Doctors and Guns Redux

heyjoe

New member
Shenna9220 Aguilar you have it spot on and it goes beyond the VA. If your primary health insurer is Medicare or Medicaid, they are required to asked about your mental health. I know this because during my last checkup the nurse started asking the questions on and I inquired why and was told the gov.

again I would like to see documentation of this. Over the last 5 years, I have had 3 primary care physicians, multiple specialists, have medicare as my primary health insurer and have never been asked about my mental health. I find that businesses sometimes cite non existent laws or government requirements for what is in reality is just that business policy.
 
Since the VA almost killed me three years ago by not letting me see a cardiologist for a VERY evident heart problem, I have kept an outside doctor on standby through Medicare. Yesterday I went to that office for my annual wellness check. Before we even started with medical stuff, there was a four-page survey that included mostly questions pertaining to mental health -- how do you feel about life, are you sad, do you enjoy living, yada yada.

To my very great surprise, it didn't ask if there are guns in the house.
 

44 AMP

Staff
To my very great surprise, it didn't ask if there are guns in the house.

They don't HAVE to! They can, and have come out with anti gun "recommendations" without asking a single question about guns. I was actually involved in one of those "surveys".

It was a "safety & risk assessment" study, done at a government facility I worked at. Standard type questions, about safety attitudes, wearing PPE, availability of PPE, and things like that, including driving habits (do you wear a seat belt, do you drive within 5mph of the speed limit, etc.)

There were NO questions about guns, hunting, or anything at all like that. The only question that even remotely touched on anything violent was "during the past year, was any member of your family involved in a physical fight?"

Now, when the "results" came back, and bear in mind that these results were intended to give us ways to improve safety, they had a list of things we could to do reduce our risks.

One of the listed things was
"avoid handguns"

I'm not kidding, that's a direct quote. I didn't flip out, but I did get ticked off! And I went to my manager about it. I didn't mention anything about gun rights, or anything like that, I pointed out how, since they didn't ask even a SINGLE question about firearms, putting in "avoid handguns" spoke directly to their credibility, and therefore, EVERYTHING they recommended was now suspect. My boss agreed. His boss agreed, and it went up the food chain.

The contractor who did the "study" lost their contract. I think only because I got things going, and because I didn't call their attitude about guns into question, what I questioned was their procedure, and how including guns in their results came from nowhere.

I mention this to make everyone aware that these agenda driven zealots can produce anti-gun "findings" without even bothering to ask any questions.

I have a strong suspicion that kind of attitude isn't just limited to anti gun bias, but that's where its easiest for me to recognize.
 

Don P

New member
Well I'll ask this, what about the drugs that prescribed for more than one ailment? I had some trouble sleeping so the doc writes a script for me. I get home and check and it also is used for treating mental disorders anxiety I believe. I called the doc back told him I would not fill the script and to remove it from my records. He did as I asked and now if he talks about a new script I ask what else if any is it used to treat.
 

heyjoe

New member
many medications are used for multiple conditions. They are even used for conditions off label. you can use rxlist to see what uses a particular medication has.
 

ThesNazud

New member
heyjoe said:
many medications are used for multiple conditions. They are even used for conditions off label. you can use rxlist to see what uses a particular medication has.

Exactly, I'm on a medication that is used mostly to treat parkinson's, but I was prescribed it for restless leg syndrome....
 

Itsa Bughunt

New member
Two things:
Narcotic drug registries. In my wife's case, it was the insurance company who caught my wife doctor shopping and put a stop to it.

I found the question, "do you keep guns in your residence?" on a pre admission questionnaire for a new clinic I was using. I left the answer blank, and wasn't questioned about it.
 

Chris_B

New member
Report:
After spending much of the last two weeks in hospital in MA, the subject came up exactly zero times. This means:

When EMTs collected me
When three major hospitals in three different cities including Boston treated me, one as a patient for five days
When three different rounds of prescriptions were written including one for oxycodone
During several followups over the phone
During surgery pre-screening
During out-patient physical therapy evaluation

I expect that the "question" would come right before 'do you feel safe in your home'. I believe that MA will at some time begin asking this "question", but right now, no.
 
Itsa Bughunt said:
I found the question, "do you keep guns in your residence?" on a pre admission questionnaire for a new clinic I was using. I left the answer blank, and wasn't questioned about it.
The problem with leaving it blank is that the information is probably transcribed by someone in the office into an electronic version of the form. You don't know if the person copying your data to the form will leave that entry blank, or perhaps interpret a blank as a "Yes."

It's even possible that the electronic form might be programmed to not allow a question to not be answered. (No, I don't know this to be the case with medical records, but I have encountered it numerous times with other types of forms.) In that case, the person entering your information has to put something. He or she probably wouldn't be at all comfortable putting "No," because what if a gun incident were to occur and the form came to light? So the "safe" answer would be "Yes."

Do I keep guns in my residence? No, my guns are all adults and they can go out any time they wish. I occasionally take them out with me when I go places.
 

Itsa Bughunt

New member
@heyjoe
"many medications are used for multiple conditions. They are even used for conditions off label. you can use rxlist to see what uses a particular medication has."

I got a medication to treat insomnia. On the Walgreens fact sheet it stated this drug is used to treat major depression, and the off label use to treat sleeplessness.

ot: Remember back in the day they'd give you Codein and flexeril to treat a sprain or fracture? Now it's Vicodin or Percoset and Xanax. Lots of people dying from the misuse of those drugs.
 

oldbadger

New member
Doctors and guns

This is so simple to understand. The AG in MA is anticipating being able to access medical records sometime in the future without going to too much trouble. She is trying to enlist doctors to influence people about gun ownership negatively and record the response, maybe in a simple way as having the doctor “check a box” in the record along with other demographic data such as date of birth. This fits nicely with the push for doctors to utilize a method of "electronic medical record keeping." I have mixed feelings about the questions about depression or being "blue".
Oh, and by the way, I liked the comment from Aguila about keeping guns in his house.:)
 

Loosedhorse

Moderator
Late to the party, but...

Keying off the OP, if I may:
this is a professional "boundary violation" on the part of doctors
No. While there are many sources discussing the term "boundary violation," I find this one, with its definitions, particularly helpful: http://www1.ucirvinehealth.org/magnetnursing/clienthtml/69/attachments-and-reference-documents/118/OO21a,%20Professional%20Standards%20of%20Conduct.pdf

So, if there is a boundary violation here, I would think it is by the AG: specifically, her trying to direct which discussions should occur between a patient and a doctor for the purposes of personal political gain. (Still, I doubt that this particular AG recognizes any "boundaries" at all for herself.)
----

presuming to lecture patients about something that's a constitutional right
It's also the doctor's constitutional right to discuss this topic (and others) with patients. At least for now, according to the 11th Circuit: http://media.ca11.uscourts.gov/opinions/pub/files/201214009.enbc.pdf

The argument that the patients' 2nd Amendment rights must blot out the doctors' First Amendment rights seems for now unpersuasive.
-----

“Gun violence is a major public health threat..."
There is at this time NO scientific or logical basis for a conclusion that legal gun ownership by lawful private citizens represents ANY health risk whatever; that goes for the owners, their families, and the public at large. Therefore, any "medical advice" against owning guns is likely unjustified and incompetent.

One can certainly make logical arguments for advice that guns not be left accessible to suicidal persons or to unsupervised children. I note that the NRA recommends that we "Store guns so they are not accessible to unauthorized persons."
Many factors must be considered when deciding where and how to store guns. A person's particular situation will be a major part of the consideration. Dozens of gun storage devices, as well as locking devices that attach directly to the gun, are available. However, mechanical locking devices, like the mechanical safeties built into guns, can fail and should not be used as a substitute for safe gun handling and the observance of all gun-safety rules.
Source: https://gunsafetyrules.nra.org/

Still, no one should confuse either safe storage of guns or gun control with suicide prevention.

There are also good arguments against violent criminals possessing guns, and against them using guns to commit crimes--in fact, there may already be some laws about all that, if I recall correctly. Perhaps the AG should stick to her true area of competence: advise criminals to follow the law.
:)
 
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squidmp

New member
Haven't been on in a while but see this post come back around from time to time and finally decided to add my worthless two cents.

Prior to Retirement

Dr.: Do you have any firearms in your home?
Me: So how much illegal and/or illicit photos do you have on your personal computer at home?

Dr: ?????, Well uh! I am asking about you.
Me: And I am concerned about you also and want to ensure you are not doing anything illegal that would prevent you from being the great care giver you are to me.

Dr. O.k. Moving along as questions about firearms dropped.

Concerning Risk mitigation:

Dr.: To ensure you avoid certain risks at home and/or on the job you need to avoid the following items, of which involves firearms, (mind you this prior to retirement).

Me; Dr, if you would look at my job description you would realize that I am a Federal L.E. and if I avoided firearms which are a part of my job description, I would not be able to perform my job. And a risk mitigation for you would be to avoid using needles when giving vaccines and so forth as you might stick yourself or poke someone in the eye.


After retirement, response is same as before except now I assist new shooters and inform during risk mitigation discussions that in order to assist others in knowing the possible dangers of firearms I inform and assist in proper handling techniques and go into the certain what ifs. Kinda the same as you (the Dr.) do when giving shots or discussing ways to live a healthier life.

Concerning the questionnaire, I always write IF I have any issues to discuss I will ask the care provider directly.

So what happens is they will ask me about my response and I will rephrase the question to them: Have there been any patients you just wanted to hit over the head today?

Then it goes to as mentioned previously about them being concerned for me and I let them know that in order for me to continue to receive good care from them I have to ensure they are in a good state of mind for their safety and mine.

Most know me now and avoid the nonsense. Every now and then I will get a new one filling in or whatever and I secretly know they want to take me out after I mess with their head.
 

DaleA

New member
I secretly know they want to take me out after I mess with their head.

Yeah, about this...

I want to tick off my health providers about the same way I want to tick off my food servers. :rolleyes:

Reminds me of an old Reader's Digest Humor in Uniform joke. A semi-deserted small town train station during WWII. A young spit and polish officer wants to buy something from a vending machine but doesn't have any change. He sees a young private and goes over to him.
"Excuse me, private. Do you have change for a dollar?"
"Yeah," says the private reaching into his pocket, "I got a bunch of change right here."
"Didn't they teach you anything in basic training private? When you answer an officer you come to attention and say 'sir'. Now let's try it again. Do you have change for a dollar?"
The private snaps to attention and loudly yells. "SIR, NO SIR!"
 

LogicMan

New member
There is no such thing as being too conspiratorial when it comes to the issue of gun rights. Constant vigilance is required.

Loosedhorse said:
also the doctor's constitutional right to discuss this topic (and others) with patients. At least for now, according to the 11th Circuit: http://media.ca11.uscourts.gov/opini...14009.enbc.pdf

The argument that the patients' 2nd Amendment rights must blot out the doctors' First Amendment rights seems for now unpersuasive.

What right of free speech is involved in a doctor asking a patient about guns? That is a very private issue.
 

Loosedhorse

Moderator
LogicMan said:
What right of free speech is involved...
Discussed at length in the opinion I linked.

It is an odd question that you ask, LogicMan. The Florida Firearms Owners’ Privacy Act had three provisions limiting physicians' speech, and those provisions were all struck down on First Amendment grounds. Would one ask after the DC Circuit panel struck down DC's handgun ban on 2nd Amendment grounds in Parker v. DC, "What right of keeping and bearing arms is involved in a person buying a handgun?"

That is a very private issue.
Perhaps the "very private" nature of conversations between doctor and patient is one of the best reasons to keep government restrictions on speech out of that space. I don't think it can be argued that the First Amendment is designed to protect only public speech, and so allow the gov't to restrict "very private" speech.
 
I don't think the 1st Amendment was intended to -- or should -- restrict a doctor's freedom to discuss any topic with a patient. That said, I remain of the opinion that a doctor who has not received extensive training in firearms safety is committing a boundary violation by presuming to enter into a field about which he or she is not knowledgeable.

There are many dangers around the home: poisons, toxic chemicals, throw rugs, bathtubs, loose or missing handrails, hand tools and electric tools, knives ... yet the AMA wants doctors to zero in on firearms. That's my clue that the concern isn't patient safety, the concern is an anti-gun political ideology.

When I was discharged to home after a heart operation, someone sent around an occupational therapist to review my living situation to be sure I wasn't in danger from things around the house while I was in a weakened condition. She went over the full list -- bathtubs, stairs, grab rails, stair handrails, loose rugs -- all the things that were likely to pose a risk of injury to someone who was weak and not fully mobile. Firearms weren't even mentioned.

Once you remove murder from the statistics, firearms are barely a blip on the radar. Here's an article listing the five most prevalent causes of accidental death in the U.S.:

http://listosaur.com/miscellaneous/top-5-causes-of-accidental-death-in-the-united-states/

1. Motor vehicles -- 42,000
2. Poisoning -- 39,000
3. Falls -- 25,000
4. Fires -- 2,700
5. Choking -- 2,500

6. Drowning -- 2,000

By contrast, accidental deaths due to firearms came in at 600.

Draw your own conclusions.
 
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ShootistPRS

New member
The fourth and fifth amendments both restrict what anyone can ask you to divulge about personal matters and expect a response. I will gladly share my medical history with my doctor but they don't need a financial statement or my recreational activities to provide health care. If necessary they can ask me to restrict my activities to aid in recovery of injury but they don't get to know whether I shoot guns or fire my howitzer in my recreational hours.
 

Frank Ettin

Administrator
ShootistPRS said:
The fourth and fifth amendments both restrict what anyone can ask you to divulge about personal matters and expect a response. I will gladly share my medical history with my doctor but they don't need a financial statement or my recreational activities to provide health care.....
No, they most definitely do not.

First, the Constitution in general regulates only the conduct of the federal government, although certain rights protected by the Bill of Rights have been found (through application of the Due Process clause of the Fourteenth Amendment) by the courts in the last hundred or so years to also be protected against some regulation by states.

Second, both the Fourth and the Fifth Amendments are very specific as to the personal interests protected against governmental intrusion. The Fourth Amendment protects one against unreasonable searches and seizures of one's person or property under federal or state governmental authority. The Fifth Amendment protects one against being compelled to testify against himself in a criminal case (as well as protecting certain other rights, such as requiring a grand jury indictment to be prosecuted by the federal, but not a state, government).

It's important to understand what the Constitution does, as well as what it does not do.
 
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