Doctors need/want to know.
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Loosedhorse
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I'll assume this is not more snark.
Asking for the doc's credit card info is not relevant (in fact, I think it's snark), unless you are selling him something and he wants to pay by CC. Asking him where he went to school, if he's been disciplined (most of which is available from Board of Med websites anyway), etc. certainly would be relevant.
If you ask him, "Hey, any hospitals ever suspend your privileges as a disciplinary measure?" and he says, "I decline to answer your question because that's none of your business; hey, do you have some TRAINING in evaluating doctors?? I can't afford that info getting into a database somewhere! What, does your profession have some sort of anti-medical care agenda???"
Then, AFAIC, you have every right to not trust him, and "dismiss" him from your medical care.
But apparently, if he asks you about guns/safe storage, and you decline to answer--maybe while giving him an earful of the same "it's none of your business/do you have some training" jibber-jabber--some here feel he does not have the right to conclude the trust he feels is needed does not exist, and exclude you.
You apparently think that gun info is so "personal" it should be off limits to a professional who is required to ask about things as private as a patient's sex life, psychiatric history and whether or not they are being abused at home. I disagree that the doc has no right to ask about such "personal info".
Hope that's cleared up.
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Birch Knoll
Member
Medical history questions concerning the patient's sex life or psychiatric history are legitimate; the answers will inform the physician whether the patient has a history of or is at risk for disease or other disorder, whether the patient is or has experienced symptoms of a disorder, and whether the patient has any condition which would effect the physician's medical care of that patient.
Questions regarding gun ownership do not relate to any medical issue whatsoever. Gun ownership is not a symptom of any disease, nor does it lead to any disorder. Physicians do not adjust their treatment of patients depending on whether the patient is a gun owner or not.
Doctors do not ask these questions to assist in their treatment of patients. They ask these questions in order to assert their putative authority to discourage gun ownership and use among their patients, because they consider guns to be a public health threat. The questions are politically, not medically, motivated.
jerkface11
Member
You might have noticed that the examples you gave are all HEALTH CARE ISSUES. Firearms are not. More people are accidentally injured with knives than guns. You don't see them asking if you have sharp objects in the home though.
This!!!!
Many doctors go by what the CDC, Center for Disease Control says on subjects. They are VERY liberal, and have an anti-gun agenda cloaked as a "health risk". I leave blank any questions about gun ownership, and have not yet been asked about it.
Loosedhorse
member
You make an arbitrary distinction without giving any basis for it, except (apparently) your opinion. Others could just as well argue that questions about the patient's sexual history "aren't any of the government's business," or "aren't what I go to a doctor to get asked." And ALL insurers feel that mental health is not "really" part of healthcare, and do not re-imburse it like the do "real" medical care.
You (and apparently others) feel that inquires about firearms and their storage are not medical issues. Perhaps you also feel that injury prevention in general is not a medical issue, or that gun questions should not be asked even in cases of suicidal depression or domestic abuse.
You are entitled to your opinion. But Pubmed's database (which used to go back only to 1966, but is slowly being extended) currrently lists firearms injury articles as far back as 1955; I have no doubt there are earlier ones. Accidental firearms inury articles currently trace to 1969. Medical articles related to general accident prevention date back to 1918 at least.
Couple that with the fact that all major medical societies have statements or policies regarding accident prevention, and usually firearms accident prevention. What that means is you can SAY that gun accident prevention has nothing to do with medicine...but as far as an objective answer to that question exists, it indicates you are clearly wrong.
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Dain Bramage
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Loosedhorse: I'm sure Pubmed lists injuries incurred in bathtubs and automobiles. However, since these are not politicised items by the AMA, you don't see them on questionnaires. My doctor can ask me about guns if my visit is about a sore wrist, and he wants to recommend a shooting glove or a different grip. Otherwise, it is non of his business.
Birch Knoll
Member
Absolutely correct -- injury prevention is not a medical issue. And if it were, there are about 100 more likely injury-related topics that physicians should be asking about before they get down to the issue of firearms.
No, I have no problem with doctors asking about guns when treating a patient who has attempted suicide, is suicidally depressed, or admits to suicidal ideation. There is a clear relevence between the query and the patient's case. Not so when asked as part of a standard medical history.
Only if you concede that the medical establishment is the sole arbiter of what is and isn't medical. By this standard, the medical community could, by consensus, subsume any topic as a medical one.
Loosedhorse
member
This perhaps coming from someone who feels the "shooting establishment" should be the sole arbiters of what is and isn't proper gun safety advice?
But you're correct--we shouldn't leave medicine to the doctors, and we haven't. Medical practice is influenced by insurers, malpractice lawyers, paragovernmental regulatory agencies--and of course, the government. So feel better--I think that we can all agree that the, ah, influence of these entities has made American health care better?
Oh, one other problem: with the (temporary, I predict) exception of the state of FL, all of the above would seem to agree with the position that having the doc ask about guns is within medical practice--just like the medical societies say.
BTW, if you want, take a look at the injunction granted against the FL law. Not at all a perfect predictor of how the case will go, but I suspect a reasonable preview.
Ah--another self-professed authority on not only what doctors should practice, but exactly how they should practice it. If you're allowed to scoff at the doc "Where'd you get your training in gun safety?" he's allowed to scoff at you: "And where'd you go to medical school?"
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jerkface11
Member
Sexual history is a medical issue. The dr needs to onow if you should be tested for herpes afterall.
Birch Knoll
Member
Did I say that? No, I didn't think so. If you have to erect a strawman to attempt to refute my point, then your argument is wanting.
What I said is that the medical establishment should not be the sole arbiter of the scope of medical purview. That is the right of the whole of society to decide, including medical consumers such as you and I. If you dispute that, bring forth your argument. Don't argue against what I did not say.
As to the Florida law, the legislature was foolish. Doctors have the right to ask anything they please, including questions about guns. That they have that right doesn't mean that it is a good or appropriate thing for them to do. But the legislature had no business poking their obscenely large noses into the matter.
Other states have not "agreed" that physicians asking about guns is within the proper bounds of medical practice; they have not spoken on the issue at all. Nor should they; it lies entirely outside the legislature's purview.
Wow, you do like the logical fallacies, don't you? Now it's appeal to authority. How about you simply respond to my argument instead?
If offering advice on how to avoid injury is within the proper scope of medical practice, why do physicians focus on firearms, when accidental firearms injuries are far, far less common than those resulting from bathtubs, swimming pools, ladders, table saws, and any number of more dangerous items? Shouldn't the most dangerous items be addressed before the less dangerous ones? Why would firearms, ranking as low as they do on the accidental injury scale, be the featured item that doctors ask about?
If I was attempting to practice medicine, he'd probably be right to ask. Just as I would be right to ask the source of his expertise in gun safety, should he try to school me in that matter.
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Loosedhorse
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Here's another: You perhaps did not see my "perhaps" and my question mark?
Asking a question about your position is not a strawman. You have clarified: thanks. And the fact remains that others have said that medical training is insufficient to allow docs to comment on firearms safety, so my statement still applies to them.
"Appeal to authority" is not just a "logical fallacy." It is also "A rhetorical strategy that calls upon an individual or other source as an expert to give credence to an argument made by an author of a work." What makes it a fallacy is if the expert has unverified credentials, speaks in a field in which he is not expert, or over-states what he actually knows.
In a case where you wish to know the properties of a certain drug, asking the researcher who invented it and who conducted the clinical studies on it would be wise; and presenting his words as authoritative would not be a logical fallacy.
Here, I am presenting medical schools and medical societies as authoritative experts in medical practice: you perhaps disagree? (Note perhaps and question mark, again)
Interesting command from someone who has presented no argument, only his opinion that (apparently) his ideas about medical practice are on equal footing with his doctor's, the AMA's, and JCAHO's. Or perhaps superior to theirs?
Are you asking because you don't know, or because you assume the answer is "Because all docs and all medical societies are involved in a vast antigun conspiracy?"
If you don't now, fine admission--do some additional research, ask some medical schools. Of course, if you already know it's a conspiracy, no need to do research. (Oh, so you don't accuse me of false dichotomy
, I'll submit that you may have other explanations for your question.)
By proclaiming that you know which safety questions a doc should ask and in which order he should ask them, that is exactly what you are attempting, IMHO.
And if he said it was covered in his medical training, you would perhaps judge that an illegitimate source? If so, why? Perhaps because, as I said to begin with, to you the "shooting establishment" should be the sole arbiter of what is and isn't proper gun safety advice?
Why do you say that? What, to you, would be a "gun safety component?"
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Birch Knoll
Member
Yes, I did. However, I stand by my initial interpretation; I believe you are being disingenuous in claiming that you did not erect a straw man simply because you framed it in the form of an (accusatory) question. You're simply squirming.
You're simply wrong about this. Firstly, I clearly indicated that I was referring to the logical fallacy termed "appeal to authority"; the like-named rhetorical argument is not at issue here. Secondly, appeal to authority is always fallacious, regardless of the credentials of the authority, since even legitimate authorities can be wrong.
Do we really have to argue over the definitions of basic fallacies?
No, I don't disagree that the medical community is the appropriate source of expertise on medical practice. I do disagree that they are the authority on the scope of medical practice, specifically with regard to the medicalization clearly non-medical issues.
Let's say I don't. Enlighten me.
Well, I'd certainly be astonished if that was his reply. And I would immediately seek to better myself by asking for detailed information on gun safety.
Doctors should not practice outside of their competent specialties, prescribe drugs whose indications, contraindications, mechanism of action, doses and side effects they do not understand, nor should they perform surgeries or other procedures in which they have not been trained. To do either would be malpractice. If advising patients on issues of gun safety does indeed fall within the bounds of proper medical practice, then doctors are professionally and ethically obliged to be fully trained in the topic. I am doubtful that most physicians can meet that standard.
Loosedhorse
member
Then we have no basis for a good-faith discussion, and I should consider you dishonest as well. Your choice, not mine.
You are being ridiculous. All textbooks are (one hopes) written by experts. All human knowledge is subject to possible future correction. So what? It does not make everything you read and everything you think you know a fallacy.
What, in your odd estimation, is the precise difference between the rhetorical device and the fallacy that are both called appeal to authority? You could look it up, and then you likely would find an authority who says the difference is pretty close to what I said. And you'd have to reject that...
Because it's an appeal to authority! In fact, you'd even have to reject it if it said you were right! Strange loop you're caught in.
This is a nonsensical distinction that you are trying to make. Even if it were true, then the real expert in medical practice scope would be...you?
Not my job: yours.
And, if you receive gun safety advice from a doctor, and if that advice does not meet the standard of medical care, and if you suffer proximate harm as a result, then you SHOULD sue for malpractice.
In my opinion, you'd win. THERE is your remedy!
Perhaps we finally agree?
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Birch Knoll
Member
I'm sorry, Loosedhorse, but in my opinion, I don't think that you and I can have a reasoned discussion. Which is too bad, because I would have enjoyed that.
DAP90
Member
I sorry, but this is just an absurd statement.
They do; about child locks on knife drawers, hot water temperature, poison storage, car seats and at least 96 others.
jerkface11
Member
How many people are accidentally shot in a year?
Clipper
Member
Since I often OC in my doc's office...I'm not in the habit of wasting my time answering stupid questions on those questionaires, so about half of the form remains blank when I return 'em.
So if Doctors got together and decided they should kill sick patients there is no recourse?
They could decide it is 'in scope"."
Doctor's are NOT the final arbitrators of what in in the "scope" of medical practice.
They have a large part in establishing the boundaries of care, but are not the final arbiters and do not get to act in a vacuum.
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I think we should all put "no" instead of blank or none of your business, because that looks like a yes if you ask me.
Not sure if you could get in trouble for that if they ever found out, but they deserve to be lied to asking questions that are none of their business.
Not sure if you could get in trouble for that if they ever found out, but they deserve to be lied to asking questions that are none of their business.
Loosedhorse
member
No recourse?
If doctors kill sick patients intentionally, they have committed murder and should be so charged. Are you then saying that doctors asking about guns or giving gun storage advice are committing felonies? If so, charge them.
(I have assumed that by "kill sick patients", you did not mean instances where doctors legally discontinue life-sustaining measures, legally perform abortion, or contribute to patient death by malpractice or misadventure.)
fact:lots of children get killed every year by falling out of second and third story windows, off balconies with low railings, etc. Most pediatricians are not carpenters, building code officials, or safety equipment installers. They still are proper to ask parents if they have childproof windows, safe railings, etc. in the interest of protecting the kids' safety.
Likewise, maybe a statement such as "if you have guns/knives/chainsaws/power tools/atvs/lawnmowers do you have a plan to keep your kids safe?" To me this would represent good practice, just like asking the older kid if they have a plan if someone behaves inappropriately towards them. They can then check off a relevant checkbox e.g. Safety discussion and move on.
Likewise, maybe a statement such as "if you have guns/knives/chainsaws/power tools/atvs/lawnmowers do you have a plan to keep your kids safe?" To me this would represent good practice, just like asking the older kid if they have a plan if someone behaves inappropriately towards them. They can then check off a relevant checkbox e.g. Safety discussion and move on.
Birch Knoll
Member
This discussion is not about pediatricians asking about child hazards. It's about adult patients being asked about gun ownership. Let's try to keep from confusing the issue.
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