Dr. gives deadline to smoking pts - page 3

Just heard a news item ........... Dr. Ross in Manitoba has issued a deadline to all pts who smoke......by March 1st.....today...... seek treatment to stop the addiction of smoking or lose him as a... Read More

  1. by   hapeewendy
    Truthfully I am kind of disapointed in the whole rallying behind Dr Ross tone of this thread.

    people keep rationalizing that smoking is an addiction and the dr should have the right to refuse to treat pts based on the fact he has "warned" them that they need to quit or else....

    well I beg to differ with those of you who somehow see alcoholism and over eating and drug abuse as addictions not worth mentioning here.

    why has this holier than thou dr not stopped treating the above type of patients also?

    smoking is the easiest one to pick on thats why, the ads about what smoking can do to your body are all over the TV and since more people are seen in the public with this addiction *not like you see people on the street corner binging and purging or drinking entirely too much alcohol* its the simplest one for people to ***** and moan about.

    I have strong feelings about smoking, I hate it, I wish that everyone would stop smoking , horrendous habit with tons of side effects
    but there are tons of other addictions/ poor behaviour that patients exhibit that all too often are not addressed.

    your job as a nurse, as someone put it *JMP* i believe is to health teach, of course it is , but it is also NOT to impose our personal beliefs on our patients.
    you health teach that smoking is bad, explain the possible side effects etc and the patient continues to smoke, what on gods green earth gives you the right to stop seeing the patient because they didnt "listen to your words of wisdom"

    JMP - you raise some good points but fail to see the other side to the issue, and just because Mario may not technically be a nurse yet he is certainly allowed to voice an opinion on this subject and I do believe he has had clinical experience and worked with patients in some capacity

    all I can say is that its disheartening to hear that so many of my co workers would so clearly back the idea of not treating patients who although make bad choices in life , deserve medical treatment nonetheless.

    this is discrimination plain and simple.
  2. by   JMP
    Wendy Look go back and read the issue.......... DR Ross is NOT saying he will not see smokers, he is saying, look you smoke, you want to continue to be my pt?.....well then, come to me and try to quit. Seek treatment. That is the point.

    As I have said before and will say again, smoking IS NOT like eating donuts, drinking or anything else we can come up with. Everyone has to eat. Drinking in moderation is OK. Some say a glass of red wine with your meal is actually good for you.

    If I am hard on mario, well so be it. I guess I have seen too much to take the live and let live crap to work with me. Smoking causes heart ache, suffering, and so on and so on.

    Dr. Ross is trying to take smoking to the level it should be at. People seem to think smoking is some benign act. IT is not. I recently read an article that said if everyone who smoked quit, half of all hospital admissions would simply not be there.

    I have watched too many people suffer years, die horrible deaths. NOT ONE OF THEM EVER SAID........ god I am glad I was a smoker...it was worth it.

    Discrimination? No, we need to face reality. TO me, smoking is in the same category as driving drunk. People used to think it was OK.... it was tolerated, people looked the other way. We can no longer look the other way and expect things to get better. Strong ideas, yes. I think Dr. Ross has made his point and just the fact people are talking about it pleases me to no end.
  3. by   VickyRN
    Discrimination? No, we need to face reality. TO me, smoking is in the same category as driving drunk. People used to think it was OK.... it was tolerated, people looked the other way. We can no longer look the other way and expect things to get better. Strong ideas, yes. I think Dr. Ross has made his point and just the fact people are talking about it pleases me to no end.
    There has to be a point in which personal responsiblity comes in. If a patient is not taking any type of responisiblity for their health, not following medical recommendations, not attempting even to do so when it is ok for the healthcare person to say enough? Or do we not have that right at all?
    Agree entirely, couldn't have stated it better. And this is coming from a nurse in North Carolinia, the tobacco capitol of the world!!! If I had a battleship, it would not be able to contain all the memories of horrific suffering I have observed that was a direct result of smoking. Sometimes the most compassionate thing we can do as health professionals is to require patients to take ownership of their health before they reach the point of no return.
  4. by   rncountry
    Wendy, I am not trying to sound like I am discriminating towards smokers, I am not. I am an ex-smoker, and know all too well how difficult it is to stop. My point was that it is not inappropriate to ask adults to act like adults. If you are going to continue to do something that you know is terribly unhealthy for you, with no thought of attempting to stop, to get healthier, then you reap the consequences. It matters not to me whether that is a smoker, an overeater or a drinker. He didn't say he wouldn't treat smokers, he said he wouldn't treat smokers who didn't want to take some responsibility for their own health. It is the rare smoker who can quit the first time around, most have to try several times. All he is asking is that they try. Why is that wrong? It is not imposing morality on someone else, it is demanding that responsibility for their own health be taken.
    Nicotine is a drug. Should the doc treat drug addicts without the idea that they should seek appropriate treatment? It's ok go ahead and snort that coke and I'll keep trying to keep your sinuses together? Go ahead and smoke that cigerette and I'll try to keep you breathing. Hardly any real difference except that health wise more people are harmed every day by nicotine than coke.
    There are many, many nurses in this country who want to go to a universal health care system similar to Canada's or the UK. It is my feeling that if that was ever to happen here, then people should be accountable for their decisions. I personally don't think the government has the right to tell me to wear a seatbelt or a helmet when I ride a motercycle, it is my right to risk my life and limb if I wish to do so, however it is then not up to the government to pay for the care it will take in a neuro unit and rehab when I go through the windshield of the car either.
    Quitting smoking is soooo hard. The physical cravings for a cigerette even months after quitting will probably always be there. Sometimes they hit out of the blue for no apparent reason. And unless someone has smoked and then quit then you have no understanding of what I am talking about. But guess what? Struggling to breathe all the time is even harder. Anyone who has ever watched the panic and anxiety on the face of the patient who can't could probably tell you that.
    I don't see this as a morality issue in the least, I see it as a way to tackle smoking for what it is, an addiction that disables you, and will eventually kill you. I quit after my 5 year old told me bluntly that if I kept smoking I would die. Figured if a 5 year old understood I sure as hell should. Do I miss it? Yes. Do I need it? NO. Sometimes people need a push.
  5. by   fergus51
    JMP,
    Bad eating habits and drinking are exactly the same as smoking! Yes people have to eat- BUT, they don't have to eat Cheetos and coke three meals a day. The same goes for smoking, drinking or anything else. Would this doctor continue to treat someone who has one cigarette a day after dinner (I doubt that would cause a lot of disease)? What's the difference between abusing cigarettes and abusing food or alcohol or drugs?

    Rncountry,
    As a staunch defender of the universal health care system, smokers pay their share of taxes to help fund the care they may one day need. Not only do they pay the same amount as the rest of us, but our provincial gov't just added an extra 8$ tax on cartons of cigarettes with the intention of using the money for health care. Would that change your mind at all?

    The problem with the blame game is that it would have to apply to everyone and not just smokers. Non-compliant diabetics, alcoholics, over-eaters, non-exercizers, non-helmet-wearers and everyone else We'd be out of a job in a week!
  6. by   mario_ragucci
    Forgive me for mentioning the gasoline addiction stuff. I should know better, because it ALWAYS makes people mad, and it's no way to make friends if people think I'm a zealot, who points out stuff that is out of the box. What else could I be? All apologies.

    The reason I say "live and let live" and referenced "communism" is because I can :-0. This ain't no battle I'm in here, with anyone. For the record, however, Mario will be an RN in 2004, come smokers, SUV's or high-water. :-)

    Live and let live...means, life, and living it, for me, and everyone, is finite. The only thing we can really control is our own life, and how we live it. Patients are not recruits, and you ain't no drill instructor :-0 America is a free country. Canada is too (?) If folks want to smoke, wear fur, binge, gamble...it's thier call. (as long as you don't hurt no one else) (can you stand to see a casino ROB a family's money?) In this country, they even sell machine guns to people if they want to buy them. Let's talk harmful stuff.
    I believe a certain level of maturity has to accompany you as a nurse/healthcare professional. No one is born via immaculate conception, meaning, we're people, and we have short comings. We help each other.

    Let me get my dirty laundry started before all the machines get taken. I enjoy the conversation, and find the topic interesting.

    (AND, if this ever changing world in which WE live in, makes YOU give in and cry :-( ...SAY LIVE AND LET DIE !!!!!!)
    (Paul McCartney)
  7. by   rncountry
    fergus, I wish this country had universal healthcare. I think we are now the only western country that does not have it. We spend more per capita, yet with less results. I also think it is totally appropriate to expect people to take responsiblity.
    Mario, I think you must be closer in age to my 18 year old son then me, he loves the beatles too. He also believes in live and let live, because he has never watched a 24 year old kid die in his mothers arm's because someone was drunk driving, that was pretty acceptable once too.
  8. by   mario_ragucci
    rncountry, Paul McCartney also founded a band called Wings back in the 70's. He didn't come up with that song until 1976, I think. It was the hit title of a James Bond 007 movie of the same name.

    Why are you putting my name in the same paragraph as a 18 year old who has never seen a 24 year old die because of a drunk driver? Do you think I am saying it's okay to drink and drive?
    Hey, i'm outta this. :-(
  9. by   rncountry
    Mario, no intent to hurt feelings here. I was trying to point out that the idea of live and let live is easier said than the results witnessed. And honey it was not just any 18 year old kid I put you in with, but my own. And I happen to like him a hellava lot. And who do you think turned him on to the Beatles? Not his friends I assure you. I am well aware of the Wings and their music, I grew up with it. But Paul McCartney will always be a Beatle no matter what.
    And please don't let your feelings be hurt that easily. Geesh.
  10. by   live4today
    Kudos for Dr. Ross from this nurse's perspective! I would do the same thing Dr. Ross did if I were caring for patients who refused to better their health while continuing to take up the doc's time, while at the same time continue to waste their own money or the state's money...whoever is paying for their frequent visits to the doc.

    As nurses, we take care of lots of "noncompliant" patients: i.e., non compliant diabetics, noncompliant cardiac patients, noncompliant obese patients, noncompliant birthcontrol users (therefore continuously getting pregnant when they can't provide for the ones they have), noncompliant respiratory patients, noncompliant HIV/AIDS patients who refuse to take their meds and/or follow the treatment plan outlined to ensure they have as healthy a life as possible, noncompliant mental health patients who fail to take their meds, noncompliant epilepsy patients who forget to take their meds, and the list goes on.

    As nurses, if we tire of dealing with "repeat visits" from noncompliant patients who we know aren't going to become compliant unless they make a concertive effort to, then why shouldn't our doctors tire of the same patients who continuously abuse the healthcare system, as well as their own bodies?


    "I've learned that to ignore the facts does not change the facts." -- Andy Rooney
  11. by   patadney
    to rncountry:re:the self destructive pt. Why has he not been committed to a mental health unit?He is clearly a danger to himself with these behaviors. Obviously a PD,we have had much experience with these types. They make bad choices and often cut on themselves or eat things like spoons or razors. The surgeons get really mad when they have to get these objects back,and then we put them on 1:1 watches and they have no choice to refuse as they are a danger to themselves. Please ask for a psych consult when you gety this type of pt.
  12. by   hapeewendy
    well it seems as though once again many of you are failing to at least appreciate the other side of this issue, therefore I am deciding not to comment on it any further, except for this one last part

    JMP - I *DID* infact read your post , and I do understand the situation fully, you are right that dr ross is offering to help his pts quit, however if they dont, he is refusing to care for them anymroe
    hence the discrimination

    and some of you are living in a dream world if you think that alcoholism, drug abuse and even overeating binging/purging are not in the same category as smoking, get real, the point isnt that smoking isnt harmful its that it seems to be the popular thing to put down.

    if your fuzzy logic theory about a glass of wine or junk food in moderation is true, whens the last time you saw a person die from smoking one cigarette? what about the other things a person might smoke, does dr ross not have an opinion about marijuana smoking, cigar smoking, pipe smoking?

    we have all seen the horrific side effects and health issues that have come up with smokers,
    my question is, how is it in any way proactive (like nurses and other health care professionals are supposed to be!) to just refuse care to a person with an addiction?

    maybe some of dr ross's patients are not ready to quit yet, ultimatums dont work, plain and simple.

    if youre gonna start thinking on this train of thought , there has to be equality, hey I got it!
    No health care for anyone that you deem as non compliant!!!
    that'll work!


    JMP to quote you "I recently read an article that said if everyone who smoked quit, half of all hospital admissions would simply not be there."

    ok lets do the math , the smokers take up the half of the admissions, why not force diabetics to be compliant, alcoholics to stop drinking, drug abusers to quit using drugs and that will account for the other half! *idealistic sigh*

    I'm not suggesting live and let live, I'm suggesting not treating one addiction different from the others.

    I'll let you come to the floor I work on so you can see the side effects of smoking, alcoholism , drug abuse and yes even overeating .......
    I myself would be hardpressed to figure out which is the worst way to die, but seems some of you have it all figured out !


    I respect everyones opinions here, I just dont enjoy people seeming to "attack" what I say..
    I respected peoples posting here on the topic enough to post my own beliefs about it
    but if its gonna come down to who's belief is right and who's is wrong......
    count me out..

    neither one is right or wrong, they are just different, I'm just a big believer in health care for all people.

    but honestly, JMP your rationalization of smoking vs drunk driving is highly debatable at best...
    and as a non smoker, even I find that a terrible
    comparison to make.
  13. by   pebbles
    here's some info about whether or not what he is doing is actually having any effect on his patients. keep in mind we have free health care in canada, but also a severe doctor shortage, and finding another dr might not be easy. there are many sides to this issue, for sure!
    md's tough love working
    50 smoking patients choose quitting over leaving doctor

    (march 2nd, 2002/ winnipeg free press)

    a tough stand by a winnipeg doctor who declared he would not treat smokers who are unwilling to give up the habit seems to have worked with some of his patients.

    dr. frederick ross, a family physician at park west medical centre, posted messages in the clinic on dec. 1 telling smokers to butt out by march 1 of this year or find a new doctor.

    yesterday, ross said only about a half-dozen of his smoking patients requested that their medical records be transferred to another physician.

    however, he said at least 50 have told him they would rather quit than change doctors.

    "i thought it would have a major impact on my practice, that i would lose a lot of patients," said ross.

    ross, who has been practising medicine for 27 years, treats approximately 5,000 patients, of whom he said between five and 10 per cent are smokers. ross said he does not yet know what the majority of his smoking patients have decided to do.

    during the past week, his ultimatum has attracted national attention, not all of it favourable. while the college of physicians and surgeons of manitoba has said that ross is not breaching any rules, some members of the health-care community claimed it unethical to withdraw medical treatment from people with an addiction.

    "i know i've taken a hard stand and some people think i'm a jerk, but all i'm interested in is their health," said ross. "i'll never give up the beat. i'm always going to try and encourage patients to quit smoking."

    he said if patients want to quit, he will bend over backwards to help them.

    ross said he wished the province would do the same. he said the government should pay for smoking-cessation products like nicotine patches and gum. he pointed out that manitoba has one of the highest smoking rates in the country.

    ross said he decided to issue the ultimatum when a patient resumed smoking after she had been successfully treated for lung cancer.

    he said his smoking patients often suffer from chronic bronchitis and heart disease.

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