Tuesday, April 6, 2010

If You Feed Your Toilet Paper UNDER the Roll, Please Seek Care Elsewhere

Dr. Grumpy had a recent post (http://drgrumpyinthehouse.blogspot.com/2010/04/sunday-seriousness.html) about the Florida urologist who posted a sign outside his practice reading "If you voted for Obama... seek urologic care elsewhere." Dr. Grumpy's take was:

"I don't discuss politics with patients. They ask me what I think of the new health care bill, and I give them a generic "We'll see what happens." Divisive discussions aren't good for a doctor-patient relationship."

That's it. That's the only way, plain and simple. Most of the commenters agreed but a few seemed to be on the fence, saying this guy has a right to run his business the way he wants, even though they may not agree with him.

Now, putting aside the fact that this urologist seems woefully misinformed --- like claiming that hospice care will be "cut" but being unable to supply any evidence of that ("I can't tell you exactly what the deal is" he says, when asked) --- I don't buy the suggestion that there's any excuse for this guy at all. Maybe it's not illegal but it is unethical, irresponsible and 100% unprofessional.

In the course of a day we occasionally have patients make comments about the news, current events or whatever, in the course of small talk or conversation. You smile and nod and make some benign remark. It's very wise to stay away from touchy subjects. If someone were to come into my pharmacy and want to engage in loud pontificating about a political viewpoint I did not agree with I would grit my teeth, shut my trap and probably get them out of there as soon as possible, but I would still do my JOB, and I certainly wouldn't tell them not to come back (my employer would take a dim view of that.) It seems to me it's kind of a sacred principle of medicine that people should be able to get medical help from a doctor no matter what their situation. You go to a doctor's office with perhaps some very embarrassing condition and you get non-judgmental HELP. The majority of medical professionals live up to that -- that's what the word 'professional' means. It's the foundation of medicine, isn't it? This Florida guy is just showing himself to be one of the 'bad' doctors if he can't do that.

It's like the cop who deals with a belligerent, abusive drunk and calls him 'sir' the whole time. I admire the hell out of that. It's his job, and he'll do it that way because he respects himself and his profession.

I will never forget when I was a new graduate and was working in the Cardiac Care unit of a hospital, doing chart and med checks. This patient had been admitted who was well known to us --- one of society's cast-offs. He was homeless, obese, had multiple medical problems and was not exactly the most attractive human being you've ever seen, if you get my drift. The med students and residents were tired of him, and here he was back again with some new problem. I sat down and looked at his admission note. The admitting cardiologist had HAND written the most elegant, thorough, organized and complete 5-page note I've ever seen, before or since. I remember thinking, this is the doctor I want. This is the doctor I want advocating for ME. He's going to do his best for this patient, no matter what. Mr. Florida Urologist couldn't even pack this guy's lunch.

In our blog world we often complain and vent about the quirks and weirdness of our jobs and our patients. It's an outlet that everyone needs. But in the end I think most of take it very seriously that we do our jobs for them the same as for anyone else. The day I stop doing that is the day I KNOW I'm finished.

I only hope another urologist arrives in the area and posts a sign on his door that says "I'm a doctor, come and see me."


Grumpy, M.D. said...

Thank you.

Pharmd Biker said...

Nice post! So, my question is should he lose his license? So many people are calling for his head on a stick.

The Redheaded Pharmacist said...

I heard about this urologist and even told the story to some people at work although I couldn't remember what state he was from at the time. He definately was trying to make a statement. Sometimes I think people just do these kinds of things to get attention. I'm sure his practice has had a lot of extra attention from the media since he put up that sign. I think that with a specialist like a urologist patients can tell him what they think about his sign by making a choice whether or not to go see him or someone else. If there are prospective patients that were upset by that sign the best thing they can do is go to another urologist and give them their business. I think that everyone is on edge lately with regards to politics. The government has made some sweeping changes and there are those that are supporting the change and those that oppose it but it seems to polarize the American public. This is just one more example of how polarizing politics can be for us all. But as a professional you would hope that someone could set aside those personal biases and treat patients regardless of who they voted for in the previous election. But what do I know?

Pharmd Biker said...

as far as i know, it was a statement- nothing else. no one turned away, no one asked political affiliation, no political questions on new patient forms.

Liz said...

Hospice is to be cut under the 500 billion $ Medicare cutbacks.

Stupid place to cut costs. Hospice was also cut last year. No raises in over 1 year, and we hospice nurses work for much less than hospital RN's (which is usually considered to be OK as the job quality is much higher)....