Protecting You From Your Doctor

[Tiassa]

Florida: Because Your Health Is Too Political To Be Trusted To A Doctor

The prevalence of gun violence, the high number of gun-related suicides, the probability of being hurt with your own gun long before you ever stop a home invasion—in truth, it never occurred to me to be suspicious when filling out my medical history paperwork.

My doctor asked about my physical health history. He asked about my mental health history. He asked what medications I use, prescribed or otherwise. He asked what dangerous activities I take part in, whether smoking cigarettes or jumping out of airplanes. He asked if I owned a gun.

Really, it never occurred to me to be suspicious. He's my doctor. I sincerely didn't expect him to turn around and report me to the cops for admitting to being a pothead. So, yeah, why would I be worried if he wanted to know if I had a firearm in the house? It's protected information, and medically relevant.

But Florida Republicans resent the idea that a doctor should know about risk factors in your life. That's why the state legislature has passed as bill that would send a doctor to prison for five years as a punishment for even asking whether a patient owns a gun.


The Orlando Sentinel explains:

The original bill filed by freshmen Rep. Jason Brodeur, R-Sanford, and Sen. Greg Evers, R-Baker, called for punishing doctors with up to five years in prison and a $5,000 fine if they inquired about whether their patients owned guns.

Gun groups have accused doctors of espousing an anti-firearm political agenda, and Evers has said he was pursuing the issue after a complaint from a constituent in his Panhandle district grilled about guns in the home.

“When this goes on in the center and heart of my district, then I have a problem with it,” Evers said. “That’s the reason for the bill, and there’s been some great compromises.”

The Florida Medical Association and other medical groups have said their are many valid reasons for why health-care professionals might need to ask whether a gun was in the home.

And over the session, the bill has been weakened to appease both sides by requiring only that doctors, emergency medical personnel and other health-care providers not enter such information into a database and refrain from asking about gun ownership unless they “in good faith [believe] that this information is relevant to the patient’s medical care or safety, or the safety of others.”

Senate Democrats have said the move was still an infringement on the doctor-patient relationship in order to appease a powerful lobbying group, the National Rifle Association — and would especially single out pediatricians, who would be precluded from asked children about whether their were guns in their homes.

Senate Democratic Leader Nan Rich, D-Weston, accused the FMA of selling out the pediatricians in order to avoid an embarrassing defeat.

“God bless the doctor who is going to ask about those firearms and not feel he has a threshold to supersede before he asked these questions,” said Sen. Maria Sachs, D-Delray.​

Seattle writer David Goldstein noted that "there's nothing more American than seeking to imprison those who espouse a political agenda at odds with one's own".

And yet it would seem that, having been watered down to accept good-faith relevance to a patient's care, the bill becomes absolutely inconsequential except as a mantelpiece tchotchke for gun lobbyists to show off to their friends.

Doctors have been asking about guns for years. Why is this suddenly so important?
____________________

Notes:

DeSlatte, Aaron. "‘Docs v. Glocks’ goes to Governor". Central Florida Political Pulse. April 28, 2011. Blogs.OrlandoSentinel.com. May 1, 2011. http://blogs.orlandosentinel.com/news_politics/2011/04/docs-v-glocks-goes-to-governor.html

Goldy. "Docs v. Glocks". Slog. May 1, 2011. Slog.TheStranger.com. May 1, 2011. http://slog.thestranger.com/slog/archives/2011/05/01/docs-v-glocks

 

[chimpkin]

I've never had any psychiatrist ask me this, and I regularly dip into suicidal ideation!

They know I do, too, because I go there to tell them: "Hey dude, life sucks, please twink with the happy pills, thanks."

I was not aware doctors asked about this stuff. None of mine ever have.

 

[Repo Man]

I've never been asked by any doctor if I kept guns in the house. I think if I were asked, I'd tell them it was none of their business. Which seems to me to be all that ought to be necessary.

 

[Tiassa]

I had no idea ....

I had no idea it was so uncommon a practice. It seems routine around here.

Interesting.

 

[superstring01]

My doctor asks about firearms as well.

What I don't get is: Why does the state care? It's not like the doctor's are denying rights, attempting to deny rights or discriminating. They are asking a medically relevant question.

Guess what! Nobody needs to answer the question! If it offends, the patient can say, "None-yuh" and move on.

How utterly idiotic.

~String

 

[superstring01]

Also: I'm inclined to believe this will not withstand constitutional scrutiny. There's the whole freedom of privacy and freedom of speech thing. I'd love to see this enforced.

~String

 

[Tiassa]

The Cynic in Me

What I don't get is: Why does the state care? It's not like the doctor's are denying rights, attempting to deny rights or discriminating. They are asking a medically relevant question.

The superficial explanation is that firearms advocates "have accused doctors of espousing an anti-firearm political agenda".

Additionally, a Republican legislator claims one of his constituents was "grilled about guns in the home". Now, setting aside left and right, young and old, parent and kid, punk and pious, or any other such consideration, yes, I have known people before who think asking a question equals the proverbial "third degree". Sen. Evers' constituent might have suffered some sort of gross unprofessionalism at a doctor's office, or might simply just be paranoid and reactionary.

We don't really know.

But the cynic in me suggests that the problem is that somehow, perhaps through actuarial tables, it eventually emerges that having a gun in the home correlates to higher likelihood of suffering gun violence, and that having a gun in the home for defense runs a higher risk of hurting an innocent. And, of course, that would be part of why firearm advocates view doctors as political opponents; some of the basic data might actually filter up through doctors to insurance companies.

For my doctor, and perhaps especially my doctor—so we can't necessarily extrapolate anything—the question of firearms in the home actually does have potential impact on treatment options. For instance, and contrary to Chimpkin's experience, the answer to the question would affect how he deals with whatever psychological or psychiatric issues I put before him. When I first asked for brain candy, he put me on a low-key SSRI and told me that he wanted me to find a counselor. Perhaps if I had answered affirmatively, he would have selected a different drug, and given specific direction, instead of a doctor's advice, to find counseling. That is, my doctor is a minimalist when it comes to treating things; if he can get me out of a situation with minimal therapy, he will. But if the circumstance looks more pressing, a bit more dangerous—e.g., is it possible I will "pull a Dualla" and spontaneously self-destruct?—he will apply a stronger therapy.

And if I'm gonnapulladualla, the question of whether or not I have a gun in the house becomes extremely important to my doctor's job of keeping me alive and healthy.

It's also important to the health of other patients in his care. My daughter, for instance. I answered the firearm question when I filled out her history, too.

 

[chimpkin]

What I don't get is: Why does the state care?

That's a very good point, yeah.
It is NOT the state's business what my doc asks me.

That having been said:
I really would find it a strange question.

I mean, think about this:

I've injured myself pretty badly cutting up veggies with kitchen knives, falling down stairs, falling off of a bicycle multiple times ( I was hit by a truck while on a bicycle too for extra crunchy goodness), and once very spectacularly by running a car into a stationary object at about 40 mph.

A physician's never asked me about whether my dwelling has a second story, I have kitchen knives and cook, ride a bicycle regularly, and here it's very unusual to be able to not own a car.

Nor has anybody asked me about the electric lawnmower, the scythes, my wife's bastard sword that I play with, the rotozip, the circular saw that I could easily take a finger off with...(I have visions of me driving to the ER with the finger packed in ice in my lunchbox..."Hey, can y'all sew this back on?" Much easier to do since I drive an automatic now...)

 

[adoucette]

The Florida Medical Association and other medical groups have said their are many valid reasons for why health-care professionals might need to ask whether a gun was in the home.

And there in lies the problem.

There are NO valid reasons for health-care professionals to ask whether I own a gun.

Arthur

 

[Tiassa]

Because you say so ...?

And there in lies the problem.

There are NO valid reasons for health-care professionals to ask whether I own a gun.

One of the problems I have with this sort of argument is that it deliberately snubs what's already up for consideration.

That is:

For my doctor, and perhaps especially my doctor—so we can't necessarily extrapolate anything—the question of firearms in the home actually does have potential impact on treatment options. For instance, and contrary to Chimpkin's experience, the answer to the question would affect how he deals with whatever psychological or psychiatric issues I put before him. When I first asked for brain candy, he put me on a low-key SSRI and told me that he wanted me to find a counselor. Perhaps if I had answered affirmatively, he would have selected a different drug, and given specific direction, instead of a doctor's advice, to find counseling. That is, my doctor is a minimalist when it comes to treating things; if he can get me out of a situation with minimal therapy, he will. But if the circumstance looks more pressing, a bit more dangerous—e.g., is it possible I will "pull a Dualla" and spontaneously self-destruct?—he will apply a stronger therapy.

And if I'm gonnapulladualla, the question of whether or not I have a gun in the house becomes extremely important to my doctor's job of keeping me alive and healthy.

It's also important to the health of other patients in his care. My daughter, for instance. I answered the firearm question when I filled out her history, too.​

You know, just ... for starters. For instance, even.

Perhaps you disagree? Perhaps you find something faulty about the ethics or logic of the proposition? We don't know, though, because—

"There are NO valid reasons for health-care professionals to ask whether I own a gun."​

—doesn't exactly do anything to explain what's wrong with what is already on the record for consideration.

In the end, what it comes down to, then, is that there are no valid reasons for health care professionals to ask whether one owns a gun ... simply because Arthur says so.

Sorry, dude. Because you say so simply isn't a good argument.

 

[Orleander]

Here in Michigan, if one parent attempts suicide, they remove the children form the home until it is decided it is safe for them to return. Even if the other parent is perfectly able to take care of them.

Do doctors ask if you have children?

 

[Tiassa]

Why wouldn't they?

Do doctors ask if you have children?

Mine does.

Yours?

 

[chimpkin]

My general physicians ask if I have kids.

If I had a child suicide wouldn't be an option anymore.

 

[adoucette]

Sorry, dude. Because you say so simply isn't a good argument.

Actually it is.

I have a right to bear arms and the doctor has no need to know if I excercise that right.

If I decide to tell him I own a gun that's entirely up to me.

As to your doctor, does he ask if you have sharp knives? razor blades? rope? gasoline? rat poison? tylenol? a car and a garage? etc etc etc?

Each of them is just as relevant.

ie, NOT

Arthur

 

[Bells]

Glad I'm in Australia..

I have to admit, I was surprised that a doctor would even ask such a question. Then again, I live in a country where we have strict gun control laws and not once have I ever been asked such a question. So you'll have to excuse me for having a quiet shake of the head at your collective expense.


My flabbergasted shake of the head aside, I can understand why it would be asked in a country with very little gun control laws. For example, if a patient has a psychotic break, which can and does happen, and the doctor is made aware of it, he/she could be in a position to advise police that the patient is armed and could be dangerous. But having said that, privacy laws, especially medical privacy laws could prevent the doctor from disclosing such information as it would be a breach of doctor/patient confidentiality. I am unsure of the laws governing this in regards to whether the patient could pose a danger to others in the US...?


But it is a strange question to ask. I think if a doctor were ever to ask me that, I would be asking why they wanted to know.


I mean I could imagine a list of reasons why a doctor might want to ask a patient if there were guns in the house - victims of domestic violence for example, or psychiatric patients who may pose a risk to others due to their illness... But yeah, still a strange question..

 

[Tiassa]

Epidemiology, Insurance, Diagnosis, and Treatment ... at least

Source: Slog
Link: http://slog.thestranger.com/slog/archives/2011/05/01/what-florida-doesnt-want-me-to-tell-you
Title: "What Florida Doesn't Want Me To Tell You", by Jonathan Golob
Date: May 1, 2011

Jonathan Golob, a.k.a. Dear Science, checks in on the new Florida law, including five points in conideration of why physicians would ask patients about gun ownership.

For instance, the fact of thousands who accidentally shoot themselves.

Add to that the thousands of firearms-related injuries that don't involve actually getting shot:

Not counting those who shot themselves, about sixteen-thousand people injury themselves with firearms each year in the United States sufficiently to require a visit to the emergency room. Usually these injuries were the result of the routine handling of firearms, with 43% from recoil.​

Or, perhaps, the idea that ninety percent of children accidentally shot with a firearm are injured by either their parents' gun, or that of a friend or relative.

Epidemiologically, if you're looking at thirty-thousand injurious outcomes a year, nationwide—i.e., fifteen thousand self-shooters, fifteen thousand other gun-related injuries, including recoil damage—that's the sort of number that gets health professionals' attention.

Right there is a reason a doctor might want to know about his patient's firearm ownership. And if not the doctor, then the insurance provider.

Doctors also ask their patients about drug use, both legal and otherwise; they inquire about chemicals in the home such as cleaning solutions; they ask about environmental hazards, including the age of the residence building (e.g., asbestos, lead paint, &c.).

And having this information has helped doctors, public health officials, scientists, actuaries, and others understand how certain societal health issues arise and affect communities.

Any doctor who does not ask about gun ownership during an annual physical, particularly a well-child check, is not practicing up to usual and customary practices—for the exact reason he or she should be asking about smoking, drug use, diet and domestic violence.​

There are, of course, certain political considerations, but even setting the labels aside, we still encounter a situation in which, as Golob puts it, we "cannot even allow medical professionals to cite scientific evidence".

 

[superstring01]

And there in lies the problem.

There are NO valid reasons for health-care professionals to ask whether I own a gun.

Arthur

Wait? Is that your medical opinion?

Even so, if your doctor asks that question, tell him or her "Sorry, that's none of your business."

This whole issue of the state attempting to illegalize even asking is--well--it's insane.

~String

 

[adoucette]

Source: Slog
Link: http://slog.thestranger.com/slog/archives/2011/05/01/what-florida-doesnt-want-me-to-tell-you
Title: "What Florida Doesn't Want Me To Tell You", by Jonathan Golob
Date: May 1, 2011

Jonathan Golob, a.k.a. Dear Science, checks in on the new Florida law, including five points in conideration of why physicians would ask patients about gun ownership.

For instance, the fact of thousands who accidentally shoot themselves.

Except this is NOT relevant to my treatment unless I present with a bullet hole in me.

Add to that the thousands of firearms-related injuries that don't involve actually getting shot:

Not counting those who shot themselves, about sixteen-thousand people injury themselves with firearms each year in the United States sufficiently to require a visit to the emergency room. Usually these injuries were the result of the routine handling of firearms, with 43% from recoil.​

Except this is not relevant unless I present with one of these injuries.

Or, perhaps, the idea that ninety percent of children accidentally shot with a firearm are injured by either their parents' gun, or that of a friend or relative.

Except this is NOT at all relevant for MY treatment though.

Epidemiologically, if you're looking at thirty-thousand injurious outcomes a year, nationwide—i.e., fifteen thousand self-shooters, fifteen thousand other gun-related injuries, including recoil damage—that's the sort of number that gets health professionals' attention.

Except NONE none of that info is relevant to treating whatever it is that ails me.

Right there is a reason a doctor might want to know about his patient's firearm ownership. And if not the doctor, then the insurance provider.

No, so far no logical reason has been put forward for a doctor to ask if I own a gun and my insurance company doesn't ask.
Wonder why?
Because the RISK is very low that I'll hurt anyone with my guns.

Doctors also ask their patients about drug use, both legal and otherwise;

Which COULD have an impact on my current condition unlike my ownership of a gun, which does not.

they inquire about chemicals in the home such as cleaning solutions; they ask about environmental hazards, including the age of the residence building (e.g., asbestos, lead paint, &c.).

Which COULD have an impact on my current condition, unlike my ownership of a gun, which does not.

And having this information has helped doctors, public health officials, scientists, actuaries, and others understand how certain societal health issues arise and affect communities.

So what? There are ways to collect that information, that protects the privacy of the providers, but unless I have a bullet hole in me, this information has NOTHING to do with my doctor treating any illness I might have at the time.

Any doctor who does not ask about gun ownership during an annual physical, particularly a well-child check, is not practicing up to usual and customary practices—for the exact reason he or she should be asking about smoking, drug use, diet and domestic violence.​

Oh BS.
Gun ownership has no impact at all on any MEDICAL CONDITION I might have and so to lump it with obvious things that could affect my HEALTH such as smoking or Diet is SILLY.


Face it, you can not give ONE solid reason why a doctor would change what he prescribes for you based on your ownership of a gun.

Indeed, asking is silly, since even if you answer NO, you can still stop by Walmart on the way home and buy a shotgun and ammo for it and get it about as fast as your prescription at the Pharmacy.

No waiting.

Arthur

 

[adoucette]

Wait? Is that your medical opinion?

Nope.
Common sense.

There is no medical condition whose treatment is influenced by the fact that I have a gun.

Which I suspect is why not once has my doctor ever asked me this question.

Even so, if your doctor asks that question, tell him or her "Sorry, that's none of your business."

Well of course that's what I'd do, but the reality is that one could make a decent assumption that anyone who says that probably does have a gun.

This whole issue of the state attempting to illegalize even asking is--well--it's insane.

With the advent of Obama-Care and this eventual national DB of patient info, not so much.

 

[WillNever]

Guys, this is old news. This bill has been in the works for at least FOUR months. That they passed a very crumby version of it does not surprise.

By the way, it is mainly pediatricians who ask if parents own guns. The reason for doing so is to assess the potential for accidents and to educate.

Right now, pediatricians ask whether parents own a gun in order to promote safety (suggesting ammunition and the gun be separately locked in two places rather than one, etc). The reason they do this is because the #1 cause of death in children is due to accidents instead of diseases, by a factor of about 7.

Child safety has l ong been in the scope of practice of pediatricians, and it has long been routine for pediatricians to ask about and educate parents on child safety, including pool fences, seat belts, smoke detectors, and such... and no one complains about that. Why is gun safety a private issue when those other safety issues are not?

Except this is NOT at all relevant for MY treatment though.

No one here gives a shit about your treatment.