Dr. gives deadline to smoking pts - page 4

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   wildhoney
    This reminds me of something I heard on the radio the other day about a doctor refusing to prescribe any form of birth control to women or Viagra to single men (young, gay or straight). Hmm. What's going on?

    I see both sides of the argument and can't seem to make up my mind about which side is more right. I guess these patient's will be forced to go elsewhere, but there will always be sick patient's to see, patient's being born, patient's getting a terminal disease not related to smoking (unfortunately), and he knows this. It's a revolving door. I don't think his financial burden will be too great or last indefinitely. I wouldn't want a doctor who is disgusted with me or my smoking habit to treat me for anything. Regardless of how long this man has been my doctor, I would say "hasta" to him and part ways. You have your beliefs and I have mine.

    I agree with Hapeewendy. Smoking is an addiction. Why is it ok to treat patient's with other addictions? This man's personal feelings are obviously interfering with his patient's care. I just can't imagine turning sick people away. I guess he has had about all he can stand with smoking related illnesses, or maybe he lost someone close to him. I do admire him for standing up for what he believes in even if I do not support his beliefs. God Bless him if he can stop just 5 people from smoking. That would be considered triumphant.

    : )

    Wildhoney <---- ex smoker x11 years : )
  2. by   pebbles
    I think that yes, smoking is an addiction, and you can say what about other addictions, etc. But you have to start somehwere. After seeing several of our "repeat offenders" with ETOH related pancreatitis come back lately, I am feeling like the system is enabling them to avoid trying to get better. We patch them up. Nobody has the time, energy or resources to enforce that they try to quit at all OR motivate them, assist them in any way at all. They leave and go right back to the addiction with no effort whatsoever to quit.

    I don't agree with punishing people who have been "morally bad" ie having an addiction, by withdrawing medical care. Addiction IS an illness. People who refuse to learn how to manage their diabetes - get neuropathy, etc. Every person with any illness at all has to participate in their own care to try and get better - we *cannot* do it all. This doctor is just saying he is refusing to TRY to do it all any more. He is dropping the facade. I applaude him.

    I also think more public education, press exposure to hammer home the idea that people are not just recipients of care but must actively participate - can only be a good thing.
  3. by   wildhoney
    Originally posted by pebbles

    I think that yes, smoking is an addiction, and you can say what about other addictions, etc. But you have to start somehwere. After seeing several of our "repeat offenders" with ETOH related pancreatitis come back lately, I am feeling like the system is enabling them to avoid trying to get better. We patch them up. Nobody has the time, energy or resources to enforce that they try to quit at all OR motivate them, assist them in any way at all. They leave and go right back to the addiction with no effort whatsoever to quit. [QUOTE]



    I agree with your comment about "repeat offenders," especially the liver transplant people who continue to drink. That really irks me. How much is a liver these days? I also have a problem with people on oxygen who continue to smoke.

    Smoking is a bit different however from diabetes. You really can't compare the two. Diabetes is acquired and smoking isn't. You can take insulin for that condition, if you don't you die, you have no choice but to manage it and educate yourself. Smoking is a drug, you crave it, your body shakes if you don't get it, smoking takes forever and a day (most of the time) to kill, you think you have plenty of time left. It's easier to manage Diabetes, all you need is a insulin and a good diet. You can manage a Neurological condition most of the time with medication, of course that depends on what it is. These people are fully aware they have a problem. Smokers are in denial, they feel they don't need any help. Why would they even want to educate themselves? Alcoholics are in denial also.

    We need doctor's to help us quit smoking, we need nurses to help us quit smoking, we need doctor's to help us quit drinking, we need doctors (and weight watcher's : ) to help us stop overeating, etc..

    It's either stop smoking or you can die from the illness smoking caused (even though you probably will), and I'm not going to treat your sickness. Shouldn't a doctor try to ease their discomfort/pain? I'm not going to give you your meds anymore, find another dr. That's ok because there will always be another doctor out there to treat them. You're an alcoholic and drunk drivers kill so I don't want to treat you, I'm sick of seeing people with alcohol related illnesses. You overeat and you have too many obesity related problems from overeating, so I don't want to see you anymore. Maybe if doctor's stop seeing obese patient's they'll stop over eating and drive the message home? Where do we draw the line?

    But again, that doctor can do what he wants to do. We can't look down on these people because they have a problem or make them feel as if they're second class citizens. Yes, smoking is ugly, it does terrible things to a body, I curse the person who ever made cigarettes, but these people are not stupid, they still have a right to be treated like human beings and not suffer regardless of their addiction.

    Some doctor's have obviously become very disillusioned and bitter.
  4. by   rncountry
    Patadney, the patient I referred to is being seen by a psych doc. He cannot go to a psych facility because he is too medically complicated, and they will not accept him. We did attempt to place in a medical psych unit at U of M hospital, they first had no beds, then when a bed became available it was denied by medicare as unnecessary as his needs were being met at my facility. We would have been better off if we had not done the psych consult, at least the patient would have gotten to a place that would have been better suited for him. According to the psych doc he is alert and oriented, with poor judgement. Not an active threat to himself because everything he is doing will not kill him immediately. Therefore if he refuses a sitter he is well within his patient rights to do so, and we most certainly cannot restrain him. Because we do long term acute care we also do team meetings on the patients once a week for utilization and appropriateness etc... we have done everything we can for this patient at this point. What eventually happens is up to the patient.
  5. by   disher
    Is his course of action best for the individual patient? His stance encourages patients to examine individual preferences and values, not just follow unexamined advice. I support Dr. Ross' stance because whether they quit smoking or not , it leads the patient take responsibility for examining interventions and understanding the impact acceptance or rejection has on their health.
  6. by   JMP
    Disher

    You hit the nail on the head.
  7. by   semstr
    JMP,

    I, as a smoker (who tries to quit every two or three years) am deeply offended, when you compare me and other smokers with a drunken driver.

    Now that really stinks!
    Renee
  8. by   JMP
    Semtr
    The comparison was made to show how socialable unacceptable it is to drink and drive....... it was once accepted. Smoking is hopefully on the same track.....becoming more and more socially unacceptable. People, in my never to be humble opinion, can not continue to smoke and not understand that there are significant health concerns and issues waiting for them down the "road". Trying to argue it is their god given "right" galls me. It costs us big time tax dollars in cour country ( and no it is not covered by the tax on cigs) and costs us our health when we or smokers children have to inhale the stuff when smokers smoke in public. It also costs our family grieve, worry and heartache when we watch someone we love die of lung ca or COPD. The denial has to stop and if that offends you, well, what can I say, except.....maybe you should stop smoking?
  9. by   mario_ragucci
    JMP - the introduction of the doctor's move to enforce intervention is noteworthy. It draws light to a medical professional's stance on one unhealth lifestyle choice of his patients. But don't abuse this information by turning it into a plank to start your own crusade here. Please consider not waste bandwidth on a lifestyle issue we all know about. Do you think we just walked out of the cotton fields or something? Stop trying to incite and polarize folks with kindergarden rhetoric, please. This is a nursing electronic forum, remember? We all know about health, and the year is 2002! Yawda know something about human nature, in that, if you keep telling folks they shouldn't do something, a measurable number of them will do it just because YOU are telling them not to.

    And RN country, sugarbaby honeybunny, please don't be addressing me with no petname . Gosh - you know - I don't like to point stuff like this out, but, again, this is an electronic forum, and unless you indicate you are kidding with me, pet names should be reserved. If we are talking to each other in person, well, thats different. Many people read these boards, okay? You shouldn't make a inappropriate comparison, then play like I get my feelings hurt. Remarking that I remind you of your teenage son is cheap shot. You don't see me comparing you with some 80 or 15 year old person. Address me like you want to be addressed, with respect. And don't be mistaking me for another body. Thanks :-)

    I respect this forum as a place that has taught me plenty. To me, its a place to vent, talk, chit-chat, learn ,and respect other peoples ideas. What are your ideas of how this thread can be used to help people?
  10. by   fergus51
    JMP,
    If we want to argue that smoking isn't a right, shouldn't it be made illegal? As long as people are not breaking the law I don't see how we can compare them to drunk drivers. Would you support it being made illegal to smoke? I don't know if any groups are working on this. Here in BC it was made illegal in public places like restaurants and pubs because of the danger of secondhand smoke on workers, but the provincial gov't has nixed that.

    I never meant to imply that the cig tax alone will pay for their health care, but they also pay regular taxes to pay for that. Just like my taxes will pay for me when I have an MI. A study done a year or so ago in the Czech Republic actually found that smoking saved the health care system money by killing people prematurely. It's sick, and was VERY criticized in the country.
  11. by   JMP
    Mario

    Umm...... my opinions may be strong. However, I am entitled to them. As far as human nature goes, give me a break kiddo. I do not see these boards as my plank. IF it is too hot for you, well maybe you should get out of the kitchen and sit in the living room for awhile? After you are cooled off...... come back and then we can talk.
  12. by   JMP
    Oh yah, as far as someone doing something because I told them not to- I raised two kids- mostly on my own and so I know about teenage behaviour. If you see smoking in that light Mario, you must be lighting one up right now?
  13. by   mario_ragucci
    JMP - please don't start now asserting I am mad. If I'm mad, I will tell you I am mad. If you want to think I am mad, and then post your thought I am mad, thats okay. You can.
    That, however, is a diversion. You can respond to what I wrote, but you instead assert your perceptions of my mood. It's okay, son.
    :-)

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