Now it's from the American College of Physicians

teratos · Apr 17, 2014

john_bud said:
But the fact remains that there are a lot of people dying after seeing doctors. Also many more LIVING because they saw a doctor. Very similar to a number of people dying from guns, but also an even greater number living because of guns saving their lives...

It's not just doctors. It's nurses, pharmacists, aids. Also, keep in mind most of these people are not robust, young and healthy. They are old and sick. In some cases, it doesn't take much. When people read these stats, they think that perfectly healthy people like themselves are being bumped off by doctors. What qualifies as deaths related to the health care system is vast.

Modern medicine has done quite a bit. There is a risk benefit ratio to anything. People die from penicillin. You know how you find out they are so severely allergic? When they have the reaction. You can latch on to these statistics, but frankly you are not seeing the big picture when you present it the way you do.

Claybreaker 2 · Apr 18, 2014

I am addressing this intrusion another way. I am taking my physician, and his son, shooting on Saturday. He has a firearms background but has not shot for several years. He also wants his son to have a proper exposure to guns rather than just what the media and school system are trying to scare him with. I will have to remember to discuss the ACP's position although he is not a member as he does not agree with their stance on many issues.

Minuteman · Apr 18, 2014

If a patient shows up in an ER with a gunshot wound, or obvious domestic violence or abuse or clearly mental or suicidal - absolutely, I can see how questioning or reporting is necessary.

My concern is when you get asked as a routinely if you own guns they are making it an issue. My privacy and safety of my family is way more important than telling a medical person or social worker what property I may or may not own. Yes, I know a motorcycle, swim, skydive, smoke, ladder, electricity, drink, shoot, pet wild animals are all potentially dangerous; does not make you safer or healthier to tell a stranger if you do or have any of those things.

Look, most of us are very honest folks, but I have no reservation about lying if it is necessary for my/family safety/security. Don't make me or my family lie because something is none of your business.

There are plenty of good doctors out there that don't have a political agenda and won't ask unnecessary questions. Several frequent this forum.

http://www.cdc.gov/injury/wisqars/pdf/10LCID_Unintentional_Deaths_2010-a.pdf

Biggfoot44 · Apr 18, 2014

Just a wild guess , but the comparison of being safer by NEVER seeing a Md , could have been sarcasm to point out the equal absurdity of the concept that not owning guns would make you safer and healthier.

eruby · Apr 18, 2014

I view the hussien-care Doctors & advisors like the Flintsones 'Doctor' who issued diagnoses of dippitydoodleitis and prescribed a trip to Frantic City.

Lucky for me I have less to life to live than I already have lived.

K31 · Apr 18, 2014

I've said it before but if Doctors don't want lawyers, politicians, insurance clerks, and LEOs practicing medicine then they should not be playing social engineer.

SCARCQB · Apr 18, 2014

Over 40K automobile Related deaths per year..... They should ban cars.

teratos · Apr 18, 2014

There are so many things doctors are being told they have to screen for and document to get reimbursed it is absurd. In primary care, I have to screen for the following:

Blood pressure
Diabetes
Cholesterol
Weight - and document counseling if you are overweight
Alcohol abuse
Smoking - give/document counseling each year in those who smoke
Drug abuse
Breast cancer - make sure if you are a woman over 40 I have a documented mammogram in the past year
Colon cancer - make sure if you are a person over 50 you have had a documented colonoscopy.
Prostate cancer - make sure if you are a male over 40 you have had a documented PSA in the past year
Depression
Falls in the elderly
Thyroid disease
Osteoporosis
Screen for low testosterone (because it is all over TV and people NEED this checked), then if you have it council you on the possibility that testosterone replacement increases the risk of stroke and heart attack
Deal with all the real medical problems like infections, rheumatologic problems, possible malignancy etc
If you have heart disease, document that you are on particular medications, and if not....why you are not on certain medications
If you have diabetes, document you last foot exam, eye exam, hemoglobin A1c, urine microalbumin, council you on your weight
Document dental visits in the elderly
Screen for potential elder abuse
Screen for domestic violence
Deal with your whining about stress,your crappy boss, sniffling, sneezing, coughing, aching, stuffy head, fever which makes it so you can't rest
Answer all the questions about the sh1t Dr. Oz says you should take
Try to get you off the subject of why you "can't lose weight because of a glandular problem nobody can find".
A whole bunch of other stuff that qualify as "real" health issues

All this BEFORE I get to even thinking about whether or not you have a gun. The people who make these recommendations do not see patients. They have no earthy idea how I am going to fit yet one more low-priority issue into my already long list of things I need to do. Most people see their doctor once....maybe twice a year. Where do you fit an Eddie Eagle program into the visit?

Pediatricians may have more time for this, and they tend to be a bit more of a liberal bunch, IMO. Kids are generally healthy, so they can worry about your guns. They are used to lecturing parents on what they do because kids are dependent on their parents for everything, including their safety and they see themselves (rightly so) as advocates. I see myself as someone who gives advice. You can take it or leave it. It's up to you.

K31 said:
I've said it before but it Doctors don't want lawyers, politicians, insurance clerks, and LEOs practicing medicine then they should not be playing social engineer.

The vast majority don't want to play social engineer. Our business is among the most tightly regulated in the nation. If we don't do certain things, we don't get paid.

Peaceful John · Apr 18, 2014

teratos said:
It's not just doctors. It's nurses, pharmacists, aids. Also, keep in mind most of these people are not robust, young and healthy. They are old and sick. In some cases, it doesn't take much. When people read these stats, they think that perfectly healthy people like themselves are being bumped off by doctors. What qualifies as deaths related to the health care system is vast.

The purpose of my posting was to lend some perspective to the conversation started by the American College of Physicians: Medical malpractice contributes to between 19 times and 40 times the deaths from firearm homicides. (Journal of Patient Safety data divided by CDC data). So if the conversation is about public health, let's focus on where the real damage is being done.

Regarding the comment "most of these people are not robust, young and healthy. They are old and sick. In some cases, it doesn't take much." The above JPS data specifically referred to preventable harm. We are not talking about deaths following appropriate medical care. The JPS data was restricted to people "who go to the hospital for care (and who) suffer some type of preventable harm that contributes to their death".

To be clear nobody, not even the Journal of Patient Safety, is asserting that medical care is undesirable. The sole issue is that the American College of Physicians are being hypocritical and every response to them should emphasize that fact.

teratos · Apr 18, 2014

Peaceful John said:
Regarding the comment "most of these people are not robust, young and healthy. They are old and sick. In some cases, it doesn't take much." The above JPS data specifically referred to preventable harm. We are not talking about deaths following appropriate medical care. The JPS data was restricted to people "who go to the hospital for care (and who) suffer some type of preventable harm that contributes to their death".

To be sure, the deaths are preventable. A lot of them occur in an older/sicker population who are much less tolerant of the errors. The perception a lot of folks have is that it is people just like them. Robust/healthy people can tolerate a lot of "error" before you kill them. It is not any more excusable to say "they are old and would die soon anyway". We can't let these statistics keep people from getting medical care for fear "their doctor will kill them".

Whenever these stats come up, and this very thing has been posted numerous times here, it becomes a doctor bashing thread dripping with ignorance. I shouldn't take it personally, but it gets under my skin.

Great efforts are made to reduce the number of errors in hospitals. Redundant checks etc. The other flaw in the argument of "focus on X" is that the people asking the gun question aren't usually the one's in hospitals. I stopped going to the hospital 7 years ago. I am strictly office. To my knowledge I have yet to kill anyone, or even cause serious harm via an error. So telling me to focus on preventable deaths is pretty pointless. As I pointed out earlier, I think we have an awful lot more to focus on than gun safety. These guidelines are put out by a group with an agenda who generally do not see patients. Those of us on the front lines don't pay their agenda-drive recommendations much mind. The exceptions are the minority.

Mooseman · Apr 18, 2014

teratos said:
Also, note that the Surgeon General is not really a general. We don't have to follow his orders.

But he is a surgeon, right? If not a general, what is his actual rank? Also, I know you are an MD not a DDS but maybe you will know the answer to this. What does the fifth dentist recommend to their patients that chew gum?

teratos · Apr 18, 2014

Mooseman said:
But he is a surgeon, right? If not a general, what is his actual rank? Also, I know you are an MD not a DDS but maybe you will know the answer to this. What does the fifth dentist recommend to their patients that chew gum?

I don't know what that other dentist recommends. I bet the other dentists talk about him behind his back.

The surgeon general usually isn't a surgeon. He holds no rank as far as I can tell. I don't know what that is all about...

Gryphon · Apr 18, 2014

Jim12 said:
ACP looks like a voluntary physicians' organization, separate and apart from licensing or certification. Much like the American Bar Association (ABA), Maryland State Bar Association (MSBA), and various county bar associations for lawyers, all of which are totally voluntary.

Which is exactly why as an attorney I refuse to associate with the ABA. Some of the anti 2A garbage they spew is absolutely nauseating, and now I can't go to my doctor for fear of being double teamed! :sad20:

In reality, my doctor is great and while railing against OweBummer Care he has never once asked me about firearms.

teratos · Apr 18, 2014

Gryphon said:
Which is exactly why as an attorney I refuse to associate with the ABA. Some of the anti 2A garbage they spew is absolutely nauseating, and now I can't go to my doctor for fear of being double teamed! In reality, my doctor is great and while railing against OweBummer Care he has never once asked me about firearms.

Most don't.

tsmith1499 · Apr 18, 2014

My PCP USED to have the gun question on their forms. Don't know why but it's not on the form now.

Minuteman · Apr 18, 2014

tsmith1499 said:
My [Primary Care Provider] PCP USED to have the gun question on their forms. Don't know why but it's not on the form now.

Powerful medicine.

[emphasis added]

Docster · Apr 18, 2014

teratos said:
It's a recommendation. It is likely most doctors won't follow it. I have no doubt that they will try to mine data from EMR's. What determines how useful that will be is whether that info actually gets put in....

This says it all and really should put most comments and concerns to rest. The majority of healthcare providers that follow such recommendations are in Pediatrics. The hostility toward your provider is likely unnecessary.

Brooklyn · Apr 18, 2014

teratos said:
It's a recommendation. It is likely most doctors won't follow it. I have no doubt that they will try to mine data from EMR's. What determines how useful that will be is whether that info actually gets put in....

The key point is that it will be used to push fear onto moms. Its the main purpose of the fear industry.. Take a listen to today's drug adds. First create the impression that what seems normal may not be, give it a $50 name, suggest a drug and say ask your Dr. If they are good they can apply for grant money and build an entires institution.

As far as useful data goes... please ... we both know all they need is the illusion of data and they are off.. ..

teratos · Apr 19, 2014

Brooklyn said:
The key point is that it will be used to push fear onto moms. Its the main purpose of the fear industry.. Take a listen to today's drug adds. First create the impression that what seems normal may not be, give it a $50 name, suggest a drug and say ask your Dr. If they are good they can apply for grant money and build an entires institution.

As far as useful data goes... please ... we both know all they need is the illusion of data and they are off.. ..

It will be used to push fear into moms? Maybe, if the idea of asking the question catches on. The pediatrics organizations have been pushing this for years. It's probably being asked about as much as it's going to be. I doubt you are going to find many internists asking, we are over-burdened with data we need to collect already. I don't think it will make much difference. People just aren't aware of our guidelines. Do you have any clue what target blood pressure or cholesterol is? They sure won't know we are "supposed" to be counseling on guns in the home.

Minuteman · Apr 19, 2014

I think this 'fear guns' mentality is already taking hold. There are already several examples of schools suspending children for drawing guns, making gun finger gestures, etc.

This past week a new coworker was talking with me about her firearms experience. She had a career as an Army helicopter and fixed wing aircraft pilot; even flew Blackhaws for several years. She had been to several military range training events, and no doubt had been trained by someone like me. I asked very politely if she wanted to go shooting sometime, and she said she had no guns because she had grand kids and was afraid they might have an accident. I acknowledged her concern, it's valid; but I suggested she could use a padlock, inside a metal box, inside a safe; this would give HER access within about 30 seconds if she needed it and would be quite safe. She related essentially that no amount of security could make a firearm safe enough for her. This coming from a retired military, very intelligent, successful and highly motivated woman.

I could only tell her what I've told hundreds if not thousands of people now :
People safer when good people have firearms.

It is my right to own firearms; and it is my obligation to keep my family safe.

Now it's from the American College of Physicians

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