Dr. gives deadline to smoking pts

Nurses General Nursing

Published

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.

Originally posted by Gromit

JMP, I >REALLY

JMP is well within rights to lambaster me anywhere/anytime. And it's Mr. Ragucci. :rolleyes: :o :confused: :-(

Specializes in Pediatric Rehabilitation.

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..

Specializes in ICU-Stepdown.

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.

(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)

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.

wow this thread is still kickin?

hehe

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?

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.:p

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

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?

I'm not in disagreement with what you say....

I've experienced a lot of what you write about ...

I guess where I was trying to go with what I was typing was that more attention needs to be paid to the other addictions...

but yeah this one was about smoking...

I got sidetracked.

I Just hope I dont get into a habit because of stress or depression or something and then have someone I've turned to for the provision of healthcare start ultimatum'ing me all over the place...

I'm not a fan of holier than thou attitudes, and thats exactly how this dr struck me, so yeah it hit a nerve.

If you consciously pick up a pack of cigs and you were not previously a smoker because you are stressed or depressed,well you made an conscious adult decision.

You could just as easily seek medical help for these conditions than to pick smoking which you know is more harmful than helpful.

You are still making excuses.

Again the ultimaitum was to accept help to quit. Surly you are not saying you would refuse?:kiss

If the doctor is not a psychologist he is incapable of curing addiction. Doctors only treat symptoms and try to manage the tx course. In that light isn't he right to refer for the wrong reasons?

Peeps I am not going to argure what constitutes an addiction. I will state that we know that a physical dependence does exist with tobacco. Physical dependencies are a medical issue and are treatable with medical means. A psycological dependence is I agree another issue.

We also know the first step in treating any addiciton issue is to break the physical dependency first then we treat the psychological.

Bottom line we dry out our addicts before we try to psycologically rehab them.

Psycological addiction in never considered cured. A physical dependency can be.

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