Why Doctors Should Not Ask Their Patients About Guns [Archive] - Glock Talk

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RussP
01-22-2013, 13:13
Dr. Hsieh posted this in Gun Control. It is appropriate here, too.I am a physician, Glock owner, and an advocate of the 2nd Amendment. I hope GlockTalk readers enjoy this piece of mine which appeared in today's Forbes.com:

Forbes: "Why Doctors Should Not Ask Their Patients About Guns (http://www.forbes.com/sites/paulhsieh/2013/01/22/why-doctors-should-not-ask-their-patients-about-guns/)" (1/22/2013)

(Please feel free to forward this onto anyone who might be interested. Thanks! --Paul Hsieh, MD)

blackjack
01-22-2013, 14:44
Well stated. I'm saving that article to print out in case a physician decides they need to make that inquiry. Since I'm in OK, I kind of doubt most physicians would make the attempt.

RJ's Guns
01-22-2013, 15:38
I have not been following this issue. Am I correct that physicans are only asking these questions if someone has minors living with them? If physicians are asking these question, whether or not a patient has minors living with them and my physician asks me about my firearms, I will refuse to answer and I will find a new physician. If I did have minors living in my home and a doctor behaved in that manner, I would do the same.

What is next, asking me about what assets that I have, my net worth, what property that I own and how and where I spend my money. Who the hell do these Doctors think they are? Their God complexes seem to be running amok.

That type of behavior would motivate me to do some legal research so as to determine what legal recourse is available. Most people would think it unwise to so motive a retired litigation attorney with a lot of time on his hands.

RJ

SouthernBoyVA
01-22-2013, 16:14
There is a great answer to this question should it ever be posed. Don't answer it. How hard is that?

akapennypincher
01-22-2013, 19:26
My reply is yes I have a Dan Quayle special, I have had since I was a kid in Florida.http://ecx.images-amazon.com/images/I/418tKnmfy7L._SL500_AA300_.jpg

SJ 40
01-22-2013, 22:06
Because it's none of there Effing business ! SJ 40

RJ's Guns
01-22-2013, 22:20
If the rationale is, “in the name of protecting child safety” almost anything and everything could be discovered under the rationale that it is “in the name of protecting child safety”. I see almost no discovery limitations on the physicians or the government with that kind of a justification.

At law, that type of abuse and misuse is called a “fishing expedition”and it is usually prohibited. Evidently, with physicians, it looks like almost anything goes.
RJ

Gunnut 45/454
01-22-2013, 23:03
SJ 40
Thats the wifes and mine standard answer! They actually started this BS in the Military Medical system back in the Clinton days!:steamed: Any doctor whos ask these stupid questions will loose my buisness IMMEDIATELY!

Southswede
01-22-2013, 23:55
Oh sir I cannot answer that question because I would feel bad if you were forced to compromise the integrity of the doctor-patient relationship.........:supergrin:

SouthernBoyVA
01-23-2013, 05:35
My reply is yes I have a Dan Quayle special, I have had since I was a kid in Florida.http://ecx.images-amazon.com/images/I/418tKnmfy7L._SL500_AA300_.jpg

That would be an AlGore Special. Quayle has more sense... he made his in pot metal.

17&27
01-23-2013, 19:44
I'm just going to make up the most sick and perverted sex story I can think of and if the doctor ever asks if I own guns I'm going to tell him this story as if it were one of my real experiences. When he drops the stethoscope and stands there with his mouth hanging open I'm gonna say "Oh, I'm sorry. I thought you wanted to talk about things that are none of your business."

wrenrj1
01-23-2013, 19:48
My Dr. sent me this today via PM:

I've been going to him for 10+years. He's on our side...

Assault Rifle vs. Sporting Rifle - YouTube

mortpes
01-23-2013, 21:05
Doctors could be asking a lot of things. For example, 400 kids have died from climbing on the new type TV that tip over. In 2010 about 4316 children age 1-4 died. Accidents the primary. Smoking causing fires among the primary up with drowning. But the fact is we hire docs to watch our bodies. They do not have much time. If they talk to you about social issues well your body just got short changed.

ChiTownPicaro
01-24-2013, 00:08
Thanks for sharing. Very good read and useful to share with my friends.

DaneA
01-24-2013, 21:26
My answer "nope I keep them on me."

Frankly though any answer besides "no" equals "yes".


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TBO
01-25-2013, 11:56
Good article.

Sent from my Nexus 4 using Copatalk 2

RonS
01-25-2013, 16:24
If my doctor asked me that I would walk out of the room, go to the front counter, ask for the form to get a copy of my records, fill it out and leave.

If he is a progressive, I won't go to him.

If he is a moral coward who does whatever his medical association tells him to do, I won't go to him.

My dentist is an NRA Highpower Rifle competitor, he and I get along just fine, I am sure he knows some MDs of like mind.

COLDSTEEL165
01-25-2013, 19:08
Does my Red Ryder BB gun count.?

Southswede
01-25-2013, 21:41
Does my Red Ryder BB gun count.?

HELL YES!! (You'll shoot your eye out!)

dereklord
01-26-2013, 03:59
I hope I don't tick anyone off here, but this doesn't really bother me. I mean, if a doctor asks me if I have firearms, I would just tell him the truth. What will they really do with that information? Correct me if I'm wrong here, honesty, I am open to constructive criticism. Its just that I am a law abiding citizen and a legal gun owner. So this doesn't bother me. Plus, if he wants to find out if I have guns he can just log on to glocktalk and look at my signature block, lol.

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superdoc
01-26-2013, 05:10
if a doctor has the time to ask about firearms in the home, he/she is wasting precious time better spent on the current medical issue at hand.

racer88
01-26-2013, 06:59
If he is a moral coward who does whatever his medical association tells him to do, I won't go to him.


Consider that the AMA can only claim about 15% of doctors as members. The importance and relevance of the AMA is GROSSLY overstated by the media. 85% of doctors are not members!

racer88
01-26-2013, 07:11
If we are to think strategically, with the goal of not enabling the gun-grabbers in government... refusing to answer, walking out, etc... are counterproductive. Any evasive answer or flat refusal to answer is tacitly an affirmative response. In other words... By refusing to answer or protesting the question, you are effectively saying, "Yes, I have guns!"

A better approach is to say, with a stone-face, "No. I do not have any guns." LIE! You're not under oath. As a healthcare professional, I naturally do not advocate lying when discussing your health. It's paramount that you are forthright about your health history, signs, symptoms, etc. Whether you drink, smoke, or mainline heroin IS relevant to your health and healthcare. But, there is no harm in lying about the ownership of inanimate objects.

Just say NO! :-) And, then you and your doctor can get on with the business of your health.

jbotstein1
01-26-2013, 07:23
I'm an MD. Let's say I had a friend who was moonlighting at a mental hospital recently and he accepted a transfer of a patient from a local ER. The patient was a young man (late 20s) who was sent there because of having troubling thoughts and hearing voices. He had never been diagnosed with any psychiatric illness. As my friend was obtaining the history of present illness, the patient was very calm and obviously upset about the thoughts he'd been having. He'd had thoughts of killing himself. He'd had thoughts of killing others. My friend asked if he had actually hurt others before and he said no. He asked if he had thought about mass shootings and harming many people and he said yes. My friend asked if he had thought about stuff like going to a school etc. and the patient said he had. When asked why, the patient said it was merely because he didn't care. This patient had been in prison before. He said that he had killed mice who were chased into his cell by tying a string around their neck and drowning them in the toilet.

As a physician, you come across many patients who may be "off" and some patients who are downright "crazy". Let's saymy friend said this guy was eery in the fact that he knew his thoughts were wrong, but he didn't care and seemed to be completely calm about the situation.


So, to all you saying MDs should mind their own business, how would you have handled this situation further? (realistically of course)
A. Prescribe some Zyprexa and go to bed
B. Call the police immediately
C. Pull out your sidearm and save society from having to deal with this guy later
D. Ask about whether or not he had access to firearms
E. Insert your own answer here

jbotstein1
01-26-2013, 07:32
I would also like to compare my previous post to a person who comes into the ER with a cough productive of blood tinged sputum, night sweats, and was born and raised in Mexico. His quantiferon gold test comes back postiive for TB. His chest xray has findings consistent with granulomas. The patient refuses to stay in the hospital and tries to leave.

Now, by law, it is my responsibility as a physician, to restrain that person and prevent them from leaving. They are putting the rest of society at risk. Compare that situation to my previous post. How do they differ?

I'm not stating my opinions, I just want to hear how others view these situations. I have found that when you aren't aware of many situations encountered in other professions, it is hard for you to understand the reasoning for some of the rules that have been put in place.

Discuss.

RussP
01-26-2013, 07:48
I'm an MD. I have a friend who was moonlighting at a mental hospital recently and he accepted a transfer of a patient from a local ER. The patient was a young man (late 20s) who was sent there because of having troubling thoughts and hearing voices. He had never been diagnosed with any psychiatric illness. As my friend was obtaining the history of present illness, the patient was very calm and obviously upset about the thoughts he'd been having. He'd had thoughts of killing himself. He'd had thoughts of killing others. My friend asked if he had actually hurt others before and he said no. He asked if he had thought about mass shootings and harming many people and he said yes. My friend asked if he had thought about stuff like going to a school etc. and the patient said he had. When asked why, the patient said it was merely because he didn't care. This patient had been in prison before. He said that he had killed mice who were chased into his cell by tying a string around their neck and drowning them in the toilet.

As a physician, you come across many patients who may be "off" and some patients who are downright "crazy". My buddy said this guy was eery in the fact that he knew his thoughts were wrong, but he didn't care and seemed to be completely calm about the situation.


So, to all you saying MDs should mind their own business, how would you have handled this situation further? (realistically of course)
A. Prescribe some Zyprexa and go to bed
B. Call the police immediately
C. Pull out your sidearm and save society from having to deal with this guy later
D. Ask about whether or not he had access to firearms
E. Insert your own answer hereYou cite a specific case in a specific setting where the patient presented symptoms in an ER and was transferred to a mental facility for further mental evaluation. Following the line of questioning in your example, it would be appropriate next to determine if the man had the tools to take action on his thoughts.

How did the man come to the ER? Voluntarily? Brought by a concerned family member or friend? Too much history is unknown to answer your A-E questions.

Your case is not analogous to visiting ones primary care doctor for a sore throat and having to answer questions about firearms.

RussP
01-26-2013, 07:50
I would also like to compare my previous post to a person who comes into the ER with a cough productive of blood tinged sputum, night sweats, and was born and raised in Mexico. His quantiferon gold test comes back postiive for TB. His chest xray has findings consistent with granulomas. The patient refuses to stay in the hospital and tries to leave.

Now, by law, it is my responsibility as a physician, to restrain that person and prevent them from leaving. They are putting the rest of society at risk. Compare that situation to my previous post. How do they differ?

I'm not stating my opinions, I just want to hear how others view these situations. I have found that when you aren't aware of many situations encountered in other professions, it is hard for you to understand the reasoning for some of the rules that have been put in place.

Discuss.The part in bold may differentiate the treatment of the patients.

Does the law require the mental health professional to restrain and report the mental health patient?

jbotstein1
01-26-2013, 07:55
If the patient has a plan to carry out his thoughts, it would be at the physicians discretion to determine if he/she thought a call to the authorities was appropriate.

What if this patient had no access to firearms? What if he said he had no plan to carry out these thoughts? Is it my responsibility to ask if he has a gun? Is that somehow infringing on his 2A right? Is it overstepping my bounds?

I think the terminology is if the patient is posing an imminent threat to themselves or others, then I can sign an order to restrain them involuntarily.

racer88
01-26-2013, 07:57
I'm an MD. Let's say I had a friend who was moonlighting at a mental hospital recently and he accepted a transfer of a patient from a local ER. The patient was a young man (late 20s) who was sent there because of having troubling thoughts and hearing voices. He had never been diagnosed with any psychiatric illness. As my friend was obtaining the history of present illness, the patient was very calm and obviously upset about the thoughts he'd been having. He'd had thoughts of killing himself. He'd had thoughts of killing others. My friend asked if he had actually hurt others before and he said no. He asked if he had thought about mass shootings and harming many people and he said yes. My friend asked if he had thought about stuff like going to a school etc. and the patient said he had. When asked why, the patient said it was merely because he didn't care. This patient had been in prison before. He said that he had killed mice who were chased into his cell by tying a string around their neck and drowning them in the toilet.

As a physician, you come across many patients who may be "off" and some patients who are downright "crazy". Let's saymy friend said this guy was eery in the fact that he knew his thoughts were wrong, but he didn't care and seemed to be completely calm about the situation.


So, to all you saying MDs should mind their own business, how would you have handled this situation further?

That scenario is VERY different than routinely asking EVERY patient about gun ownership.

The point is whether the question is relevant to the health of the patient (as it most definitely is in your scenario).... Or, whether it's a politically-driven question asked of every single patient during a routine physical... when it is most definitely NOT relevant.

racer88
01-26-2013, 07:59
I would also like to compare my previous post to a person who comes into the ER with a cough productive of blood tinged sputum, night sweats, and was born and raised in Mexico. His quantiferon gold test comes back postiive for TB. His chest xray has findings consistent with granulomas. The patient refuses to stay in the hospital and tries to leave.

Now, by law, it is my responsibility as a physician, to restrain that person and prevent them from leaving. They are putting the rest of society at risk. Compare that situation to my previous post. How do they differ?

I'm not stating my opinions, I just want to hear how others view these situations. I have found that when you aren't aware of many situations encountered in other professions, it is hard for you to understand the reasoning for some of the rules that have been put in place.

Discuss.

Again... you are comparing very specific medical presentations vs. the broad questioning about guns being mandated by a politically-driven agenda that has NOTHING to do with health.

jbotstein1
01-26-2013, 08:02
I understand that, but my point is, doctors didn't make the legislation. In fact, I would bet that most doctors oppose this legislation. There are plenty of doctor gun owners. I think that too much is being made of this whole situation. The patient is not required to answer the question either at all or truthfully.

And I know that my example is an extreme, but I was making a point that there are clear cut examples when it would be relevant to ask.

jbotstein1
01-26-2013, 08:05
Again... you are comparing very specific medical presentations vs. the broad questioning about guns being mandated by a politically-driven agenda that has NOTHING to do with health.

I didn't think it was mandated in the executive order. I just thought that the executive order said as follows :


"Release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities"

"Clarify that the Affordable Care Act does not prohibit doctors asking their patients about guns in their homes"

"Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover"

jbotstein1
01-26-2013, 08:09
It just puts the ball in the docs court. It says, if your clinical judgement thinks it is relevant whether or not this patient owns a gun, you're not prohibited from asking. I thought it was just a buncha lip service from Obama that really had no relevance, and now a bunch of people are all up in arms about it.

racer88
01-26-2013, 08:21
I understand that, but my point is, doctors didn't make the legislation. In fact, I would bet that most doctors oppose this legislation. There are plenty of doctor gun owners. I think that too much is being made of this whole situation. The patient is not required to answer the question either at all or truthfully.

And I know that my example is an extreme, but I was making a point that there are clear cut examples when it would be relevant to ask.

I see. In that case, I agree 100%! :cool:

RussP
01-26-2013, 09:34
I didn't think it was mandated in the executive order. I just thought that the executive order said as follows :


"Release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities"

"Clarify that the Affordable Care Act does not prohibit doctors asking their patients about guns in their homes"

"Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover"It just puts the ball in the docs court. It says, if your clinical judgement thinks it is relevant whether or not this patient owns a gun, you're not prohibited from asking. I thought it was just a buncha lip service from Obama that really had no relevance, and now a bunch of people are all up in arms about it.As a physician, do you believe the language could be interpreted as opening, or could open a pathway through/around HIPAA?

jbotstein1
01-26-2013, 09:56
Possibly. I guess one could worry that having this information documented in yet another place would make it easier for the gov't to find said information, but I don't think it would be legal unless they made everyone's medical information public knowledge, which would be a huge deal obviously.

redbaron007
01-26-2013, 10:30
Are there occasions where a physician should ask more questions.....yep.

However, to make it part of the everyday exam/conversation......nope.

If asking in everyday exam/conversation, then why don't they ask about the avenue of transportation to and from the Drs facility. It's proven automobiles cause far more deaths and injuries than the firearm. You'd think if safety is the important issue, then this would be addressed long before guns in the home.

Just an example of twisted liberal gubbermit control.

:wavey:

red

RussP
01-26-2013, 10:33
Possibly. I guess one could worry that having this information documented in yet another place would make it easier for the gov't to find said information, but I don't think it would be legal unless they made everyone's medical information public knowledge, which would be a huge deal obviously.Do you believe HIPAA is as strong as it was when enacted in 1996? In other words, is the public living under a false sense of security believing HIPAA is protecting them?

jbotstein1
01-26-2013, 10:55
Are there occasions where a physician should ask more questions.....yep.

However, to make it part of the everyday exam/conversation......nope.

If asking in everyday exam/conversation, then why don't they ask about the avenue of transportation to and from the Drs facility. It's proven automobiles cause far more deaths and injuries than the firearm. You'd think if safety is the important issue, then this would be addressed long before guns in the home.

Just an example of twisted liberal gubbermit control.

:wavey:

red

A doctor can and should certainly ask about seatbelt usage, wearing a helmet and protective gear on motorcycles etc.

And just to clarify, I don't ask my patients about guns, nor will I ever (I'm going into radiology :) )

jbotstein1
01-26-2013, 10:57
Do you believe HIPAA is as strong as it was when enacted in 1996? In other words, is the public living under a false sense of security believing HIPAA is protecting them?

Honestly, I was still in high school in 1996 :) but I can tell you that in the medical community, at least, HIPAA is taken VERY seriously. Does that prevent a hacker from accessing medical records? I dunno.

Southswede
01-26-2013, 12:32
Honestly, I was still in high school in 1996 :) but I can tell you that in the medical community, at least, HIPAA is taken VERY seriously.

I remember when I was young and naive too.

jbotstein1
01-26-2013, 12:36
From what perspective are.you speaking? Are you a healthcare professional?


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redbaron007
01-26-2013, 13:00
A doctor can and should certainly ask about seatbelt usage, wearing a helmet and protective gear on motorcycles etc.

And just to clarify, I don't ask my patients about guns, nor will I ever (I'm going into radiology :) )

Can and should are two different avenues. Why should he ask about the seat belt/helmet usage? Again, could it be a question to ask, depending on the circumstances....sure...however, not as part of the routine visit. Can the physician ask about vehicle usage or guns...yep....but one doesn't have to answer and shouldn't be obligated to for fear of being reported or it logged in their medical information.


Glad to hear you won't be asking. :)

:wavey:

red

bug
01-26-2013, 13:16
I'm an MD. Let's say I had a friend who was moonlighting at a mental hospital recently and he accepted a transfer of a patient from a local ER. The patient was a young man (late 20s) who was sent there because of having troubling thoughts and hearing voices. He had never been diagnosed with any psychiatric illness. As my friend was obtaining the history of present illness, the patient was very calm and obviously upset about the thoughts he'd been having. He'd had thoughts of killing himself. He'd had thoughts of killing others. My friend asked if he had actually hurt others before and he said no. He asked if he had thought about mass shootings and harming many people and he said yes. My friend asked if he had thought about stuff like going to a school etc. and the patient said he had. When asked why, the patient said it was merely because he didn't care. This patient had been in prison before. He said that he had killed mice who were chased into his cell by tying a string around their neck and drowning them in the toilet.

As a physician, you come across many patients who may be "off" and some patients who are downright "crazy". Let's saymy friend said this guy was eery in the fact that he knew his thoughts were wrong, but he didn't care and seemed to be completely calm about the situation.


So, to all you saying MDs should mind their own business, how would you have handled this situation further? (realistically of course)
A. Prescribe some Zyprexa and go to bed
B. Call the police immediately
C. Pull out your sidearm and save society from having to deal with this guy later
D. Ask about whether or not he had access to firearms
E. Insert your own answer here

I think example A. is part of the problem to many folks now believe the answer to life's problems is in a pill bottle...

In your specific case I believe B or AT least D would be a good choice.

But the problem most folks have is the real possibility that for example, you send your son in for his preseason Football physical and the doctor while there decides to ask about firearms in the home.
Is that ok?

what about school nurse?

Would it be ok for her/him to ask such a thing?

I think most folks want to keep crazy's from have access to weapons but the reality is that is just not possible when a person is determined to get one.

I am not willing to give up my liberty for any perceived safety.
I will take my chances.

RussP
01-26-2013, 14:14
...(I'm going into radiology :) )What is your practice now?

RussP
01-26-2013, 14:20
Honestly, I was still in high school in 1996 :) but I can tell you that in the medical community, at least, HIPAA is taken VERY seriously. Does that prevent a hacker from accessing medical records? I dunno.I'm not talking about hackers. Talking about the vulnerable of the law to government intrusion. What is your understanding of how you legally may be required to turn over patient records to government authorities?

Southswede
01-26-2013, 14:40
From what perspective are.you speaking? Are you a healthcare professional?


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Life's perspective after having lived in the real world. You might not realize the difference between how things should be and how they actually are.

deputy1199
01-26-2013, 14:43
My doctors never say anything about my Glock when I remove it prior to their examining or treating me.

jbotstein1
01-26-2013, 16:48
Life's perspective after having lived in the real world. You might not realize the difference between how things should be and how they actually are.

So, in actuality, your assumption of my naivity is based on a lot less experience in the healthcare arena when compared to mine. I would venture that your life experience doesn't make you anywhere near qualified to know how things work in the health care field. I guess what they say about assumptions is correct.

jbotstein1
01-26-2013, 16:50
I'm not talking about hackers. Talking about the vulnerable of the law to government intrusion. What is your understanding of how you legally may be required to turn over patient records to government authorities?

I'm currently in my residency training to be a radiologist.

I don't have a good understanding of what it would take for the government to change the law to enable them to legally have access to healthcare records. My guess is an executive order would be sufficient because it is not making legislation, merely changing it? But again, I'm not educated in legislation.

All I can speak about with certainty is that doctors, nurses, and other medical professionals take HIPAA seriously and do not dispel patients records to people who shouldn't have access. What the government does is anyone's guess. They could be tapping my phones, monitoring this forum, and accessing all of our medical records. I don't know. Does that make me naive?

jbotstein1
01-26-2013, 17:10
Can and should are two different avenues. Why should he ask about the seat belt/helmet usage? Again, could it be a question to ask, depending on the circumstances....sure...however, not as part of the routine visit. Can the physician ask about vehicle usage or guns...yep....but one doesn't have to answer and shouldn't be obligated to for fear of being reported or it logged in their medical information.


Glad to hear you won't be asking. :)

:wavey:

red

I ask about smoking, drinking, drug use, seatbelt useage, etc. These are all things that affect one's health. Now the debate here is whether or not guns fall into that territory. I don't think they do. Nor do the majority of people. I think we should remind ourselves that none of the events that have transpired with executive order command people to do anything or punish anyone for not doing anything. It was a reminder and a backhanded way of the president telling docs he thinks it's a good idea for us to ask.

Doctors don't like to be told by anyone especially the government how to practice medicine. This is an overextension of the gov't. Patients only have to say no or I don't wish to answer. No big deal needs to be made of this. If it becomes law, then it's a different story.

cowboy1964
01-26-2013, 17:16
Just say no. Don't get into privacy issues, 2nd Amendment, or anything else. Just say no.

RussP
01-26-2013, 18:36
I'm currently in my residency training to be a radiologist.Thank you...I don't have a good understanding of what it would take for the government to change the law to enable them to legally have access to healthcare records. My guess is an executive order would be sufficient because it is not making legislation, merely changing it? But again, I'm not educated in legislation.That wasn't my question.

I'll give you the answer. A warrant can be issued for your patient's records in connection with a crime. Under certain conditions, the Patriot Act can be used, suspicion of a patient being a victim or a suspect, domestic violence...

That's what I'm talking about.All I can speak about with certainty is that doctors, nurses, and other medical professionals take HIPAA seriously and do not dispel patients records to people who shouldn't have access. What the government does is anyone's guess. They could be tapping my phones, monitoring this forum, and accessing all of our medical records. I don't know. Does that make me naive?Government agents are on this site. :cool:

I am familiar with the various levels of concern within the medical community. My wife, an RN, retired a few years back after over 40 years in various positions within medicine, including overseeing HIPAA compliance.

Not naive, inexperienced. That will come with time... :cool:

Bruce M
01-26-2013, 19:01
A doctor can and should certainly ask about seatbelt usage, wearing a helmet and protective gear on motorcycles etc.

And just to clarify, I don't ask my patients about guns, nor will I ever (I'm going into radiology :) )

One time that springs violently into my mind about a time when asking about guns would be very appropriate is before putting a patient into the MRI...

jbotstein1
01-26-2013, 20:16
Very true

Southswede
01-26-2013, 23:24
So, in actuality, your assumption of my naivity is based on a lot less experience in the healthcare arena when compared to mine. I would venture that your life experience doesn't make you anywhere near qualified to know how things work in the health care field. I guess what they say about assumptions is correct.

My assumption is based on your naive comment about the health care system. Sorry if the truth hurts your feelings.:dunno:

And as Russ pointed out, inexperienced too.

RussP
01-27-2013, 08:41
My assumption is based on your naive comment about the health care system. Sorry if the truth hurts your feelings.:dunno:

And as Russ pointed out, inexperienced too.Southswede, when I said inexperienced, it was in no way derogatory, as the good doctor knows.

In medicine experience comes, hopefully, in a steady stream. You get the basics crammed into 6 or so years, then the real world including more responsibility hits. Residency is a *****. You can but you can't. You're expected to practice, learn and sometimes teach all at the same time. Hopefully, there's never a moment where a student, intern, resident, physician says, "Now I have all the experience." They should always be wanting one more patient that will add to that experience.

Doc here, unless he opens a private practice, he's insulated. HIPAA compliance will be the responsibility of people several layers away from him.

Southswede
01-27-2013, 09:38
Southswede, when I said inexperienced, it was in no way derogatory, as the good doctor knows.

In medicine experience comes, hopefully, in a steady stream. You get the basics crammed into 6 or so years, then the real world including more responsibility hits. Residency is a *****. You can but you can't. You're expected to practice, learn and sometimes teach all at the same time. Hopefully, there's never a moment where a student, intern, resident, physician says, "Now I have all the experience." They should always be wanting one more patient that will add to that experience.

Doc here, unless he opens a private practice, he's insulated. HIPAA compliance will be the responsibility of people several layers away from him.

I see HIPAA evaporating incrementally in favor of federal funding. The "affordable health care act" most certainly guarantees this. For proof of this idea, just look to highway funding. If certain things (mandated) are not followed, no highway funding. There are also several other areas where this concept applies too. To not see this makes one naive or inexperienced is how I see it and what I am saying.

The second amendment has been targeted for longer than most of us have been alive. The Second Amendment is a God-given birth right in this Country. It is eroding away. Russ do you really think a little rule like HIPAA will stand in the way of continued erosion of the second amendment?

Checking blocks on a form can be done by the Dr, then simply reported later by other staff members-could it not? Would this not bring the Dr into the chain of events violating HIPAA?

pizza_pablo
01-27-2013, 10:51
Also, the fact that gov is paying for healthcare and the ease of access to electronic med records, could easily be abused and used to "classify" a "rebel" as a "threat" and remove their guns. Once that info is in your record, its not leaving.
I don't believe this is so far fetched as to be a tin foil hat conspiracy. I believe this is exactly where THEY are heading.

And BTW, how is seat belt use related to health?
What about whether I prefer to write with a pencil or pen? Does that affect my blood pressure, too?

steveksux
01-27-2013, 11:11
If the patient has a plan to carry out his thoughts, it would be at the physicians discretion to determine if he/she thought a call to the authorities was appropriate.

What if this patient had no access to firearms? What if he said he had no plan to carry out these thoughts? Is it my responsibility to ask if he has a gun? Is that somehow infringing on his 2A right? Is it overstepping my bounds?

I think the terminology is if the patient is posing an imminent threat to themselves or others, then I can sign an order to restrain them involuntarily.

If this is his first involvement with a mental health professional where his thoughts/plans of mass murder/suicide have been discussed, he may be able to perfectly legally purchase a firearm.

Curious, if you do not decide to an involuntary commit (which I'm assuming leaves a mark on your record preventing you from passing the background check, correct me if I'm wrong), what CAN you do that would leave such a mark? And should you do so?

I'd say yes, myself. But I'm not a professional, I have no idea how many of these sorts of crazy folks are out there that never harm anyone.

Question for others? Do crazy dangerous people have the same 2A rights we do? Shall not be infringed? Crazy dangerous people have the right to defend themselves too?

Half in jest I ask, do drunk people have the right to defend themselves via the 2A also? The condemnation of carrying a firearm while under the influence is fairly universal, does a beer or two invalidate their 2A rights? If the answer is no because they are temporarily mentally impaired, how would that differ from the scenario above where the patient is mentally impaired for an unknown duration from an unknown cause, and possibly not their fault?

Randy

steveksux
01-27-2013, 11:13
As a physician, do you believe the language could be interpreted as opening, or could open a pathway through/around HIPAA?
Does HIPPA prevent releasing private info to the govt, or just to other people/private agencies?

Just sayin, its pretty rare that the govt passes laws that apply to it... :upeyes:

Randy

Southswede
01-27-2013, 12:06
Also, the fact that gov is paying for healthcare and the ease of access to electronic med records, could easily be abused and used to "classify" a "rebel" as a "threat" and remove their guns. Once that info is in your record, its not leaving.
I don't believe this is so far fetched as to be a tin foil hat conspiracy. I believe this is exactly where THEY are heading.

And BTW, how is seat belt use related to health?
What about whether I prefer to write with a pencil or pen? Does that affect my blood pressure, too?

If this is his first involvement with a mental health professional where his thoughts/plans of mass murder/suicide have been discussed, he may be able to perfectly legally purchase a firearm.

Curious, if you do not decide to an involuntary commit (which I'm assuming leaves a mark on your record preventing you from passing the background check, correct me if I'm wrong), what CAN you do that would leave such a mark? And should you do so?

I'd say yes, myself. But I'm not a professional, I have no idea how many of these sorts of crazy folks are out there that never harm anyone.

Question for others? Do crazy dangerous people have the same 2A rights we do? Shall not be infringed? Crazy dangerous people have the right to defend themselves too?

Half in jest I ask, do drunk people have the right to defend themselves via the 2A also? The condemnation of carrying a firearm while under the influence is fairly universal, does a beer or two invalidate their 2A rights? If the answer is no because they are temporarily mentally impaired, how would that differ from the scenario above where the patient is mentally impaired for an unknown duration from an unknown cause, and possibly not their fault?

Randy

Does HIPPA prevent releasing private info to the govt, or just to other people/private agencies?

Just sayin, its pretty rare that the govt passes laws that apply to it... :upeyes:

Randy

Seems I am in good company.:cheers::cheers:

vikingsoftpaw
01-27-2013, 12:42
G Prior to the Community Mental Health Act, the patient would have been institutionalized at a sanitarium and never gotten out.

racerford
01-27-2013, 13:05
I ask about smoking, drinking, drug use, seatbelt useage, etc. These are all things that affect one's health. Now the debate here is whether or not guns fall into that territory. I don't think they do. Nor do the majority of people. I think we should remind ourselves that none of the events that have transpired with executive order command people to do anything or punish anyone for not doing anything. It was a reminder and a backhanded way of the president telling docs he thinks it's a good idea for us to ask.

Doctors don't like to be told by anyone especially the government how to practice medicine. This is an overextension of the gov't. Patients only have to say no or I don't wish to answer. No big deal needs to be made of this. If it becomes law, then it's a different story.

Do you ask about seatbelt usage if they come in with a cold? If so, why would you?

If you think it is safer for people to where seat blts do, ask them if they use them. Tell them it is safer. Ask they if they are aware that is safer to use them. They is no need to ask them if they use seat belts. If they come in from a car crash, then it might be medically relevent to ask if they were wearing a seat belt as it might be a reason to check for internal injuries to the area covered by a belt. Or it might explain that hip and abdominal bruising. If they wereon a motorcylcle in the crash would you ask if they wear seat belts when in a car? If so, why.

As to guns, If a person has a child, there is no reason to ask if they have guns. Just tell them that IF they guns, poisons, knives, etc, they should secure them from the children. It is that simple, no need to ask about the types posseesions they have.

If you prescribe a patient Fentanyl, you should tell all of them that the medicine should be secured from children and other irresponsible people. This sort of thing is at least as important as random questions about guns. I read a story about a woman given her 8-year old child a Fentanyl patch for a headache. The child died. There are plenty of dangers in the home. Doctors should be much more concerned about the dangers THEY are introducing into the home than the ones they have nothing to do with.

RussP
01-27-2013, 13:21
I see HIPAA evaporating incrementally in favor of federal funding.How so?The "affordable health care act" most certainly guarantees this.Again, how will .gov tie what funding to HIPAA's mandate of patient confidentiality?For proof of this idea, just look to highway funding. If certain things (mandated) are not followed, no highway funding. There are also several other areas where this concept applies too.Sure, schools are a blatant example.To not see this makes one naive or inexperienced is how I see it and what I am saying.No doubt many, many people have no knowledge of what the .gov ties to its benevolence. Many, many others don't care as long as they get theirs.The second amendment has been targeted for longer than most of us have been alive. The Second Amendment is a God-given birth right in this Country. It is eroding away. Russ do you really think a little rule like HIPAA will stand in the way of continued erosion of the second amendment?I would suggest you read up a bit on the HIPAA regulations and the exceptions available based on need for the information and the requirements to actually access records.Checking blocks on a form can be done by the Dr, then simply reported later by other staff members-could it not? Would this not bring the Dr into the chain of events violating HIPAA?Into the chain of events, yes, but liability for violating HIPAA by unauthorized dissemination of information, depends on the doctors part in actually ordering or allowing the release of the information.

RussP
01-27-2013, 13:29
Also, the fact that gov is paying for healthcare and the ease of access to electronic med records, could easily be abused and used to "classify" a "rebel" as a "threat" and remove their guns. Once that info is in your record, its not leaving.This is the more immediate problem, a big problem. It is the topic of the thread. We need to keep info not related to specific medical treatment out of the records.I don't believe this is so far fetched as to be a tin foil hat conspiracy. I believe this is exactly where THEY are heading.Yes...And BTW, how is seat belt use related to health?
What about whether I prefer to write with a pencil or pen? Does that affect my blood pressure, too?Seat belts, don't know.

Pencil? Depends on how many times the point breaks as to the effect on your blood pressure. :cool:

RussP
01-27-2013, 13:31
Seems I am in good company.:cheers::cheers:Randy? I'm not sure about him...:supergrin:

Donn57
01-27-2013, 16:17
I understand that, but my point is, doctors didn't make the legislation. In fact, I would bet that most doctors oppose this legislation. There are plenty of doctor gun owners. I think that too much is being made of this whole situation. The patient is not required to answer the question either at all or truthfully.

Sorry, but legislation encouraging physicians to ask questions that will result in patients feeling that they have to lie to their doctor is probably not good legislation.

Donn57
01-27-2013, 16:20
A doctor can and should certainly ask about seatbelt usage, wearing a helmet and protective gear on motorcycles etc.

Why is that?

Donn57
01-27-2013, 16:24
I ask about smoking, drinking, drug use, seatbelt useage, etc.

I'll go along with the smoking, drinking, and drug use, but my seat belt usage does not affect my health.

redbaron007
01-28-2013, 08:05
I ask about smoking, drinking, drug use, seatbelt useage, etc. These are all things that affect one's health. Now the debate here is whether or not guns fall into that territory. I don't think they do. Nor do the majority of people. I think we should remind ourselves that none of the events that have transpired with executive order command people to do anything or punish anyone for not doing anything. It was a reminder and a backhanded way of the president telling docs he thinks it's a good idea for us to ask.

Doctors don't like to be told by anyone especially the government how to practice medicine. This is an overextension of the gov't. Patients only have to say no or I don't wish to answer. No big deal needs to be made of this. If it becomes law, then it's a different story.

I appreciate your thoughts on asking about firearms. I can understand all of the underlined being asked, except for seat-belt usage. To me, that falls in the same line of asking about firearms. Again, I am speaking from the point of view of a regular visit to the physician. Perhaps in the ER, some questions may need to be asked...however, I am blank at moment as to why.

The EOs on healthcare that King Obama signed seem to be general enough to be interpreted broadly until they are told it is not appropriate to ask/share the information. Which is why they are written.....like the shotgun approach, get as much as they can until limited.

But unfortunately, the sheep will follow and swallow until it's too late for them, then they'll scream bloody loud...having no impact.

:wavey:

red

jbotstein1
01-28-2013, 09:23
90% of the patients I deal with in my training are uninsured or Medicaid. If I can educate them on a simple thing such as seat belt usage, when they get into a car wreck, we all will have to pay less for their medical care. Many of you probably don't need that education, but, like it or not, there is an element of paternalism in medicine that is necessary because, unfortunately, most of our patients are not responsible for themselves.

And, yes, these questions should be asked at every visit. Most of the patients I see only come to the doctor when they have a cold. 50% of my scheduled appointments are no-shows.


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racerford
01-28-2013, 09:37
90% of the patients I deal with in my training are uninsured or Medicaid. If I can educate them on a simple thing such as seat belt usage, when they get into a car wreck, we all will have to pay less for their medical care. Many of you probably don't need that education, but, like it or not, there is an element of paternalism in medicine that is necessary because, unfortunately, most of our patients are not responsible for themselves.

And, yes, these questions should be asked at every visit. Most of the patients I see only come to the doctor when they have a cold. 50% of my scheduled appointments are no-shows.


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Again, questions do not need to be asked. If you think it is important that they wear seat belts, just inform them. You mentioned paternalism. Parents don't ask their children the right thing to do, when they are not responsible in their own behavior, they tell them the right thing to do.

You may have selected the right profession. You appear to have a god complex. These are adults you are dealing with; unless they have diminished capacity they should be treated as adults, not children. You are not their father.

Darkangel1846
01-28-2013, 09:58
Its easy...when a Phy. ask about you owning a handgun just respond "That is none of your business Doc!"

pizza_pablo
01-28-2013, 09:59
Hey Doc, maybe if you didn't tell the takers how to be safe, the Darwin effect would lessen the burden on the makers.

redbaron007
01-28-2013, 12:06
90% of the patients I deal with in my training are uninsured or Medicaid. If I can educate them on a simple thing such as seat belt usage, when they get into a car wreck, we all will have to pay less for their medical care. Many of you probably don't need that education, but, like it or not, there is an element of paternalism in medicine that is necessary because, unfortunately, most of our patients are not responsible for themselves.

And, yes, these questions should be asked at every visit. Most of the patients I see only come to the doctor when they have a cold. 50% of my scheduled appointments are no-shows.


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Do you record this 'education moment' in their medical records?

I really don't understand the education issue, because in most states it's required. If they drive, they know to use the seat belts and know the consequences. This dove-tails with a firearms 'educational moment'. Would you note it in their medical file?

Please don't misunderstand my questions, they are not to challenge you, but are in regards to the general physician community handling this issue.


:wavey:

red

jbotstein1
01-28-2013, 12:27
Anything you discuss with a patient should be documented. If its not, you can later be held accountable. Most of what is done nowadays is on the basis of covering your rear. Often times, we see things as being common sense, but you would be surprised by the amount of ignorance we deal with daily. Smoking cessation, for instance. Despite the widespread knowledge of smokings deleterious effects, people still choose to smoke. There are warnings on the pack, there are a thousand crutches to help with quitting, but people continue to smoke. I have many people who have quit after being admitted for pneumonia and me showing them the emphysematous changes seen on their ct scan.

Call it a god complex if you want, but those of us who understand the current status of healthcare realize that we are in a pool with a lot of uneducated ignorant people. Their health determines and affects the availability to and quality of the healthcare we receive. If i can convince someone to quit smoking or wear their seatbelt I'm going to try and it, and being a physician gives me a platform from which to speak that people often listen to. If that's a god complex, so be it. I'm trying to do my part. What are you doing? Other than calling names that is.


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RussP
01-28-2013, 12:28
I understand that, but my point is, doctors didn't make the legislation. In fact, I would bet that most doctors oppose this legislation. There are plenty of doctor gun owners. I think that too much is being made of this whole situation. The patient is not required to answer the question either at all or truthfully.Sorry, but legislation encouraging physicians to ask questions that will result in patients feeling that they have to lie to their doctor is probably not good legislation.Like the doc said, there will be those doctors who do not like and will not yield to suggestive, suggestive legislation, just like the patient not yielding, giving in and answering the questions.

RussP
01-28-2013, 13:10
Again, questions do not need to be asked. If you think it is important that they wear seat belts, just inform them. You mentioned paternalism. Parents don't ask their children the right thing to do, when they are not responsible in their own behavior, they tell them the right thing to do.

You may have selected the right profession. You appear to have a god complex. These are adults you are dealing with; unless they have diminished capacity they should be treated as adults, not children. You are not their father.Call it a god complex if you want, but those of us who understand the current status of healthcare realize that we are in a pool with a lot of uneducated ignorant people. Their health determines and affects the availability to and quality of the healthcare we receive. If i can convince someone to quit smoking or wear their seatbelt I'm going to try and it, and being a physician gives me a platform from which to speak that people often listen to. If that's a god complex, so be it. I'm trying to do my part. What are you doing? Other than calling names that is.[/URL]Don't know many doctors with a god complex, racerford?

Paternal, maternal methods of treatment are not the traits of a god complex.

Wielding a parental attitude over an adult patient, depending on the circumstances, yeah, could be interpreted as god-complex like. BUT, there is a difference between paternal and parental.

Didn't your parents ever ask you, "Do you think that is the right thing/wrong thing to do?" Mine did. My chances were in the beginning 50-50, yes or no. As I learned right from wrong, my answers were guided by past experience.

In medicine, the practice of the healing arts, patients do present less than adult like behavior. They do not need to have diminished mental capacity. They throw temper tantrums. They lie about how they feel. They lie about personal habits related to their complaint. They exaggerate for sympathy. They cry crocodile tears for sympathy. They admit to symptoms that in no way can be related to their original complaint. That was just during my last visit to the ER.

True, doc here is not their father. However, he is the one they come to for making the pain go away, the boo-boo go away, whatever they complaint, he's obligated to sift through the childlike behaviors to determine the problem and fix it.

Doctors with god complexes are dictators. They generally surround themselves with a few other doctors who worship and desire that god-like recognition. But, before the patient can be seen by the top dogs, there is a level of physicians who dig through the BS, diagnose the problem, order the tests, scans, etc., which are presented to the god-like wannabes who pass "their diagnosis" to god-doc.

I believe jbotstein1 will be in that level of physicians. I believe he will avoid the god-like road. I hope he never even steps on that path.

jbotstein1, am I wrong? Did I leave anything out?

jbotstein1
01-28-2013, 13:55
I don't know. I just think racer ford has is definition of a god complex wrong. A surgeon claiming that he can cure all pancreatic cancer might have a god complex. A cardiologist on a streak of 20 successful Caths that saved a persons life who had an mi might have a god complex. A physician telling someone that they should stop smoking and should wear a seatbelt, in my mind, doesn't have a god complex, but an inclination to try to help someone. Trying to spin that into a negative is ludicrous IMO.


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fwm
01-28-2013, 14:21
I hope I don't tick anyone off here, but this doesn't really bother me. I mean, if a doctor asks me if I have firearms, I would just tell him the truth. What will they really do with that information? Correct me if I'm wrong here, honesty, I am open to constructive criticism. Its just that I am a law abiding citizen and a legal gun owner. So this doesn't bother me. Plus, if he wants to find out if I have guns he can just log on to glocktalk and look at my signature block, lol.

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Under the Obamacare laws, ALL medical records are available to the government. My small doctors office has been forced to spend nearly a million dollars to buy equipment and data entry personnel to put their patients on a government compatible system. It wouldn't take me 20 minutes to write a program that could continually search the databases for positive gun ownership answers, so I have to assume the Government already has one written. THAT'S why.

ETA: My doctor gave me permission and encourages me to carry concealed in the clinic, despite the no-gun sign on the door. (Legal to do in my state) It adds to his defense response power.

racerford
01-28-2013, 14:24
Don't know many doctors with a god complex, racerford?

Paternal, maternal methods of treatment are not the traits of a god complex.

Wielding a parental attitude over an adult patient, depending on the circumstances, yeah, could be interpreted as god-complex like. BUT, there is a difference between paternal and parental.

Didn't your parents ever ask you, "Do you think that is the right thing/wrong thing to do?" Mine did. My chances were in the beginning 50-50, yes or no. As I learned right from wrong, my answers were guided by past experience.

In medicine, the practice of the healing arts, patients do present less than adult like behavior. They do not need to have diminished mental capacity. They throw temper tantrums. They lie about how they feel. They lie about personal habits related to their complaint. They exaggerate for sympathy. They cry crocodile tears for sympathy. They admit to symptoms that in no way can be related to their original complaint. That was just during my last visit to the ER.

True, doc here is not their father. However, he is the one they come to for making the pain go away, the boo-boo go away, whatever they complaint, he's obligated to sift through the childlike behaviors to determine the problem and fix it.

Doctors with god complexes are dictators. They generally surround themselves with a few other doctors who worship and desire that god-like recognition. But, before the patient can be seen by the top dogs, there is a level of physicians who dig through the BS, diagnose the problem, order the tests, scans, etc., which are presented to the god-like wannabes who pass "their diagnosis" to god-doc.

I believe jbotstein1 will be in that level of physicians. I believe he will avoid the god-like road. I hope he never even steps on that path.

jbotstein1, am I wrong? Did I leave anything out?

Paternal = fatherly = parental just how are they different. Perhaps god complex is a bit strong.

The issue is why does it have to be a question, rather than a statement. A statement would be recorded as:

" reminded patient that they should wear seat belts, safely store medicines, poisons, kives, guns or any other dangerouos objects they may have".

A question is recorded as:
"asked patients if they had guns in their home. they responded they had 6 guns. I informed them that they should be secured from children and other irresponsible people".

Do you not understand the difference that makes in a permanent medical record accessible by others? What did the asking achieve beyond the telling in informing this person that guns should be stored safely away from people that shouldn't have access?

It is none of your business if the aptient has 1 gun or 100 hundred unless from other questions you determine I am immediate risk to myself or others. Even, then it should not matter, I should be detain for evaluation. If the patient says "no", do you not tell them to safely store guns, when you know full well that many patients will lie to you. Don't you see asking if they have guns in the home doesn't cover your butt any more than just telling them about safe storage of guns. Every patient should know about gun safety, even if they don't have a gun in their home. They may encounter one somewhere else. They don't encourage you to have your children learn to swim only if you have a pool. They encourage you to teach regardless, in case they encounter water someplace that is deep enough where swimming is needed. Like if they cross a bridge over water.

The is no general need to ask about guns, just telling is enough and avoids recording, forever, the private possessions of someone else. Does you ask about kinves? ropes? bath tubs? Do ask abot ALL of the things in their home that are more likely than guns to rsult in an accidental injury or death. If not, there are more effective question you need to ask to protect the health of your patients.

To answer, I don't know many "god complex" doctors because I do not tolerate that behavior in my physicians. I have the right to ask questions about my treatment and expect to get answered like an adult.

redbaron007
01-28-2013, 14:55
Anything you discuss with a patient should be documented. If its not, you can later be held accountable. Most of what is done nowadays is on the basis of covering your rear. Often times, we see things as being common sense, but you would be surprised by the amount of ignorance we deal with daily. Smoking cessation, for instance. Despite the widespread knowledge of smokings deleterious effects, people still choose to smoke. There are warnings on the pack, there are a thousand crutches to help with quitting, but people continue to smoke. I have many people who have quit after being admitted for pneumonia and me showing them the emphysematous changes seen on their ct scan.

Call it a god complex if you want, but those of us who understand the current status of healthcare realize that we are in a pool with a lot of uneducated ignorant people. Their health determines and affects the availability to and quality of the healthcare we receive. If i can convince someone to quit smoking or wear their seatbelt I'm going to try and it, and being a physician gives me a platform from which to speak that people often listen to. If that's a god complex, so be it. I'm trying to do my part. What are you doing? Other than calling names that is.


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The underlined is why I have the problem with this line of questioning by a physician. It is now in a record that is accessible and can be used against you. In civil litigation, this can be discovered. Now, with Obamacare and the EOs recently established....it opens that door for more to have access, leading to more potential abuse by local, State or even Federal authorities.

I'm fine with you having educational conversations, the problem is now you (physicians in general) are collecting data.....which opens the doors for accessing the medical records for more than just medical consultations.

Under the Obamacare laws, ALL medical records are available to the government. My small doctors office has been forced to spend nearly a million dollars to buy equipment and data entry personnel to put their patients on a government compatible system. It wouldn't take me 20 minutes to write a program that could continually search the databases for positive gun ownership answers, so I have to assume the Government already has one written. THAT'S why.


My concern.

:wavey:

red

jbotstein1
01-28-2013, 15:19
Understood.


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igor
01-28-2013, 15:26
a while ago i had my docs new pa ask the question . really new. i was still an active deputy at that point. being the smartass that i can be i handed her a business card and said read it. whe wanted me to take off my polo shirt and then i said just to let you know i have my of f duty weapon handcuffs extra ammo a badge on my belt.i dont want you to freak put. she l;eft and told my dr what i said he laughed and said i sure hope so. thats his job. he said to not worry about the form all active police officers are armed as well as retired ones. no one has even asked me again

Southswede
01-28-2013, 15:37
Under the Obamacare laws, ALL medical records are available to the government. My small doctors office has been forced to spend nearly a million dollars to buy equipment and data entry personnel to put their patients on a government compatible system. It wouldn't take me 20 minutes to write a program that could continually search the databases for positive gun ownership answers, so I have to assume the Government already has one written. THAT'S why.

ETA: My doctor gave me permission and encourages me to carry concealed in the clinic, despite the no-gun sign on the door. (Legal to do in my state) It adds to his defense response power.

And yet posters believe HIPPA won't allow this.......:faint::faint:

pizza_pablo
01-28-2013, 17:22
And yet posters believe HIPPA won't allow this.......:faint::faint:

Doc's building, Doc's rules....right? :supergrin: (in reference to the gun carrying)

RussP
01-28-2013, 17:52
To answer, I don't know many "god complex" doctors because I do not tolerate that behavior in my physicians. I have the right to ask questions about my treatment and expect to get answered like an adult.How many doctors have you left because of their behavior?

RussP
01-28-2013, 17:55
And yet posters believe HIPPA won't allow this.......:faint::faint:No doubt, HIPAA will not prevent .gov from having access.

racerford
01-28-2013, 20:43
How many doctors have you left because of their behavior?

Two doctors.

Southswede
01-29-2013, 05:03
How many doctors have you left because of their behavior?

Several! And for a variety of reasons.

dereklord
01-29-2013, 13:35
Under the Obamacare laws, ALL medical records are available to the government. My small doctors office has been forced to spend nearly a million dollars to buy equipment and data entry personnel to put their patients on a government compatible system. It wouldn't take me 20 minutes to write a program that could continually search the databases for positive gun ownership answers, so I have to assume the Government already has one written. THAT'S why.

ETA: My doctor gave me permission and encourages me to carry concealed in the clinic, despite the no-gun sign on the door. (Legal to do in my state) It adds to his defense response power.

So, judging by this, your doc already knows that you carry, and that you own firearms? Well, looks like one more person off the list of people who should care whether their doc asks them about gun ownership.

And I still don't see how this response answered my question. It is just information about how medical records are essentially going electronic and are accessible to the gov. Yet another thing that doesn't bother me. Exactly what will they do when they find out that I have a few handguns and rifles? Arrest me? Come take them? tax me on them? When those things become an issue, maybe that is when I will get my feathers ruffled, but not now. Again, I may be naive, or under-informed, so if anyone can guide me in the proper direction here, I would appreciate it. Otherwise, I think I will just continue watching the entertainment and mass hysteria from in front of my computer screen :supergrin:

pizza_pablo
01-30-2013, 22:44
Exactly what will they do when they find out that I have a few handguns and rifles? Arrest me? Come take them? tax me on them? When those things become an issue, maybe that is when I will get my feathers ruffled, but not now. Again, I may be naive, or under-informed, so if anyone can guide me in the proper direction here, I would appreciate it. Otherwise, I think I will just continue watching the entertainment and mass hysteria from in front of my computer screen :supergrin:

I reckon that's what the folks in New York thought, a few months ago.

Gunnut 45/454
01-30-2013, 23:37
jbotstein1
Wow your a real good Obamatron! Well programed to do the bidding of your master excuse me Messiah!:rofl:

RussP
01-31-2013, 07:55
jbotstein1
Wow your a real good Obamatron! Well programed to do the bidding of your master excuse me Messiah!:rofl:Where did you stop reading, Gunnut?I'm an MD. Let's say I had a friend who was moonlighting at a mental hospital recently and he accepted a transfer of a patient from a local ER. The patient was a young man (late 20s) who was sent there because of having troubling thoughts and hearing voices. He had never been diagnosed with any psychiatric illness. As my friend was obtaining the history of present illness, the patient was very calm and obviously upset about the thoughts he'd been having. He'd had thoughts of killing himself. He'd had thoughts of killing others. My friend asked if he had actually hurt others before and he said no. He asked if he had thought about mass shootings and harming many people and he said yes. My friend asked if he had thought about stuff like going to a school etc. and the patient said he had. When asked why, the patient said it was merely because he didn't care. This patient had been in prison before. He said that he had killed mice who were chased into his cell by tying a string around their neck and drowning them in the toilet.

As a physician, you come across many patients who may be "off" and some patients who are downright "crazy". Let's saymy friend said this guy was eery in the fact that he knew his thoughts were wrong, but he didn't care and seemed to be completely calm about the situation.


So, to all you saying MDs should mind their own business, how would you have handled this situation further? (realistically of course)
A. Prescribe some Zyprexa and go to bed
B. Call the police immediately
C. Pull out your sidearm and save society from having to deal with this guy later
D. Ask about whether or not he had access to firearms
E. Insert your own answer hereDid you stop reading here?I would also like to compare my previous post to a person who comes into the ER with a cough productive of blood tinged sputum, night sweats, and was born and raised in Mexico. His quantiferon gold test comes back postiive for TB. His chest xray has findings consistent with granulomas. The patient refuses to stay in the hospital and tries to leave.

Now, by law, it is my responsibility as a physician, to restrain that person and prevent them from leaving. They are putting the rest of society at risk. Compare that situation to my previous post. How do they differ?

I'm not stating my opinions, I just want to hear how others view these situations. I have found that when you aren't aware of many situations encountered in other professions, it is hard for you to understand the reasoning for some of the rules that have been put in place.

Discuss.Or, was it after reading that?If the patient has a plan to carry out his thoughts, it would be at the physicians discretion to determine if he/she thought a call to the authorities was appropriate.

What if this patient had no access to firearms? What if he said he had no plan to carry out these thoughts? Is it my responsibility to ask if he has a gun? Is that somehow infringing on his 2A right? Is it overstepping my bounds?

I think the terminology is if the patient is posing an imminent threat to themselves or others, then I can sign an order to restrain them involuntarily.Was it here?I understand that, but my point is, doctors didn't make the legislation. In fact, I would bet that most doctors oppose this legislation. There are plenty of doctor gun owners. I think that too much is being made of this whole situation. The patient is not required to answer the question either at all or truthfully.

And I know that my example is an extreme, but I was making a point that there are clear cut examples when it would be relevant to ask.Possibly here?I didn't think it was mandated in the executive order. I just thought that the executive order said as follows :


"Release a letter to health care providers clarifying that no federal law prohibits them from reporting threats of violence to law enforcement authorities"

"Clarify that the Affordable Care Act does not prohibit doctors asking their patients about guns in their homes"

"Release a letter to state health officials clarifying the scope of mental health services that Medicaid plans must cover"How about here?It just puts the ball in the docs court. It says, if your clinical judgement thinks it is relevant whether or not this patient owns a gun, you're not prohibited from asking. I thought it was just a buncha lip service from Obama that really had no relevance, and now a bunch of people are all up in arms about it.Maybe there?Possibly. I guess one could worry that having this information documented in yet another place would make it easier for the gov't to find said information, but I don't think it would be legal unless they made everyone's medical information public knowledge, which would be a huge deal obviously.Yeah, could it be there?A doctor can and should certainly ask about seatbelt usage, wearing a helmet and protective gear on motorcycles etc.

And just to clarify, I don't ask my patients about guns, nor will I ever (I'm going into radiology :) )I see. In that case, I agree 100%! :cool:Did you read that part where the doctor said he never would ask about guns?I ask about smoking, drinking, drug use, seatbelt useage, etc. These are all things that affect one's health. Now the debate here is whether or not guns fall into that territory. I don't think they do. Nor do the majority of people. I think we should remind ourselves that none of the events that have transpired with executive order command people to do anything or punish anyone for not doing anything. It was a reminder and a backhanded way of the president telling docs he thinks it's a good idea for us to ask.

Doctors don't like to be told by anyone especially the government how to practice medicine. This is an overextension of the gov't. Patients only have to say no or I don't wish to answer. No big deal needs to be made of this. If it becomes law, then it's a different story.Did you get that far, Gunnut? Or did you read it and dismiss any of the doc's comment that didn't fit your likings?

It is crazy how some people treat those talking about contentious issues, who explain their position, who state that they are on the Second Amendment side.

It is getting pathetic, people.

Do we not need more doctors who "Say NO to Obama"?

SCmasterblaster
01-31-2013, 08:11
I wonder how many doctors ask if a patient has a swimming pool?

redbaron007
01-31-2013, 08:15
I wonder how many doctors ask if a patient has a swimming pool?
^^^
This.

How many ask about having childproof locks on cabinet doors containing cleaning supplies? :whistling:

:wavey:

red

jbotstein1
01-31-2013, 08:37
jbotstein1
Wow your a real good Obamatron! Well programed to do the bidding of your master excuse me Messiah!:rofl:

Malfunction. Cannot compute.


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jbotstein1
01-31-2013, 08:39
I think pediatricians are supposed to ask about pools etc.


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jbotstein1
01-31-2013, 08:41
I think pediatricians are supposed to ask about pools etc.




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SCmasterblaster
01-31-2013, 08:55
^^^
This.

How many ask about having childproof locks on cabinet doors containing cleaning supplies? :whistling:

:wavey:

red

So true. Cleaning supplies are full of poisons.