Joel Sherman, MD

Embarrassment is one reason why men don’t see the doctor

by | in Patient | 16 comments

It is well known that men see doctors much less frequently than women.  The reasons are multifactorial and not all that well studied.  It’s certainly not because men are healthier than women as they die on the average seven years before women.  Clearly women are accustomed to seeing doctors at an earlier age than men for reasons relating to childbirth and birth control.  Most accept the recommendations to get an ...

Sports physicals often includes no provisions for privacy

by | in Patient | 6 comments

Sports physicals are universally required in the U.S. on an annual or seasonal basis for students wishing to participate in sports.  All states have requirements covering public schools.  The reason for the exams is to ensure that the athletes can participate safely.   These exams are not intended to replace a regular physical.  There are no absolute standards for what should be included in these exams.  Most would agree that ...

Implementation of a rational system of medical care

by | in Policy | 18 comments

The patient entered her private solo physician’s office and handed her medical ID card to the doctor.  He put the card in his desktop reader and reviewed her medical history.   All of her visits, vaccinations, medications, tests, x-rays etc from all providers were inscribed on the data chip in the card.  The card also included insurance and billing information.  At the end of the visit, he updated her information on ...

When your privacy is violated in the doctor’s office

by | in Patient | 13 comments

Few patients enter our health care system prepared for the unexpected and embarrassing circumstances that can routinely happen.Most can accept it when we’re treated with modesty and respect.  But not many are prepared for those times when you might be unnecessarily exposed or treated rudely.  The possibilities for embarrassment are endless and it is usually unexpected.   When avoidable incidents do happen, most patients are not prepared to speak up.  Many ...

Are chaperones a hindrance to patient privacy?

by | in Patient | 82 comments

Chaperones are increasingly recommended for routine use in Western medicine.  There are semi-official recommendations in both the UK and USA.   The AMA has long had this.The rationale for using chaperones is twofold.  In theory their primary purpose is to protect, comfort and assist the patient.  In reality though, the usual purpose is to protect the physician against claims of sexual assault or harassment.Preferably, chaperones should be real professionals, ideally ...

Patient gender preferences for medical care

by | in Patient | 13 comments

Patients’ gender preferences for medical care are a factor that we all know exists yet most physicians prefer to ignore it in daily practice hoping that modern medicine is gender neutral.  Forty plus years ago when I started in medicine this wasn’t a consideration.  Nearly all physicians were men and nurses were women.  Patients simply had no choice.  Male physicians felt entitled to see all comers and present day women ...

Informed consent is missing from Pap smears and cervical cancer screening

by | in Conditions | 107 comments

The American College of Obstetrics and Gynecology (ACOG) has just revised their guidelines for Pap smears under some pressure. This resulted from an Annals of Internal Medicine article which documented that only 16.4% of gynecologists followed the College’s prior guidelines. Most did more screenings than indicated, the worst record of the specialties tested. But the ACOG still recommends that nearly all women obtain regular screening at intervals of 1-3 years.The ...