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Well, it's already been a big week on the #GunFAIL front so far, as four cops (that I know of)u accidentally shot themselves. Seriously! Plenty more where that came from, too. My next #GunFAIL list already tops 30 items.

We've got tabs to clear, and news to discuss. And if this damn Stitcher player goes haywire again, I'll probably want to yell about that for a bit. And so will you!

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Originally posted to Daily Kos on Wed Feb 06, 2013 at 05:30 AM PST.

Also republished by Daily Kos Radio.

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Comment Preferences

  •  good morning! (4+ / 0-)

    follow-up on physician duties from yesterday's show (a doc discharged a patient because the patient refused to discuss guns and gun safety in FL):

    In recent months, there has been media attention surrounding an incident in Ocala, Florida, where, during a routine doctor’s visit, a pediatrician asked a patient’s mother whether there were firearms in the home.  When the mother refused to answer, the doctor advised her that she had 30 days to find a new pediatrician.

    The doctor stated that he asked all of his patients the same question in an effort to provide safety advice in the event there was a firearm in the home.

    He further stated that he asked similar questions about whether there was a pool at the home, and whether teenage drivers use their cell phone while driving for similar reasons – to give safety advice to patients.  The mother, however, felt that the question invaded her privacy.

    This incident has led many to question whether it should be an accepted practice for a doctor to inquire about a patient’s firearm ownership.

    Many? You mean the NRA. But see the following 4 points.

    1. physician duty to treat:

    Physician Duty to Treat

    A physician assumes a duty to treat a particular person when he or she agrees to do so or is expected to do so as a condition of employment. For example, if a mother brings her child to see a physician in private practice, the physician assumes responsibilities toward that child by seeing the child, conducting a history, physical examination, and so on. If that same mother takes her very sick child to a hospital, the physicians in the emergency department assume the responsibility to care for that child as a patient until such time as any life-threatening condition is brought under control or the child is transferred to other appropriate care.

    Both physicians and healthcare institutions can bring relationships – and their duties – to an end. Suppose a patient consistently fails to appear for appointments, fails to comply with recommended treatment, and fails to pay the physician. Under these circumstances, a physician can provide advance notice to the patient that he or she will not longer see and treat the patient. Patients can also be turned away for being unable to pay if physicians make efforts to ensure that the patient is not abandoned with regard to needed critical care. Healthcare institutions can take similar steps. In both cases, however, patients may not be abandoned at times of critical need.

    Broken appointments and fights between parents over management of their kids are pretty common and on rare occasion engender severance of relations. But yes, the doctor can do so, so long as the pt is not abandoned without care. But the doc, and not just the pt. can end the relationship. Also, if you have not seen or contacted the doc in three years (or so), the relationship ends. You can't call a doc and say "I haven't seen you in six years, you have to see me right now for x,y or z". The idea that the doc can fire you and not the other way around rarely occurs to patients.

    2. there is a process for it and 30 days is typical. Here is a how-to guide for the doc.

    Either offer to provide the patient with assistance in finding a new physician, or provide some suggestions directly in the letter, such as advising the patient to contact his or her insurer for names of nearby physicians who are panel providers. Provide the patient with a clear timetable for discharge, indicating that you will continue to see him or her for a specified period of time (i.e., 30 days) for any acute problems until he or she has had the opportunity to establish a relationship with another care provider.
    3. AAP has counseled inquiring about firearms since 2000. This news story (subscription wall) was from Oct 2012:
    The American Academy of Pediatrics (AAP) today released a policy statement urging pediatricians to counsel parents about the dangers of allowing children and adolescents access to guns. The statement, an update of a position paper first published in 2000 and reaffirmed in 2004, was published online today in Pediatrics and will appear in the November print edition of the journal.
    The full text is here (Firearm-Related Injuries Affecting the Pediatric Population).

    4. Public reaction via Carl Hiaasen (Florida loses another ridiculous legal battle):

    Written by the National Rifle Association, the so-called Firearm Owners’ Privacy Act would have prevented concerned physicians from asking patients about guns kept in their houses. It’s a reasonable query in domestic situations in which children might be at risk [and you can't know the risk until you make the inquiry — ed.].

    But the GOP-controlled Legislature wants doctors to shut up about guns and stick to lecturing women about their abortion decisions. So much for privacy.

    By necessity, doctors ask lots of personal questions. Are you using any illegal drugs? How much alcohol do you drink in a week? Do you smoke cigarettes? Do you suffer from depression?

    We’ve all filled out the checklists while sitting in the waiting room. And, on the examination table, we’ve all heard doctors and nurses ask things we wouldn’t post on Facebook.

    Say, have you noticed if your urine is changing color?

    Uh, no.

    Not all docs are happy about this battle, and some want the right but not the obligation to ask (adding 10 minutes for every patient adds up over the week and obligation implies penalty if you don't ask). And want to be paid for their time (there's no code for gun counseling, there's no procedure to bill for and 2500 extra minutes a week every week of unbilled time is daunting).

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Wed Feb 06, 2013 at 04:53:41 AM PST

  •  on a lighter note (1+ / 0-)
    Recommended by:
    justiceputnam

    Dick Morris sucks more than toes.

    Unpopular Rick Scott wants to buy another term.

    Obama may have gained the upper hand on the GOP. But to what end?

    "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

    by Greg Dworkin on Wed Feb 06, 2013 at 05:34:51 AM PST

  •  a link (2+ / 0-)
    Recommended by:
    Greg Dworkin, justiceputnam

    here is a link to a page on the neuroskeptic blog I may want to discuss on today's show

    link

    Blake: I am an enemy of the Federation but it is corrupt and oppressive. I will destroy it if I can

    by GideonAB on Wed Feb 06, 2013 at 05:41:00 AM PST

    •  good link (1+ / 0-)
      Recommended by:
      justiceputnam

      I think the 'open access' issue mentioned at the end is one of the most important bits. I hate when good data is behind paywalls, and the price of scientific specialty journals is now prohibitive.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Wed Feb 06, 2013 at 05:45:47 AM PST

      [ Parent ]

      •  Even more problematic (1+ / 0-)
        Recommended by:
        Greg Dworkin

        are research results that are never published.  How can scientists find cures if they don't know what didn't work?

        Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

        by Betty Pinson on Wed Feb 06, 2013 at 06:09:33 AM PST

        [ Parent ]

    •  Great topic (1+ / 0-)
      Recommended by:
      kareylou

      Breast cancer activists are trying to work on some systems change in scientific research.  

      Democratic Leaders must be very clear they stand with the working class of our country. Democrats must hold the line in demanding that deficit reduction is done fairly -- not on the backs of the elderly, the sick, children and the poor.

      by Betty Pinson on Wed Feb 06, 2013 at 06:08:30 AM PST

      [ Parent ]

  •  Please fix "Resuming episode". (3+ / 0-)
    Recommended by:
    Carol in San Antonio, yuriwho, raboof

    Autoplay is anti-community.

  •  Medicine is a tough job and tougher than it should (0+ / 0-)

    be. A doctor has to be infaliable and needs to be profitable in high cost environment.

    "That's some catch, that Catch-22,"

  •  Keystone is .8 million barrels per day so it won't (0+ / 0-)

    by itself produce a lot of CO2. Tar sands is a redline/"slippery slope" issue for environmentalists.
    Right now the environmentalist line is that we must reduce world fossil energy production by 50% by 2050 to keep
    CO2 levels below 450 ppm(2 degree C rise). In fact
    world FF is increasing, especially coal in India and China
    so they feel anything which could increase or even maintain fossil fuel production will overshoot 450ppm.
    About 43% of world fossil energy comes from oil so oil
    must be reduced and all of future oil production is coming from heavy oil and bitumen and heavy oil refining produces
    more CO2 than light oil.
    US industry wants keystone to keep Gulf refineries busy(very cheaper tar sand oil increases profits) and they have written off the Middle East as terminally violent.

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