America Docs suck!

Not sure I want to enter the political debate, but I have pointed out in these forms before that my doctor DOES NOT perform a genital exam as part of my physical. He does perform a digital rectal exam.

Why? I couldn't help but notice that on the insurance EOB, there is a separate payment for the DRE because it includes the check for occult blood. There is no separate "fee" for a genital exam, it is part of the physical. So I have to bare my butt and get probed so the doctor can add an extra procedure to the physical, but the family jewels go untouched.

I have to agree about the prudishness. I had a problem with my penis swelling a year ago. When my doctor "examined" it he never even touched me at all to palpate - just looked at it briefly.

I agree about the prudishness. Our family doctor doesn't examine my genitals or do a rectal exam at all anymore. Does blood work, asks for a urine sample, heart, lungs and that's about it. I couldn't figure out why I even had to undress the last time I went for my annual physical. I had a urinary infection a few months ago and he didn't even examine me--he prescribed amoxicillin and said call him if it didn't clear up.

Physicians are so over-worked anymore, they are not taking the time to do proper examinations any more--and that's putting the fetish thing aside, in my opinion. Take a look at some of the older urology videos and the exams on there. My urologist doesn't come CLOSE to an exam that detailed---that exam was filmed in 1965. Doctors today get you in--and out--as quickly as possible. They don't spend the time with patients like they used to.

I am not sure that it is necessarily prudishness on the part of the doctor as much as a fear that some patient is going to claim they crossed the line of "modesty" and call the first available television lawyer on them. I do think it has slowly become epidemic in the medical profession. My wife and I really like our family physician of over 15 years but we have even noticed it with her. As I wrote about at a different time here, my wife had not gone to a gynecologist for over four years and had not had a pelvic exam or pap smear in all that time. Yet we were seeing our family doctor several times a year and it was only when I mentioned this fact to the doctor, did she perform one right then and there - much to my wife's displeasure. It has been going on three years since I stopped going to a urologist that I have had a prostate exam and I am in my upper 50's and I see our family doctor at least twice a year and she hasn't checked below the waist for at least five years on me. Yes, it is up to the patient to take charge of their own healthcare and I won't let it go much longer before saying something, but I do believe the doctors want to address only the immediate problems that patients present and avoid creating what they perceive as an embarrassing situation for the patient, even if it is for the patients own good.

I agree with Mr Peacock, and I also believe that malpractice lawsuits probably have a lot to do with it as well. Doctors are afraid to do proper exams unless the patient asks for it---and that's putting modesty aside. Our family physician has a female physician's assistant under him, and they already have an agreement that she does physicals on ONLY females and he does physicals ONLY on males. I asked her if I could make an app't with her for a physical the last time I had an appt with her and she refused, saying that she only did physicals on females. The fear or being sued is pretty evident.

Here in the USA the medical professional is your employee.

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Don´t want to be pedantic, but don´t you mean that you hire a medical professional´s time and expertise. You do not actually hire them as blue or white collar workers are hired ... being an employee encompasses a whole different set of responsibilities from an employer.

All people do when going to a doctor is pay for the doctor´s time time and expertise, maybe pay for certain procedures and their associated costs. But the legal relationship regarding payment does not go beyond that. You are not obligated to pay severance pay, medical insurance, provide vacation time and all the other myriad things and benefits that employees are entitled to.

That should mean that you cannot actually boss a doctor around and command him to do this or that. Obviously you can refuse to pay, but that is a different level of compulsion than happens when you fire someone from a full time job and take away his means of livelihood. When you refuse to pay a doctor (or do not come back again) because he refuses to do as you demand, then all he is loosing is a sale, much like in a store.

That is something completely different.

Maybe it is simpler understood when it is put this way.

A doctor, lawyer, notary etc is paid a fee. Employees are paid a salary. And a salary implies that the employee is constantly employed at an agreed upon number of hours per week or month or whatever. A fee covers a specific thing such as giving advice, performing a specific service and so on ...

And it might be useful to remember that just because you pay someone money, that said person is not at your beck and call. It´s perhaps a moral matter, but when you pay someone a fee it is a transaction between more or less equals. You don´t get to say ´the customer is always right´ when you pay someone a fee for a service.

Besides, a professional like a doctor is legally prohibited from treating someone for a disease or condition they do not really have. You cannot ask for a tetanus shot for instance and just get one on demand just because you are into injections. Nor can you hire a doctor to give you a colonoscopy just because you´d like to get one. There has to be a valid reason for what a doctor does.

Of course you can lie about symptoms and make things up, but that is something else altogether.

I am beyond shocked at your statement Andrea. What the heck are you thinking? In one short sentence you have just managed to undermine everything we TRUE medical professionals have been fighting for. Are you freaking serious?

To be one's employee, it would mean that you the boss are in complete charge of said medical professional, that you make the rules, decide when we take breaks, lunch, pay for our insurance, provide our other benefits, and pay into our unemployment and social security, along with a slue of other things.

You can trust me when I tell you, our patients are NOT in any way shape or form our boss. Patients are and need to in fact be in charge of themselves, and some can't even do that right. You hire us to do a job, but again, that doesn't make you our boss. An employee has to do what the boss says, again, trust me, we medical professionals do not ever have to do what our patients say.

Our boss is the law and our governing boards. It is them who dictate what we do, how we do it and why we do it. We are like independant contractors, you can hire us to do a job, and if you don't like the job we are doing then fire us, but that no way implies you are going to tell us how to do our jobs. You are not at all qualified to do so.

While I can't and won't speak for the other medical professionals on this site, I for one have worked real hard at educating and imforming the public about the realities of health care in this country and it's medical professionals. I will be the first one on here to admit that I am one kinky bitch, but I'm also a real nurse and play is play and work is work, we don't mix them. I educate about respect, and the importance of our time and how it's never enough to care for those who are really sick and need it, in other words, don't waste our time trying to fulfill your fantasies. And probably the most important thing I ever talk about is how bad the medical professionals are treated here, over worked, under paid. The family doc's are being forced to see one patient every 5 minutes just to survive and pay the bills. Doctors and nurses are quitting because patients are demanding things from us we can't provide. Our patients turn right around and sell their medications on the street to buy crack, then wonder why we dismiss them from the practice.

And that last statement is what brings me to my last and final point on exactly how and why we TRUE medical professionals are NOT your employees. We medical professionals can and will and do FIRE our patients. There are no laws that say we have to provide you with care outside of a true life threatening emergent situation. If you push us, abuse us, disrespect us or we just don't like you, we can Fire you and kick you out of our practice. Now, if you were our boss, we wouldn't be able to fire you now could we?

Just sayin........

Mashie

I think this exchange is out of hand. Here in the United States, we enjoy the finest Medical System in the world. Our physicians, and nurses, are the highest trained and they practise is the best of facilities; somewhat correlated with population centers in that the greater the population, the higher the probability of a teaching university which is where the finest care is delivered. Employess of us? I do not think so. The term employee denotes a master/servent relationship which does not apply to the patient/physican relationship.

Like Mashie said, It's an independent contractor situation. Jut like your plumber an electrician. If either party wants out of the relationship, they are free to do so.

Mashie, let me ask you an analogous situation. What would you say about a police officer who doesn't want to respond to a domestic violence call when it's the third time in a year that he's been to thy house. Should he be allowed to "fire" the woman because she won't listen to him when he says she needs to get out of that relationship? What happens sometimes with domestic violence calls is that the woman decides not to press charges and sometimes, even attacks the police officer herself if the officer tries to arrest a man. Should a police officer be allowed to "fire" that woman and no longer respond to her calls?

Mashie, people "fire" their bosses all the time. It's just usually called, "quitting your job.". Lol

Brad, the answer to your question is no, police are a totally different situation. Why you ask, it's simple really. Police are public servents. They are provided and paid for by our tax dollars. They can't pick and choose who they serve (for the most part) because again, the entire community pays for their services. It's the same for doctors and nurses in non-private hospitals. Their paychecks come from government funded sources. Family practice and or private practice docs and other various medical professionals are not government funded, or locally funded, so it is their right to pick who they want to treat.

So no, it's not even close to the same situation.

Mashie

If a person attacks a police officer, that is usually treated as a serious offence - that is what happens.

Depending on circumstances an investigating authority (DA in the US - investigative judge in many European countries) will decide to press charges or not, or add them to already existing charges ...

Since many people in such circumstances are often distraught, upset or emotionally out of control, in most civilized countries this is taken into consideration when judging if charges should be filed or not ... even so, you shouldn´t think that officers of the law can be attacked and/or injured with impunity. This is taken far more seriously than you imply. Citizens do not have a free pass to attack police officers.

Don't get me started with cops in this thread.

For the most part THEY SUCK and have no place in "domestic violence."

If it happens between a couple, that's their problem,they should solve it some way, and the police should stay the hell out of it. Most of those complaint calls are fraught with false statements and lies. The fact is who ever calls first, usually the woman, gets the cops on their side. If the man calls first, he gets the support of the cops, but the man rarely calls first.

Okay, the purpose of this thread was: Let's face it America has gotten too prissy about medical taboo, Bring back the rectal temps for everyone young and old, make and give suppositories for all medication or at least the option, Bring back the large volume enemas, and get everyone use to getting injections in the ass not just the arm.

For me I think it's a combo of what's been said here - the system says to get patients in, check exactly the complaint/problem of the moment, as quickly as possible and move on to the next one to see as many people as possible. And yes, is partly from fear of litigation. It's also a change in attitude about how much of ourselves to reveal to the doctor, which is hilarious when you look at fashions these days - the outfits women are almost wearing - and what we watch from Hollywood. For me, I just don't like how I look and prefer to keep as much of me covered as possible, even though I DO like rectal temps and if I have to get a shot would rather have it in my backside.

*reels the conversation back to topic and ties off the slack*

Chester wrote: "*reels the conversation back to topic and ties off the slack*"

Nicely done, too.

A forum I used to frequent had a useful device one could post on a thread; it was a little cartoon figure (with a serious expression on its face) carrying a placard bearing the words "OFF TOPIC!". I sometimes think we could do with having that option here.

Mashie,

I didn't realize we were talking about private practice specifically. I was thinkong about public hospitals. Yeah, that makes total sense and I agree wih you.

Susie,

I agree with what you said. Generally speaking, the one who calls is the one who gets believed.

Chester,

I will now bring my post back on topic. I think you are basing your statements more on your fetish than reality. One of the points of technological progress in medicine is to make it easier on patients. For example, it is known in GI medicine that people won't go for colonoscopies because of embarrassment or the discomfort factor. Now they have virtual colonoscopies and that pill camera. So, are you saying medicine should bring back rectal temps and make them mandatory or bring them back only if the patient wants?

I'm not saying anything about bringing back rectal temps, and I really don't have much of a medical fetish. I don't like going to the doctor at all, much less get turned on by going, and I tried a little bit of playing here with someone and did not like it. I simply commented that I like rectal temps.

It's OTHER members here, including the one who started this thread, who want rectal temps to be the standard at the real doctors' offices. I see no reason to have that done in an office visit unless a medical condition at the moment warrants it.

Okay, the purpose of this thread was: Let's face it America has gotten too prissy about medical taboo,

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I have a feeling that a secondary undercurrent of this thread is the feeling that seems to be so prevalent today, that just because you pay for something, it gives you control over who accepts payment. That paying someone means entitlement, that people should be at your beck and call and do things as you wish them to be. Just because you pay them a fee ...

The customer is not always right ... or in this case, a patient who mistakenly thinks himself a customer when going to a doctor or for medical treatment ...

There is a wonderful commercial for an OTC gastric acid med --- and I hate medical commercials in general --- where the doctor substitutes for her patient in a string quartet and another for his patient as a relief pitcher. It asks "if you wouldn't want your doctor to do your job, why do you do his, or hers?". No we shouldn't try to tell our docs what to do just because we (or our insurance company) is paying the bill. But we do know how our bodies ought to feel and we are justified in complaining when our doctors do not take the time to listen to us and hear what we are saying. Lack of (or poor) communication is a MAJOR cause of malpractice suits.

Chester,

Gotcha, makes sense, thanks for explaining.

Agracier,

I never really bought into the customer is always right belief either in any situation. Good call.

Srg,

Those are funny commercials, lol.

To Chester:

Thanks for bringing things back to the topic at hand

To Mashie:

Great insight from a medical providers perspective