Went into the doc's for a checkup...


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Fletchette
August 12, 2005, 07:25 PM
At the end of the check up I am given this form for the insurance company. It asks all the embarrassing questions (any heart problems? blood pressure? Smoke? use drugs/alcohol? etc.). In the same section they ask "Any firearms in your house?"

Well, I was taken aback to say the least. I wrote a little diatribe that will probably make them cancel my policy. Anyone else notice this going on?

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NeveraVictimAgain
August 12, 2005, 07:27 PM
Thank you for standing up for our rights.

Regards,
Dave

Waitone
August 12, 2005, 07:33 PM
Was it the doc's paperwork or the insurance co's paper?

Chris Rhines
August 12, 2005, 07:37 PM
Today I went over to the dentist to have a cavity filled. They asked for my Social Insecurity number, for some insurance paperwork or some such. I declined.

It's really easy - all you have to say is no. I'm out of pocket on all dental expenses, so they don't need my SS# anyhow...

- Chris

SMMAssociates
August 12, 2005, 07:43 PM
Flechette:

Rock & a Hard Place time....

The correct answer is "none of your <expletive> business."

(I think it's related to the bogus "a gun in your house is more likely to be used against a family member" - or however it's worded - statistic.)

Given that health insurance is hard to get, and hard to keep, for some people, my answer would have been to leave it blank.

Standing up for our rights in this situation probably would do nothing - the clerk who reads this and tells their computer about it probably could care less, but the "yes" answer might count against us. If we could cancel the policy and send 'em a letter, that'd be another story.

My wife's a diabetic. If she loses her insurance, which has been in force since before she was diagnosed, odds are we'd be uninsured until she's on Medicare, in about ten years....

So, what we want to do is name the insurance company, and warn others to avoid them. There are a lot of young an healthy folks out there who can take the option.

It would be nice if the PTB at the insurance company would see a large number of gun owners and maybe change their minds, but raising our rates is the more likely consequence.

Just IMHO....

ctdonath
August 12, 2005, 08:05 PM
After 9/11, my doc asked me what gun to buy. (Mossberg 590, of course.)

WT
August 12, 2005, 08:32 PM
Yup, while my doctor gives me the 'one finger wave' we talk about 9mm vs .45 ACP .......

scout26
August 12, 2005, 08:38 PM
I'd just put N/A, as it is NOT APPLICABLE to whether or not I have high blood pressure or am eating enough fiber or getting enough exercise, etc.........

gezzer
August 12, 2005, 11:10 PM
Boundary Violation:
Gun Politics in the Doctorís Office
Timothy Wheeler, MD


--------------------------------------------------------------------------------

Appeared originally in the Medical Sentinel of the
Association of American Physicians and Surgeons,
March/April 1999, pp. 60-61

Imagine this scenario: you visit your doctor for back pain. Your doctor asks if you have firearms in your home. Then he announces that your family would be better off (especially your children) if you had no guns at all in your house. You leave the doctorís office feeling uneasy, wondering what guns have to do with your backache. Does your doctor care about your familyís safety? Or instead, did he use your trust and his authority to advance a political agenda?
American families may soon find themselves in this scenario. Social activists are taking their war on gun ownership to a new battleground: the doctorís office. (1) The American Medical Association (AMA) (2), American Academy of Pediatrics (AAP) (3), and American College of Physicians (ACP) (4) are urging doctors to probe their patients about guns in their homes. They profess concern for patient safety. But their ulterior motive is a political prejudice against guns and gun owners. And that places their interventions into the area of unethical physician conduct called boundary violations.

Doctor-patient sex is the most well-known and sensational example of a boundary violation. More recent literature recognizes a wide variety of nonsexual violations. (5) These cover such issues as finances, confidentiality, and gratification of the doctorís needs. Although boundary violations were first addressed in the psychiatry literature, it has become clear that they also occur in general medical practice. (6)

Boundaries in the doctor-patient relationship derive naturally from the relationshipís fiduciary nature. In general, "treatment boundaries can be defined as the set of rules that establishes the professional relationship as separate from other relationships and protects the patient from harm. A patient who seeks medical or psychiatric treatment is often in a uniquely dependent, anxious, vulnerable, and exploitable state. In seeking help, patients assume positions of relative powerlessness in which they expose their weaknesses, compromise their dignity, and reveal intimacies of body or mind, or both." (7)

Thus compromised, the patient relies heavily on the physician to act only in the patientís interest and not the physicianís. A doctor must put the patientís needs before his own. But a physician reverses the priorities when because of passionate political beliefs he tries to influence his patient against guns. This physician puts his own need to "do something" about the perceived evil of guns before the needs of his patient. He crosses the line from healer to political activist. Such doctor-on-patient political activism is recognized in Epstein and Simonís Exploitation Index (8) as a boundary violation.

Just as some physician sexual transgressors may insist their sex relations with a patient are therapeutic, the activist doctor may protest that he only seeks to prevent "gun violence." However, the conduct of the medical activists strongly indicates that their interest in patientsí guns is political, not therapeutic.

The AAP, ACP, and AMA are members of the Handgun Epidemic Lowering Plan (HELP) Network, based in Chicago. HELP is an exclusive advocacy group dedicated to banning guns. Physicians who disagree with HELPís anti-gun agenda are barred from attending HELPís conferences, a policy unthinkable in any scientific organization. HELPís founder and leader Dr. Katherine Christoffel has compared guns to viruses that must be eradicated. (9) The groupís militant advocacy has no place for differing viewpoints on firearms, and apparently neither do the medical organizations which have signed on as HELP members.

In fact, the AAP has adopted its "gun safety instruction" patient materials from the gun-ban lobby Handgun Control, Inc. (HCI). The AAP and Handgun Control, Inc.ís informational wing the Center to Prevent Handgun Violence advise families in their STOP pamphlet, "The safest thing is to not have a gun in your home, especially not a handgun." (10) And a survey of pediatricians showed 76% supported a ban on handguns. (11) Patients who seek objective advice on firearm safety should not look to pediatricians as a group. And any doctor should know that patient counseling based on these materials is politics, not medicine.

Perhaps the most revealing aspect of organized medicineís anti-gun bias is its persistent refusal to address the criminology literature on guns. For over twenty years, criminologists have studied firearms, their use and misuse, their risks and benefits. Especially in the last two years prominent researchers have found that firearm ownership is not the scourge that medical activists have claimed it to be. The best and latest research finds that private gun ownership by responsible citizens not only is safe, but protects the individual as well as his community from violent crime. (12)

One would think that medical firearm researchers would be intensely interested in this scholarship. But so far the editorial boards of the journals of the AAP, AMA, and ACP have neither responded to nor acknowledged it. With their silence these editors have effectively ended whatever credibility they had in firearm research. That field of study is apparently useful to them only as a vehicle for the advancement of their political goal of gun prohibition. When the scientific process yields knowledge contrary to that goal, activists either attack its author (13) or ignore it altogether. Such conduct is inexcusable in any area of scientific endeavor. Honest scientists face conflicting data objectively. And honest doctors do not use biased research to give false authority to their negative feelings about guns.

So how can a patient tell if his doctorís advice about guns is good preventive medicine or political activism? Patients can assess a doctorís advice by keeping the following questions in mind:

Does the doctor respect your right to keep guns? Or does he subtly send a message that guns are somehow bad? Moral judgments about the right to self defense, hunting, or other legitimate uses of guns are not acceptable subjects for a doctor talking to a patient. Does the doctor quote statistics from the American Academy of Pediatrics or the American Medical Association about the supposed risks of guns in the home? Do you see anti-gun posters or pamphlets from these organizations in her office? These materials are based on the "advocacy science" of anti-gun activists like Dr. Arthur Kellermann, much of which was funded by the federal Centers for Disease Control and Prevention (CDC). Congress cut off all the CDCís 1997 funding for gun research because of the CDCís anti-gun bias. (14) No doctor who knows firearms would base her advice on this frankly political literature. Is the doctor familiar with the National Rifle Associationís (NRA) Eddie Eagle gun safety program for children, or other established gun safety education programs? If not, is she interested in learning about them? Unlike the AAPís Stop program, Eddie Eagle educational materials for children contain no political or moral judgment about guns. This NRA program has been honored by the National Safety Council, the American Legion, and the governments of 19 states. The Eddie Eagle slogan "If you see a gun, Stop, Donít touch, Leave the area, Tell an adult" was even endorsed by the generally anti-gun California Medical Association (CMA). (15) Despite intense publicity for the AAPís Stop program and similar initiatives, most doctors shy away from scrutinizing their patientsí gun ownership. In a recent study 91% of surveyed doctors felt that firearm violence is a public health issue. But only 3% said they frequently talk to patients about firearms in the home. Two thirds of the surveyed doctors said they never talk to patients about the subject. (16) This may indicate that although they are generally concerned about firearm injuries, doctors do not see politically motivated patient counseling as appropriate professional conduct.

In a revealing section, the AAPís Stop speakerís kit warns would-be lecturers of "resistant audiences" who may disagree with them on scientific or ideological grounds. One section offers talking points for dealing with these "challenging individuals." (17) The kitís authors seem to anticipate their audiences may recognize its political nature.

Patients do have remedies for the boundary-crossing doctor. In todayís competitive health care market most patients can choose from many doctors. Changing doctors is the simplest solution. A written complaint to the health planís membership services department can send a powerful message that boundary violations by doctors will not be tolerated. If the problem persists, patients can file a complaint with the doctorís state licensing board. Medical licensing boards are increasingly aware of the problem of boundary violations. Although state boards have addressed primarily sexual and financial misconduct, the broad principles they have developed to guide doctors in these areas apply to the entire doctor-patient relationship. (18, 19)

The author cannot advise the reader to take a particular course of action. A patient confronted with physician misconduct must decide for himself which action, if any, to take. But patients should realize they do have choices in dealing with physician boundary violations involving political activism, especially in such personal matters as firearm ownership. And physicians should be aware of the personal risks they take when they bring political activism into the exam room.

Endnotes

HELP Network News, Winter / Spring 1998, p. 1. This quarterly newsletter is published by the Handgun Epidemic Lowering Plan (HELP) Network.
Ibid. p. 2.
American Academy of Pediatrics Policy Statement, vol. 89, no. 4, April, Part 2, 1992, pp. 788-790.
American College of Physicians Position Paper, "Firearm Injury Prevention," Annals of Internal Medicine, 1998, vol. 128, no. 3, p. 238.
Frick, D., "Nonsexual Boundary Violations in Psychiatric Treatment," Review of Psychiatry, vol. 13, (Washington, D.C.: American Psychiatric Press, Inc.), 1994, pp. 415-432.
Hundert, E., and Appelbaum, P., "Boundaries in Psychotherapy: Model Guidelines," Psychiatry, vol. 58, November 1995, pp. 346-347.
See reference 5, p. 416.
See reference 5, pp. 418-419 reprinted with permission from the Bulletin of the Menninger Clinic, vol. 56, no. 2, pp. 165-166, The Menninger Foundation, 1992.
Somerville, J., "Gun Control as Immunization," American Medical News, Jan. 3, 1994, p. 9.
"Keep Your Family Safe From Firearm Injury," American Academy of Pediatrics and Center to Prevent Handgun Violence, 1996.
Olson, L., and Christoffel, K., "Pediatriciansí Experience With and Attitudes Toward Firearms," Archives of Pediatric and Adolescent Medicine, vol. 151, April 1997.
Lott, J., More Guns, Less Crime: Understanding Crime and Gun Control Laws, (Chicago: University of Chicago Press), 1998.
Ibid. pp. 122-157.
Report from the Committee on Appropriations, U.S. House of Representatives: Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Bill, 1997, p. 49.
California Medical Association, Actions of the House of Delegates 1995, San Francisco 1995, Resolution 109-95, p. 9. The Eddie Eagle slogan was originally introduced in a resolution crediting its creator, the National Rifle Association (NRA). But the CMA Delegates refused to mention the NRA in the final version of Resolution 109-95, preferring instead to credit the California Department of Justice. This agency had adopted the Eddie Eagle slogan in its own gun safety program.
Cassel, C.K., and Nelson, B., "Internistsí and Surgeonsí Attitudes Toward Guns and Firearm Injury Prevention," Annals of Internal Medicine, 1998; vol. 128, pp. 224-30.
American Academy of Pediatrics, "Preventing Firearm Injury: Protecting Our Children Speakerís Kit," tab 1, section 5, Elk Grove Village (Illinois), 1998.
Medical Board of California Action Report, April 1996, p. 3, California Department of Consumer Affairs, Sacramento, California.
Massachusetts Board of Registration in Medicine, "General Guidelines Related to the Maintenance of Boundaries in the Practice of Psychotherapy by Physicians (Adult Patients)," Boston.
~~~o~~~

Timothy Wheeler, MD is Director of Doctors for Responsible Gun Ownership,
a project of The Claremont Institute.

~~~o~~~

Art Eatman
August 12, 2005, 11:26 PM
I like Tamara's proposed answer: "Yes, officer, what kind would you like?"

:), Art

Fletchette
August 12, 2005, 11:37 PM
Was it the doc's paperwork or the insurance co's paper?

Insurance.

The correct answer is "none of your <expletive> business."

That was almost exactly what I wrote.

Lone_Gunman
August 12, 2005, 11:39 PM
Here we go again with the boundary violation stuff... I assure you that you are wasting your time with that idea.

The boundary is set by organized medicine. Organized medicine wants gun questions asked and wants anti-gun legislation passed. So if you sue your doctor over this "boundary violation" he will have no problem finding about a thousand "experts" from the American Medical Association who are willing to testify this is not a boundary violation.


Also, the publication mentioned, the Medical Sentinel of the Association of American Physicians and Surgeons...

I have never heard of it, or that association... and I have been a doctor since the late 80's.

Fletchette
August 12, 2005, 11:46 PM
Here we go again with the boundary violation stuff... I assure you that you are wasting your time with that idea.

So, how do we fight on this front? We cannot simply roll over and let them decide that gun ownership is a "disease".

F4GIB
August 13, 2005, 12:02 AM
As Mrs. Reagan put it so elequantly "Just say 'no'." They aren't entitled to a correct answer.

mnrivrat
August 13, 2005, 12:11 AM
Seen the questions on forms and just left them blank.

Been asked the question by a nurse and just told her it was none of their business.

AMA is not pro-gun .

Lone_Gunman
August 13, 2005, 12:45 AM
So, how do we fight on this front?

Money talks. Don't answer the question, tell them its none of their business, and find another doctor.

I assure you if your doctor sees himself losing money by pushing organized medicine's political agenda, he will stop.

SMMAssociates
August 13, 2005, 01:23 AM
Lone Gunman:

I assure you if your doctor sees himself losing money by pushing organized medicine's political agenda, he will stop.

My doc's not a problem. He's from India, and probably wouldn't have a problem asking the question, nor would he have a problem if it was ignored.

Our problem here is that many of these guys are so busy that losing a few patients wouldn't bother them at all....

I am proud to say that my Optometrist is more likely to show me a picture of his latest elk than his kids, but I can't get him to go for a CHL either....

I suppose this could work in some areas, but this isn't the same thing as a bank or grocery store, where bad karma seems to really hit 'em. These docs, after all, all but pray to get admitted to practice in hospitals that are very happy to be posted. One local hospital must have spent $10,000 on signs....

Haven't looked, but I doubt if there's a hospital within 100 miles that's not posted....

Regards,

nvrquit
August 13, 2005, 02:11 AM
.... Under the Sun.


Lone_Gunman,

Here's a few links for you:

http://www.haciendapub.com/medsent.html
http://www.aapsonline.org/press/medsentpolicy.htm
http://www.thecre.com/access/medical-sentinel.html

I have no dog in this fight, other than to say that while one may or may not have valid grounds to bring suit in the issue at hand, I believe the question(s) in debate ARE a boundary violation. The links are not intended as a validation, only as a few examples of a quick Googling.

Later......

Lone_Gunman
August 13, 2005, 09:35 AM
Whether you believe it is a boundary violation or not does not matter though, it is what organized medicine thinks, because in a lawsuit the experts will come from organized medicine. And they will all testify this is not a boundary violation.


Does anyone have any info on how many members this AAPS organization actually has? I have never heard of anyone being a member of it.

c_yeager
August 13, 2005, 10:04 AM
So, how do we fight on this front? We cannot simply roll over and let them decide that gun ownership is a "disease".

Its really easy. Tell your doctor to shove-it, and go find a new physician who doesnt feel that your private life is his business. Be sure to tell your original physician WHY you are now doctor shopping.

Lone Gunman is right with regards to the boundary violation issue. The "boundary" is a matter of accepted practice within the medical field. This accepted practice is established by the very organizations that are promoting the asking of this question in the first place. Let your money do the talking and the problem will easily solve itself. I have yet to have a doctor ask me this question (although i have had some ask for advice regarding firearms), so that cant be all that hard to find.

geekWithA.45
August 13, 2005, 10:18 AM
I've run into this before @ the pediatricians, and we invoked


Rule 6: Mom and Dad's guns are no ones business, ever, therefore, We don't talk about them. We do not tip our hand, or do anything to suggest the armory even exists.


Although I'd normally give someone like that a good talking to, I consider medical records to be a special case, because of the information sharing collective built by the insurance companies.

You know that insurance companies have mutually arranged to share information, and that you've signed that as OK when you bought the insurance, right?

AirForceShooter
August 13, 2005, 11:17 AM
Never Ever tell your Doc you have weapons at home.
I'm still trying to figure out what it has to do with my heath.
If the Doc has a problem with it FIRE HIM/HER.
It's a real hoot to stand in the waiting room and in front of everybody tell the person in the front "tell your boss he's fired". do it loud and don't say why. It can be amazing to see who follows you out the door. And somebody will.

Be happy

AFS

Shovelhead
August 13, 2005, 12:25 PM
"I have no firearm at home because I'm presently carrying it in an IWB holster." :neener:

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