some drug or another whether the patient needs it or not and call it “medical care.” We have a system that is run by doctors who are more judges and accountants than healers—doctors who are used to getting paid the same amount of money regardless of whether they successfully treat their patients or not. Doctors who seem more interested in dissecting and analyzing their patients’ character and motivations than getting to the root of what ails them and solving their problems.
They have created a system that is the third leading cause of death and the number one cause of bankruptcy in our country, clearly indicating that we are paying a whole lot of something for a whole lot of worse than nothing, yet many doctors feel they are entitled to force the rest of us to maintain this abominable and utterly dysfunctional, amoral system. The needs of one million doctors outweigh the needs of 300 million Americans.
That, and the politicians who feed upon it.
You should thank those politicians for helping to create a system in which the American medical profession is the only game in town and you can’t play unless you pay the piper. Without that you and the rest of the medical industrial complex would not be able to charge the monopoly rents that are so thoroughly bankrupting so many people in this country—people who then get to deal with your contempt when they come into your office with a child or two too many for your exacting standards.
But God forbid a doctor share an opinion!
God forbid you should perform to the same standards of professionalism demanded of a cashier at WalMart.
Paynehertz, you’re riding a very high horse.
If a patient asks me what I think about healthcare reform (it doesn’t happen often, but it happens), I’m going to tell them. That hardly meets the definition of “proselytizing”. I did not check the rights of citizenship at the door when I got my medical degree.
“What makes a doctor so special?” Well, I dunno. Could it be 7-15 (or more) years of post-college medical training and indentured servitude?
As the daughter of a teacher and a salesman (in other words, I was not “rich”), I studied hard and busted my tail for years (overcoming an undiagnosed learning disability to do it) in order to get to something that turned out to be an illusion. When I finally got to where I was going (my hometown), the government I served (in order to pay off my medical student loans) could not be bothered to intervene when my $300,000 worth of training was deemed a “dime a dozen” by two non-profiteers who fired me for saving a baby’s life.
Let’s just say I did a WHOLE LOT MORE than just “nod my head”. And pray tell me, where were noble folk like you when I got EVISCERATED for it?
When I fought back, the government I served (the one you want to turn healthcare over to – on the premise they can oversee medicine better than anyone else) dived under its desk. My child-bearing years were spent being professionally raped and ultimately swindled in Court (by as yet unprosecuted perjury, contempt and fraud).
Got no help from anybody there. I “won” that battle on my own.
I spend my days as a Pediatrician now taking care of the children of other women . . . many of whom who can have as many babies as they like – by as many men – on the public dole – because there are no limits or rules set. I do know that a lot of them DON’T THINK about it at all. I see it EVERY DAY. And please don’t tell me that their taxes cover their bills.
But mine – and those of my colleagues – do. And Obama is getting ready to tax me/us some more. As bad as our system may be now, if you keep adding to that equation, sooner or later, the math is going to stop working.
Meanwhile, I (and most of my medical/nursing colleagues – the ones you seem to have such a low opinon of), who pay our own bills, cannot have . . . or cannot afford to have . . . more children.
It’s interesting that you should bring up Walmart, because that’s EXACTLY what we are being asked to practice these days, Walmart Medicine.
Cheap. Fast. The customer is always right – even when they are dead wrong.
The POINT kind of is that doctors are NOT cashiers at Walmart. And maybe we’re tired of being devalued and talked to/treated like we’re dirt, and blamed for all of the ills of the world.
And/so if your argument to me is that, as an American physician, I should sit down and shut up – especially when someone asks me for an opinion, well, we’re gonna have a VERY LONG argument.
Paynehertz, you’re riding a very high horse.
Coming from someone with such an extraordinary sense of middle class entitlement and self-righteous fury, I should take that as a compliment.
If a patient asks me what I think about healthcare reform (it doesn’t happen often, but it happens), I’m going to tell them. That hardly meets the definition of “proselytizing”. I did not check the rights of citizenship at the door when I got my medical degree.
Nice attempt at a strawman, but that isn’t what I criticized. I specifically referred to the example given in the article of a doctor distributing Fox News-inspired propaganda in his waiting room, and also doctors wasting their patients paid-for time by offering unsolicited comments about health care reform. Of course, you can an answer a question if a patient asks it. As for your citizenship rights, it is well understood that you check your Constitutional rights at the door when you show up for work, a reality the right-wing has labored hard for centruies to maintain.
“What makes a doctor so special?” Well, I dunno. Could it be 7-15 (or more) years of post-college medical training and indentured servitude?
As the daughter of a teacher and a salesman (in other words, I was not “rich”), I studied hard and busted my tail for years (overcoming an undiagnosed learning disability to do it) in order to get to something that turned out to be an illusion. When I finally got to where I was going (my hometown), the government I served (in order to pay off my medical student loans) could not be bothered to intervene when my $300,000 worth of training was deemed a “dime a dozen” by two non-profiteers who fired me for saving a baby’s life.
Indentured servitude? Spare me the melodrama. Did someone hold a gun to your head and force you to become a doctor? You act as if you’re the only one who ever had to go into debt to gain an education or start a business, or ever held a job. You apparently got screwed by the very system you support, yet have absolutely no sympathy for the millions of patients whose lives have been destroyed by this system. You have no sympathy for the millions of Americans who become real indentured servants to the medical industrial complex through no fault of their own when they develop chronic pain or develop other disabilities and are forced by government fiat to purchase medications at outrageously inflated monopoly prices from Big Pharma or suffer torture.
Let’s just say I did a WHOLE LOT MORE than just “nod my head”. And pray tell me, where were noble folk like you when I got EVISCERATED for it?
Do I know you? Perhaps I was too busy using my godlike powers to solve the rest of the world’s problems to notice you, but it seems you expect society to step forward and fight your battles for you as well as pay your legal expenses whwever you get into a pissing contest with your fellow doctors, yet you would begrudge assistance to anyone else in need, particulary if you or your oh-so-compassionate colleagues deem them unworthy.
I spend my days as a Pediatrician now taking care of the children of other women . . . many of whom who can have as many babies as they like – by as many men – on the public dole – because there are no limits or rules set.
What would you have us do, Pharoah, kill all the first-born children? Perhaps we should institute mandatory sterilization or perhaps send poor women off to work camps. It’s amazing how quick wingnuts are to beat up poor women for their personal failings or misfortunes. They are invariably blamed for everything that is wrong in our system. Yet when it comes to the epidemic of malpractice and medical fraud in this country, these same spoiled children insist they be spared the “personal responsibility” rod.
I do know that a lot of them DON’T THINK about it at all. I see it EVERY DAY. And please don’t tell me that their taxes cover their bills.
You don’t know what your patients think. That requires empathy. If you think women go out and have babies to get an extra $75 a month in welfare benefits, you need to get a grip.
Meanwhile, I (and most of my medical/nursing colleagues – the ones you seem to have such a low opinon of), who pay our own bills, cannot have . . . or cannot afford to have . . . more children.
When I hear this kind of absurd wingnuttery it takes the mental discipline of a Zen monk to avoid bursting into laughter. We spend over $2 trillion a year on medical care in this country, yet the right wing would have us believe that no one out there, especially in the working class, actually works to pay for this, except for doctors and nurses, of course. Everybody else is just sponging off the system. The money must grow on magic trees in a secret forest somewhere. Meanwhile, despite the fact that medical careers top the list of highest paid professions, you actually expect us to believe doctors don’t make enough money to afford to have kids. Amazing.
Well, if they don’t, then who does? I don’t doubt there are people who get more out of the system than they pay into it, yet the right wing always focuses on this small minority rather than the overwhelming majority of people in this country who do pay into the system and have a right to something better for their $2 trillion than a system that kills 250,000 Americans a year and leads millions into bankruptcy. We continue funding this broken, dysfunctional and rapaciously kleptocratic system solely to protect your corporate rice bowl, yet you dare criticize others for getting something for nothing.
It’s interesting that you should bring up Walmart, because that’s EXACTLY what we are being asked to practice these days, Walmart Medicine.
Nonsense. You have always practiced assembly-line medicine where people are funneled into and out as quickly as possible and with the greatest diligence in maximizing profits rather than on ensuring safe and effective outcomes. Now the millions of evil McJobsmurfs out there who pay your salary are tired of being indentured servants to the medical industrial complex and paying something for nothing and want a system that is safer, more cost-effective, more efficient and more humane than the rip-off abomination we have now. But no, we are to all sacrifice our desires as a nation to protect your rice bowl and because some poor kid whose mom’s on welfare might be able to get the medical care she needs for free.
To hell with that.
Paynehertz, at this point, I’m fairly certain that you and I are the only people reading this thread. But hey, it’s been a great weekend, so far (courtesy of a cyber-stalker) so why not?
It’s middle-class disgust and righteous fury. You see, had I ever been able to have children, I would not have expected anyone to provide for their totally free medical care and feeding. I don’t expect anyone to pay for my own now.
I expect/I know a huge portion of the middle class feels that way. We’d like to see some fairness exercised in the system.
I don’t read minds. Your response appeared to lump in any kind of physician communitcation about matters-other-than-medical-care during a patient encounter as some kind of warped/unethical behavior.
I am well aware of the lack of Constitutional or any other kind of rights as an employee of a corporation. That’s what I spent three years in Court fighting about – and it’s why I’m still trying to send two hospital CEO’s to prison. It’s why I independently-contract now.
Indeed, muzzled by privacy and confidentiality and Star-Chamber-like peer reveiw statutes, physician-employees have fewer rights than anyone else under the iron hand of human resources – including the “McJobsmurfs” (it helped pay my way through college) and Walmart clerks.
OBTW, my troubles started during the days of Hillary’s “village” – a decidedly “left-wing” regime.
In terms of my sympathies, you are projecting quite a bit (still from that high horse of your own self-righteous indignation) and you are wrong.
You don’t know me, and to further your agenda, you don’t want to get to know me. It serves your purposes for all doctors to be evil and selfish /greedy and silent.
And why let the facts of what I’ve done with my life – or the way I’ve practive medicine – or advocated for children in that time – get in your way?
I have railed against malpractice (indeed, my life was de-railed for reporting it) and medical fraud/abuse/waste (what a good portion of my Court case was about) . . . especially in my home-state of North Carolina (where billions were wasted in just one scam run on Medicaid – and mental healthcare has become a joke). For those sins I’ve been called every name in the book. You’re actually one of the lightweights in that department.
One person, beaten to a pulp, cannot do it.
You’re asking a Pediatrician who longed for a child and could not have one if she would like to kill all the first-born children. YOU REALLY NEED TO GET A GRIP AND THINK BEFORE YOU SPEAK.
And YES! As part of reform, I would like to see my government begin to insert checks and balances that emphasize personal responsibility in ALL aspects of the system. We’ve had free public education (including sex education by the 4th grade) in this country for a very long time. The welfare state is 50-some years old. But we cannot seem to stem any tides. I deal with it every single day. And it’s because there are no real rules and no reasonable limits.
At some point, the excuses for irrespondible behavior do not cut it.
To pass any kind of healthcare – especially if you want passionate, dedicated people with a strong work ethic and superior skills providing your care – you are going to have to have the people providing it on board.
So keep making your toxic generalizations about physicians. If it makes you feel better and will keep you from hurling from the keyboard, I will concede right now that you clearly are a god-like, morally superior being compared to all of us.
Oh, and by all means, keep talking to us – individually or collectively – like we’re dogs to kick around and do your bidding. It’s a very strong persuasive tool.
“Toxic generalizations,” “like we’re dogs to kick around and do your bidding?”
You might want to tone down the melodrama a bit. But your advice is noted. It seems you can dish out the contempt for your patients, but can’t take it when some criticism comes back your way. You claim to “advocate” for children, but your “advocacy” involves denying these children and their mothers medical care and benefits if they don’t meet your exacting standards fo worthiness. When these women and their children are denied medical care and welfare benefits, they often suffer malnutrition, sickness and death. So my question of what you intend to do to stop these women from having kids is not a rhetorical one. The methods you propose will result in deaths of the children you claim to advocate for.
It would be nice if people took more personal responsibility, sure. The problem is it is impossible for us mere mortals who do not share your lofty perch up there on Olympus to determine with any degree of certainty who is, or has, exercised personal responsibility over their situation and who has not. Many of the women you despise may have had their kids when they were married, working, and able to afford them, but due to divorce, disability and unemployment now find themselves unable to afford America’s overpriced medical care. While you can’t seem to wait to wield the ban-hammer on the unworthy, I have to ask the question, what exactly qualifies you and your fellow doctors to play personal-responsibility cop?
The government-created monopoly drives up the profits in your profession and leaves people with no alternative but to deal with you at whatever price you care to charge. It adds trillions of dollars to the cost of medical care and yet you seem to think everyone else but you is getting a freebie from Uncle Sam. Our entire populace has been made into indentured servants of your profession and the medical industrial complex.
Yet you are rock solid certain in your attitudes towards your patients. You enthusiastic “YES!” to the idea of implementing limits to people based on the nebulous concept of “personal responsibility” speaks volumes. You could care less of the consequences to human life and suffering. You have not the slightest doubt of the righteousness of your agenda, which like many in your profession is to generate contempt and derision for whole classes of patients and limit their ability to get proper medical care, as well as protect your monopoly-inflated rice bowl. This is what self-righteousness is, Dr. Johnson.
It is interesting that all “solutions” from right-wing authoritarians always involve this same pattern of thinking. Your response is invariably to judge, ridicule, condemn and punish people for ordinary human behavior, rather than educate, persuade and support them in doing the right thing. You want women to have less kids, but the right wing opposes comprehensive sex education, free birth control and abortion. No, they must receive no assistance, but must be punished for something that is an essential reality of our species: childbirth.
Let me tell you something they obviously failed to teach you in medical school. Since the dawn of human history, the overwhelming majority of human beings have been born into poverty. It is only in the modern age that a substantial middle class has arisen anywhere. Are we to conclude from this fact that all our ancestors were just feckless and irresponsible, and that only people from the middle class have a right to have children? That would be a very ignorant and ahistoric view, to be sure.
You criticize sex-education, but the reality is that in the Netherlands, which is one of the most sexually-permissive societies on the planet, the rate of teen pregnancy is 1/9th what it is in the US. The reason for this is that the Dutch have comperehnsive sex-education in secondary school and at at least partial in most primary schools. There is also open discussion of sexuality, relationships and sex-education in the media which is aimed at kids. Contraception is free and widely available without judgement or question. Rather than punish people like the American right wing proposes, the Dutch have chosen to educate and inform their populace, as well as give them the means to reduce unwanted pregnancies. The results speak for themselves. School kids in the Netherlands are not told to “just say no” but they are taught how, when and why to say no. Dutch girls are taught how to deal with a boyfriend who doesn’t want to wear a condom. With education, free contraception, and open discussion of sexuality at all levels of society, Dutch kids have been given the tools they need to exercise personal responsibility. American kids have not. They also have a generous social welfare program and living wage laws which help to eliminate the poverty and despair that drives families apart and makes women more prone to getting pregnant. They have a medical system that is superior to ours in quality, costs half per capita what ours does, and covers everyone without the judgementalism or contempt that is the hallmark of American medical “care.”
http://women.timesonline.co.uk/tol/life_and_style/women/the_way_we_live/article5208865.ece
So forgive me if I’m not interested in rice-bowl protection propaganda from the medical industrial complex, moral panic or right wing authoritarian judgementalism, particularly when your profession kills 250,000 of my fellow citizens and bankrupts millions more, every year. Your pot is way too black to judge the color of anyone else’s kettle. I am interested in the facts, and the example of Europe clearly indicates what works and what doesn’t.
Payne, I’ve been involved in a cyber-wall all weekend with a stalker, and actually had to call the police today. This was icing on the cake.
ALL of us are mere mortals and I don’t despise anybody (well, except my cyber-stalker right now), so STOP projecting.
But I REALLY am tired of taking care of a lot of the ugly business you talk about – only to be dumped on and talked to like I’m a dog. Especially today.
You sir, if you want ANY kind of REAL reform, are going to have to GROW UP and realize that the status quo (i.e. one segment of the population endlessly playing the victim card to get everything it wants/needs for free . . . while the rest of us, including those of us providing the service, pay for it) CANNOT continue and it most certainly CANNOT expand.
It is not sustainable.
I did NOT criticize sex education, I noted that sex education, as it is taught in this country – in conjunction with 50 years of the welfare state – is a FUNDAMENTAL FAILURE (I believe that supports your point) in stemming any tides of poverty and despair.
OBTW, have you ever been to Holland?
So maybe, just maybe, instead of continuing the failed public policy of the last 50 years, we could start to modify it – slowly at first – to insert more personal responsibility into the equation – to insert a tad more (dare I say it?) morality into people’s choices.
In order for people to police themselves there has to be incentive – both negative (in the way of rules and limitation) and positive (rewards for responsible behavior). It ain’t happening now, and Obama’s plan will for sure keep it from ever happening.
I’ve done all I can do as an individual physician (and again, you have no idea – but there’s no point in saying any more about that because you don’t want to have an idea). I’ve bled about all I can bleed. So have others.
But it’s not enough. It’s never enought. You/others like you want MORE. You want it ALL.
Like I said, keep using these persuasive tactics with physicians (i.e. we’re cold-blooded killers and bankrupt millions for the greedy sport of it – nevermind that most of us have been cogs in a government-runwheel for YEARS – the same government you seem to think can “save” us) and you’ll go far with all of your arguments.
Payne, I’ve been involved in a cyber-wall all weekend with a stalker, and actually had to call the police today. This was icing on the cake.
Sorry to hear about your troubles, but they’re not my responsibility. I have been writhing in agony for oh, the last 18 years, because I can’t get my pain treated. Since we’re discussing our personal problems now, can you explain to me why I need to go to a doctor to get medicine, and pay good money, only to be denied treatment.?
You sir, if you want ANY kind of REAL reform, are going to have to GROW UP and realize that the status quo (i.e. one segment of the population endlessly playing the victim card to get everything it wants/needs for free . . . while the rest of us, including those of us providing the service, pay for it) CANNOT continue and it most certainly CANNOT expand.
Give me a break. No one plays the victim card as well as your profession. Everything that effects you (and your income) is a “crisis.” There is the “malpractice crisis” the “primary care crisis” and the “tuition repayment crisis” and a hundred other crises. But the epidemic of medical errors, the huge numbers of people uninsured… none of that constitutes a “crisis.” It’s only a crisis when it effects your profession.
How long do you think Americans are going to be fooled by this Chicken Little hysteria? You can only cry wolf so many times.
It is not sustainable.
You’re right, the current system is unsustainable. We can no longer afford to cater to the whims of the insurance companies, pharmaceutical industry, or doctor lobbies with their endless demands for more and more of our money. We are already giving over 15 percent of our GDP to you every year and getting crap in return. Our system is overpriced, doesn’t serve everyone, and generates a yearly body count that would put Pol Pot to shame. Do you seriously dispute these facts?
So maybe, just maybe, instead of continuing the failed public policy of the last 50 years, we could start to modify it – slowly at first – to insert more personal responsibility into the equation – to insert a tad more (dare I say it?) morality into people’s choices.
Yes, and we can start with your profession, Let’s address the “morality” of leaving millions of people with chronic pain wirithing in agony for want of treatment, treating us all like criminals and the scum of the Earth while your profession fleeces us for everything we’re worth. I have yet to meet a person with chronic pain who doesn’t have a horror story of abuse at the hands of your profession. Not one. That is not an over generalization, it is a simple fact. Even the ones who eventually find humane doctors and get proper treatment have, at some point in their journey, been abused by someone in the system. I go on medical blogs and I see the incredibly arrogant, pig-ignorant and sadistic comments made by so many doctors, and this confirms the reality of all the horror stories I have heard from patients. What conclusion am I to draw from this, that most doctors are compassionate and caring? Tell me how I make such a conclusion without completley making a blind leap of faith and ignroing the evidence to the contrary I have seen for years. Please tell me, without resorting to ad hominem attacks or excuse-making about “drug-seekers” or any other bugaboo, why I should think differently.
Let’s talk about the morality of depriving the victims of medical malpractice of their right to sue in court, particularly when your profession largely ignores the massive epidemic of medical error in this country. Let’s discuss the morality of sending a bill and collection agencies after people who’ve had their lives destroyed by malpractice. Let’s discuss the fact 11,000 Americans are killed by doctors’ handwriting on scripts, every year. Is it really so hard to write a legible script when it can save someone’s life?
Let’s discuss the morality of you and your colleagues launching into ad hominem attack againsts anyone who tries to point out these realities, all of which are backed by evidence, and not just my say so.
Yes, everyone is human, and everyone makes mistakes. But you seem to think that when you make a mistake it should be forgiven out of hand, but when we make a mistake it must be punished.
In order for people to police themselves there has to be incentive – both negative (in the way of rules and limitation) and positive (rewards for responsible behavior). It ain’t happening now, and Obama’s plan will for sure keep it from ever happening.
Obama’s plan is just to make poor people indentured servants to the corrupt health insurance industry. Now poor people will be forced to buy insurance or risk paying a fine. Isn’t this the kind of “personal responsibility”—forcing the poor to pay—that you want?
But it’s not enough. It’s never enought. You/others like you want MORE. You want it ALL.
What we want is a sustainable, affordable system that covers everyone without the abuse, profiteering, exploitation and sheer chaos of the current system. And we can have that at half the price of the current system if we borrow the European model.
It is your profession and the medical industry in general that wants it all. $2 trillion plus a year is not enough for you. You want more money, free education, the ability to punish people who exercise their right to autonomy and do things different than their doctors demand. You want absolute control over our lives and then you want to send us a bill for it. Why should we give in to your demands, threats and blatant extortion?
Like I said, keep using these persuasive tactics with physicians (i.e. we’re cold-blooded killers and bankrupt millions for the greedy sport of it – nevermind that most of us have been cogs in a government-runwheel for YEARS – the same government you seem to think can “save” us) and you’ll go far with all of your arguments.
And just keep on putting down hard-working and struggling Americans and stereotyping us as a bunch of leeches who want something for nothing. See how long we will go on financing the gravy train you and the rest of the industry are riding on. It is a fact that your industry kills over 250,000 Americans a year. Do you dispute this? How dare you demand that I, or anyone else, remain silent about this atrocity just to suit you and your ego.
I am not interested in trying to persuade doctors who can’t or won’t be persuaded by the facts, or have only their own self-interest and ego in mind at all times. The good doctors know what the deal is, know what needs to be done, and they don’t need a lecture from me or anyone else. What they need is the guts to step up and do what they know is right.
But I do not write to convince doctors. I am writing to convince my fellow Americans that we need to start getting angry and revolt against this system. Our whole medical system needs to be completely overhauled from scratch and replaced with something civilized and workable. Waiting for some corporate shill like Obama or whoever else the oligarchy foists on us to fix the system is a losing proposition.
“What they (good doctors) need is the guts to step up and do what they know is right.’
Once again, you do not know who you’re talking to on that point – and what’s she’s been through for doing just that. And you don’t want to know. Moreover, I’m the LAST physician in the world to lecture on the dangers of apathy and silence . . . or what lies behind “the White Wall”.
Your fellow Americans want the kind of doctors who have done the things I’ve done – yet gotten professionally slaughtered for.
I know. It’s not your problem. But it actually is.
Your fellow Americans are not going to have such doctors if things remain as they are. And they’re for sure not going to have them if Obama has his way.
At this point, you are talking to yourself. I don’t plan to respond further.
Good evening.