Dr. gives deadline to smoking pts

  1. 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 Dr.

    Apparently Dr Ross is frustrated with smokers who keep coming back with smoking related problems....who do not seek treatment to quit. Understand he is not saying he will not treat smokers what he is saying is I WILL NOT CONTINUE TO TREAT PTS WHO DO NOT SEEK MEDICAL TREATMENT TO STOP.

    I find it interesting and as a nurse understand his frustration when people smoke their brains out....... don't even try to quit and end up with tons of chronic smoking related problems.

    Now I know this board and I know certain people will try to liken this to bad diet choices, drinking ect.....but understand his point.....he wants people to TRY or LEAVE his practice.

    The Canadian Medical Association has stated no one has made a compliant against him....... but several civil lib types are up in arms...... it will certainly make people think. Especially with the doctor shortage there is in Canada.
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  2. 109 Comments

  3. by   ERNurse752
    Interesting...definitely makes a statement!
    I like his idea, actually (dodging flames.)
    But I'm not a smoker...
  4. by   ohbet
    It is similar to bad diet choices and drinking,however,smoking is more addictive.
  5. by   mario_ragucci
    Then Dr. DoRight had it up to here with patients who refued to live normally. His patients refused to eat any fruits or vegetables, stop drinking colas and couldn't drink water. They all suffered with forms of depression, lack of energy, chronic GI problems and malnutrition. Dr. DoRight couldn't understand the blatent disregard most of his patients had for their own well-being. So, he told the helpless patients to seek other help and only helped the patients who would try to eat people food.

    Here we go again :-) :-) :-)
  6. by   SICU Queen
    I wonder if he's going to stop treating his fat patients who continue to eat improperly and suffer the myriad of complications that tag along with obesity?

    I myself don't smoke, but used to... watching all those vent patients gave me excellent incentive to stop. My lungs suffered for seven years though...

    He's in a definite gray area. I'm curious to see how this will turn out. I just thought of this too... like any business entity, doesn't he have the right to refuse service to anyone he chooses?
  7. by   Stargazer
    Legally I think he's on solid ground. He is giving his patients plenty of advance notice, so no one can accuse him of abandonment. I sort of see his point: he's telling people that if they don't quit smoking, then he's just not the best "fit" as a doctor for them.

    Physicians are allowed to terminate relationships with specific patients if they believe the therapeutic aspect of the relationship has been irrevocably damaged (e.g., pts who lie to their physicians, non-payment of bills, pts who refuse to follow instructions repeatedly). I'm guessing this guy may whittle his practice down to a very few select patients, but if he wants to starve, that's certainly his perogative.
  8. by   P_RN
    Anybody know if there is a set protocol for a doctor "firing" his patients?

    My inlaws doctor informed them he no longer took Medicare assignment, and "referred" them to a new doctor. This new one was in a family practice group and had been in practice less than a month. The former doctor was a Board Certified Internist in practice nearly 15 years.

    Does the new doctor have to be equivalent? Why isn't this abandonment? The first thing the new doc did was miss an obvious PE.
  9. by   Stargazer
    P-RN, I think the loophole there is that a referral doesn't obligate you to start seeing the doctor to whom you're referred--it just ensures that you're not going to be out on the street without a doctor at all unless you so choose.

    Retiring docs have been selling their practices to brand-spankin' new ones for years. As long as the receiving doc is qualified, I think attempting to mandate or quantify "equivalence" would be next-to-impossible.

    I share your frustration. My parents have both had internists and cardiologists leave their practices and refer my parents to clinics where different docs rotated the duty of "visiting specialist" each week. In no way was that satisfactory to me. It took a while for me to get them set up with docs they liked, that I was happy with, and who looked like they were going to stick around for a while.

    Edited for waaaaaaay too many quotation marks.
    Last edit by Stargazer on Mar 1, '02
  10. by   hoolahan
    BRAVO!!!! For him!! Maybe that's what us chubbies, and smokers need to take the health risks seriously.

    I got a referral today for a pt with CHF COPD and "history of non-compliance with meds." Two addresses, no phone number. I had to watse 45 minutes of my day trying to locate this guy. And what if I did? What am I gonna do, wave my magic wand and make him compliant? Maybe a correct address would help??!!
  11. by   JMP
    Mario

    I knew some would try to compare this situation to bad diets and drinking whatever.......re-read the post. He is saying, YES if you smoke you can be my pt- BUT YOU HAVE TO TRY TO QUIT WITH MEDICAL TREATMENT. If you just continue to suck the butt and then keep coming to me with various health problems related to the habit.....then time for you to find another doctor.

    IT is in no way connected to eating pop, chips or driving a car to the doctors appointment.

    As an ICU RN I see so many people who can NOT BE EXTUBATED due to years of smoking. THeir lungs are non-compliant..........they have tons of gross secretions and end up with long term trachs. When you get to nursing school, perhaps it would be interesting for you to do some papers on smoking, in particular young people and smoking. Getting them NOT TO START is the key to all of this.

    Anyway, I will get off my soap box. I hold strong ideas regarding smoking. I thought this doc was brave and certainly on the right track.
  12. by   VickyRN
    I can truly understand where this doctor's coming from. I share his frustration. Just six years of nursing and have seen enough human misery caused by smoking than most people would see in a hundred lifetimes--worked in a skilled nursing ventilator unit; also worked med-surg and have seen more than my share of end-stage COPD patients, maxed out on benzodiazapines, wasting down to skin and bones, struggling for each breath; lung cancer victims on morphine pumps with their grieving relatives--you know the picture I'm sure--could go on and on and on and on and on.... This doctor's stand may seem harsh, but perhaps he's doing the most compassionate thing if he motivates even one of his patients to stop the cigs before it's too late.
  13. by   hapeewendy
    I've been hearing a lot about this situation
    being in Canada myself

    just to clarify , if the patients are upset with his ultimatum they can file a greivance of sorts with the board of physicians in manitoba etc
    no one has commented as to whether or not anyone has just yet though.

    In a way I see the drs frustration and point etc, but where is the line drawn? does he have the same policy for alcoholics etc?
    if you look at it , smoking is an addiction, why is it okay to abandon pts with a smoking addiction as a opposed to an overeating addiction, or drug abuse /alcoholism

    I am a non smoker , with significant asthma so I value these lungs of mine, but I just dont think we should give MD's that kind of power.....

    think of all the years he saw those patients, they contributed greatly no doubt to the money he received as income etc

    its not an easy topic to tackle, but it just seems like although his frustrations are understandable, it seems unrealistic to give ultimatums like that to patients, if more Dr's adopted this train of thought , we'd be in real trouble

    lets say youre a smoker,so dr ross wont see you, then some of his collegues follow suit, so on so forth, thats neglectful in my opinion, everyone deserves the same kind of medical care

    being that he is in private practice he probably has more of an ability to do this, but still, it feels wrong.
  14. by   numerouno
    You know i'm sorry i am an ex-smoker and thank my stars everyday i don't miss them. Come on now okay people will try and stop several times i myself tried for 6 times. Will this DR. set a limit on that too. I will only treat you if you stop after 4 tries...What happened to the oath he took.(i assume it's a he?) What if we as nurses said you know what i'm not going to take care of noncompliant diabetics come on get real. I have also seen a large number of obese who will not stop eating and are also on vents due to respiratory complications if they lost weight would he treat them then? I also see people who eat poor diets and die of colon cancer or on vents after it spreads to the lungs. This is a cop out on his part recognize it for what it is. It is not illegal to smoke it is to do drugs but we treat them. We all make choices some good some bad and we deserve the treatment of caring individuals. Quite frankly i think it's biased and someone is going to see that. Until he states he is not going to treat all patients who do not try to stop thier poor behvaviors it's plain bias!

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