Dr. gives deadline to smoking pts - page 8

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   Lausana
    Just curious how this is working out for him? How many of his patients left or quit.

    Interesting idea!
  2. by   JMP

    IF you go back and read my orginal post you will see that the DR. in question is in CANADA, not the US.

    If you see smoking in the light you just described then you need a few more "months" of nursing school.

    Just the way I see things of course, sorry if I sound hard about it, but I have seen more than a fair share of people die of lung cancer. I have suctioned crap out of ET tubes that is truly gross.

    Smoking and drinking to excess are things that if we where able to stop, 1/2 to 3/4 of our hospital beds would be empty. The health care system continues to focus on illness...RATHER THAN PREVENTION!

    I will get off my soap box now.
  3. by   renerian
    My Dr told me she would not give me any scripts. Since I wanted my ESTROGEN, LOL I quit that day.

  4. by   mario_ragucci
    JMP - If smoking related illness disturbed me, then I would avoid it. How would you interact with a person who smokes? Would it affect you professionally? You are free to expound on respiratory and carcineogenic factors...it's all known and undisputed. Don't let it affect your professional demenour. Medics still go into battle with soldiers. Imagine the lunacy at work there. You know what I mean. Men and women choose to fight, as well as smoke, or anything else. Nurses help them, but can't prevent war or carcinoma. :-) Intervention, but respect too.
  5. by   Gromit
    JMP, I >REALLY< don't think its your place to tell Mario that he should considder some other field or portion of the profession. Obviously (anyone care to differ?) you have a >VERY< strong opinion regarding smoking, smokers, tobacco in general, etc.
    Fine. We can all deal with that. We all have our opinions.
    Personally, I think the doctor at the beginning of the thread (yeah, way back there) made a personal decision. I think he is a bit off ONLY because its biased at smokers. If the Good Doctor made that statement regarding ANY patient who refused to try to get help or fix their bad habits, I'd say 'Fine. Kudos to you.' (I'd also find another physician).
    You continue to reiterate how bad things look, what you've seen, etc. Well, I'm still a year away from my RN, but I DO work as a CNA/Tech in an ICU, and while ours is a small one, we get our share of gross, oddities, and repeat customers. Thats good, I like a variety, and it only solidifies my resolve to get my schooling done, and get in there and do my part.
    HOWEVER, I've spent a LOT of years (more than a decade) on the streets, in an ambulance and seen enough of that as well. Everyone (or nearly) on here has seen these things, and we all choose the path we have taken, for our own reasons.
    Cardiology is my love of choice. Trach care is probably the nastiest thing I've ever done, but the patient also breathed a lot better afterward.

    Now, before you go and tell me I'm naive as you seem to think of Mr. Mario, let me explain my own experience in this:
    I dislike cigarettes with a passion. HOWEVER, I do enjoy an occasional (and I mean rare) fine hand-rolled premium cigar. (The kind you DON'T buy anywhere except a quality tobacco shop). I burn one once in a while, to relax and reflect on a 'job well done', or some special accomplishment. A 'once in a while event'.
    I'm a good cook, and really need to pay a bit more attention to my waist.
    I ride motorcycles. Its my main mode of transportation. I'm not talking about the rockets, but the big heavy cruisers. Chrome and all.
    --I USED to ride helmetless, but do not any longer. I support those in their right to choose, even though I think its rediculously risky.
    I like a drink, from time to time. I used to drink like a fish, but nowdays, a 'six-pack' will last for well over a month, or two, or even longer. A glass of wine is even rare these days, and I used to make my own.
    We all have habits, and in moderation, they will NOT affect our health. My bloodwork is exemplary, and my lungs are as clean as a whistle (used to have a job that required regular scans. The job scared me, and I no longer do that).

    For the record, you say you have seen the ills of alcohol (tobacco use, and all the others), and the little girl that (ultimately) died due to the drunk driver. >I< brought her to you. I peeled her face back OUT of the shattered glass windshield, and called the trauma-alert and subsequent helicopter for her (that couldn't fly due to weather).
    The realities of poor choices are seen by all aspects of the health-care industry.

    Don't preach about what you've seen, and how others should see it, and 'it will change your opinion' if you SEE it the way >I< have. It doesn't work and nobody on this forum is impressed by the 'experiences'.

    You will have to deal with your own obsessions as we all must, and when it comes to opinions, I usually just 'live and let live'.
    --But to berate someone else, and even be so bold as to suggest that they change their career path, well, I've heard that one myself, and I HAVE to jump in on such talk.

    OK, I've said far more than enough.
    NOW, I have to get back to the books.
    btw, its truly nice meeting all of y'all!
    Last edit by Gromit on Dec 6, '02
  6. by   mario_ragucci
    Originally posted by Gromit
    JMP, I >REALLY< don't think its your place to tell Mario that he should considder some other field or portion of the profession. I'm naive as you seem to think of Mr. Mario, let me explain
    JMP is well within rights to lambaster me anywhere/anytime. And it's Mr. Ragucci. :-(
  7. by   nurs4kids
    hmm, gromit, remind me to never cross you..
    you DO have a way with words

    just one question..and I've not read the beginning of this thread since waaaay back when it started (it IS the same one, isn't it?)..

    anyhow, is this doc not breaking the hypocratic oath?? i mean, don't they take an oath to treat..and not selectively treat??

    just wondering..
  8. by   Gromit
    Sorry for that, Mr. Ragucchi. Meant no slight.

    Nurs4kids - I really don't know about that. To be honest, I'm not really very good at philosophy, and that seems to be where that lies.
    But if he were at LEAST consistent (ie. not just pointed at the smoking population) then I could at least grant him the benefit of the doubt (it DOES seem counter-productive to treat a patient that has no real intention of getting better).

    However, JMPs' typing indicated that this doctor treated some 'thousands' of patients. How close to a patient can he be?
    My doc is not a 'doc-in-the-box' (at least, what we call those of 'drive-through-medicine'). His private practice is relatively small, and he does know us.
    I'm fortunate that way.
    take care,
    good night.
    Last edit by Gromit on Dec 6, '02
  9. by   mario_ragucci
    (giggle) It's cool Gromlet :-) JMP is cool and shoots off on this board like so many. Having a strong opinion is fine. Smoking illnesses are preventable, and clearly a diagnosis of "failure to comply if someone with COPD, for example, doesn't stop smoking. In nursing school they use the example of a nurse who objects to abortions. The nurse should keep personal feelings out of anothers right to choose...and so on.
    They have "doc-in-the-boxes' everywhere. They provide a service. Just like Jack in the Box does. Love those Western Hamburgers for a dollar. (giggle)
  10. by   Agnus
    Originally posted 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.
    How is it unreasonable for a doctor to require that a patient take some responsibility for thier own health? How is it unreasonable for him to require that a patient accept medical help to stop an addiction?
    Insurance companies are selective in the care that they will pay for.

    Wendy I would not classify this as abandoment. Here in the states there are procedures that a MD can follow to fire a patient. It looks like this MD is doing that.

    Certain patients, particularly smokers who refuse to accept help to quit feel they can go their merry way and do what they will. And the good doc will just fix everything with a magic pill.

    They expect the docs to be gods. I work in NV were the smoking rate is highest in the nation. I have a lot of vent patients and the only reason they are on vents is because they smoked. Is this judicious use of resources when the cost and availablity of heath care has become what it is today? I would like to see equal distribution of health care reguardlesss. Yet, today that is not a realistic expectation. Is it really too much to ask adults to accept help that will stop the cause of thier illnesses? He is not telling them quit. He is saying accept medical help to quit.
    Personally I think anyone who refuses such a proposal is worse than an over indulged child. He is asking them to accept the best treatment for them. And it is a lot less painful to accept that treatment than the alternative treatment.
  11. by   hapeewendy
    wow this thread is still kickin?
    I agree with much of what you say ...
    but I'm kind of tired of smoking being the whipping boy for all ...
    there are many addictions, and as an addiction should be treated the same as any other
    what about the people that eat themselves into poor health? or the alcoholics waiting for liver transplants etc?
    my point is just that whatever the habit , the behaviours come from the same place and in my opinion are what needs to be addressed and treated...
    if doctors issued ultimatums for behaviour changes across the board they would have no patients to care for...
    people take up addictive behaviour for many reasons.. stress being a huge reason, and the threat of losing your doctor if you dont stop a nasty habit you've picked up probably isnt the best way to get people to stop...
    its just my opinion
    i dont smoke ,rarely drink and although I enjoy a chocolate or two or ten I'm not morbidly obese
    I just dont understand how smoking is always the addictive behaviour people focus on
    I can tell you that I have seen many more patients at least where I work that can blame pickling themselves with booze for their ill health... or the 400 pounder who cant move and complicates his or her course of recovery... but yes I have seen smokers who have smoked themselves into COPD etc...thats my point though..... why draw the line at smokers?
  12. by   Peeps Mcarthur
    As a healthcare practitioner the good DR is obligated by the responsibilities he accepted for his position.
    If one can call themselves moral in this position they will educate and enlighten, treat disease(both the addiction and the pathophysiology), and do it objectively.

    Besides that fluffy talk..................................What the heck is he thinking? Addictive, legal drugs, are the cornerstone that holds up our economy.

    It's just not good for business, those patches and whatnot.

    I smoked from 13 y/o to 30 y/o and was sick with something incapacitating about 5 times a year until I got the hint.

    Look, everybody's got an addiction to something. The search for pleasure and avoidance of pain is instinctual. The cruel reality is that the search usually drives us toward the unseen pain of our denial.

    Take it from an expert in both.:imbar
    Last edit by Peeps Mcarthur on Dec 6, '02
  13. by   Agnus
    Wendy I just popped back to add something to my post when I saw your answer.
    What I was going to add is this. Those smokers on vents want every thing medically to be done. When these patients do die their family who are often puffing away themselves, become angry with the docs and us because this realtive died.

    Wendy I care for each of my paients as any other. I agree everyone needs to take responsibility for thier health in ever way possible. I believe the line is being drawn at smoking because it is the area that is responsible for the greatest preventable cost in health care. As you know it is not just COPD but heart, kidney and a miriade of other body systems that are diseased by this habit.
    And there is effecitive treatment to stop it.
    Diet of course is another problem, and alcohol another. Of the three I think the treatment to stop smoking is most effective. I have known too many smokers who just don't want to quit. Then you get those who take the stance, "you can't make me stop." No I can't make you but what childish behavior.
    You gave a number of excuses to smoke or to continue smoking. These are just excuses not legitamate reasons. Making excuses for them is enabling.:kiss
    We are not picking on these folks. We do understand addition and are offering effeive help. But they have to take adult responsibility. More than diet more than alcohol this is the biggest price tag in preventable health care. Is that really fair to those who need the resource and are not smokers but cannot get the care because care has become so expensive and resources so limited?
    Last edit by Agnus on Dec 6, '02