tag:blogger.com,1999:blog-5883634615775822475.post468882619247678674..comments2024-03-18T09:00:31.992-04:00Comments on Doctor Grumpy in the House: Sunday EditorialGrumpy, M.D.http://www.blogger.com/profile/09858110332436246760noreply@blogger.comBlogger47125tag:blogger.com,1999:blog-5883634615775822475.post-44661304591142967432010-04-07T12:10:43.651-04:002010-04-07T12:10:43.651-04:00I do agree. I think the whole thing is way out of...I do agree. I think the whole thing is way out of control with those in congress asking for his license to be removed. I think he would almost be in a better situation if he would have kicked a puppy instead.Pharmd Bikerhttps://www.blogger.com/profile/10778665371601282617noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-24266747765231149922010-04-07T11:30:26.205-04:002010-04-07T11:30:26.205-04:00PharmD Biker- No. He should not lose his license. ...PharmD Biker- No. He should not lose his license. He has a right to his opinion, just as I have a right to mine.<br /><br />Like I said originally, it's his practice. He can do what he wants. I don't agree with what he did.<br /><br />I agree that this has gone out of proportion. He was an expressing an opinion. I just disagree with the way he did it.Grumpy, M.D.https://www.blogger.com/profile/09858110332436246760noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-74285075337850711802010-04-07T11:24:15.346-04:002010-04-07T11:24:15.346-04:00ok, wrong or right i have 2 questions.
1- why are...ok, wrong or right i have 2 questions.<br /><br />1- why are people calling for his head on a platter? <br /><br />and <br /><br />2-should he lose his license to practice? some congressman (to late- its waaaaay political now), and some "concerned" citizens are demanding it. <br /><br />My opinion: Have we come to the point in out history that if you do not agree, you must be attacked and silenced?Pharmd Bikerhttps://www.blogger.com/profile/10778665371601282617noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-5117100089027795662010-04-07T04:08:23.090-04:002010-04-07T04:08:23.090-04:00What this urologist did is just downright immature...What this urologist did is just downright immature. We all have taken care of patients with all sorts of abhorent behaviors like violent crime or drug addiction, and do it without being insulting or intimidating. So this guy is drawing the line at voting? No, he didn't do anything illegal, but that's kinda moving the goal posts. There's all sorts behavior that is legal but is still unprofessional.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-59915220409292151442010-04-06T12:21:46.243-04:002010-04-06T12:21:46.243-04:00This comment has been removed by the author.Pharmd Bikerhttps://www.blogger.com/profile/10778665371601282617noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-84676315173636733622010-04-05T23:17:06.269-04:002010-04-05T23:17:06.269-04:00I notice plenty of folks are outright hostile towa...I notice plenty of folks are outright hostile towards this doc. True, lots of folks consider it unprofessional. Unethical, probably not. He is expressing an opinion, not denying care. I noticed no one mentioned the more disturbing aspect of this situation. Rep. Alan Grayson has publicly announced he will seek to file complaints with all relevant boards or agencies as retribution for the doctor expressing his opinion. Florida Department of Health has already announced that Dr. Cassell has broken no medical laws. Doesn't matter. <br /><br /><br />Regardless of whether or not you agree or disagree with Dr. Cassell's unenforced sign, you should be fairly disturbed at politicians directly attempting to harm medical professionals for expressing disagreement with medical laws. <br /><br />I am personally not entirely fond of the way Dr. Cassell is making his point. But I don't think he is being ethically or morally wrong for attempting to educate his patients on the new health care law. It is shocking how few people, even in Congress, have ANY knowledge of what the law contains. Whether you support or oppose Patient Protection and Affordable Care Act, READ THE BLOODY PROVISIONS. I have no idea, NONE, why people will moan, bicker, and scream over this without even skimming the Wikipedia entry. (No, I'm not saying you should rely on Wikipedia for anything, but ANY knowledge of the law is better than NO knowledge of the law.)<br /> <br /><br />In the interest of providing educated entertainment, here is the short version. Folks will be required by law to obtain coverage by 2014 or face a 2.5% fine or $695 per family member up to a $2,085 cap. Medicaid eligibility will be expanded. Tax credits and subsidization for insurance premiums. Restrictions on insurance policies barring certain practices. To compliment the expected increase in Medicaid patients, Medicare and Medicaid reimbursement schedule is being cut. Numerous taxes added, including a 40% excise tax on certain health insurance premiums. <br /><br />Don't take my word for anything, do your own research and make up your own mind. This shouldn't be Left vs Right, Tea Party vs Obama, or any other "Us vs Them" arrangement. It should be "Is it legal? Is this law good or bad for our country? Do I think this is the right way of achieving what I believe should be done? etc etc" I personally don't care what your opinion is. If you have an informed and reasonably educated opinion, you and your opinion are worthy of respect.<br /><br /><br />That said, there is one huge aspect of the law that perturbs me. I've talked to doctors, nurses, ambulance drivers, administrative folks, etc. In short, Medicare/Medicaid will likely only be widely accepted at very large hospitals or Medicare-mill practices. Numerous private practices started dropping Medicare and Medicaid prior to this law passing. The reimbursement schedule was cut to the point where most doctors lose money each and every time they see a client paying with Medicare/Medicaid. I don't mean "don't make much profit", I mean "directly lose money". <br /><br />A friend of mine that does IT stuff for medical billing systems explained that any normal practice with more than 30% of patients being Medicare/Medicaid will fold. There are exemptions to that rule (certain specialists, Medicare mills, etc), but it's more or less an industry rule of thumb. With the reimbursement schedule to be further cut, expect numerous additional private practices to flat out be unable to accept any Medicare/Medicaid. They cannot operate on a loss. The power company, the employees, the supply company, landlords, etc all expect to be paid.RevDiskhttp://www.revdisk.netnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-12269388860467902242010-04-05T22:41:17.406-04:002010-04-05T22:41:17.406-04:00I 100% support this doctor's rights not to acc...I 100% support this doctor's rights not to accept people who voted for Obama, but I do not understand why people are saying he's not refusing to see the patients based on the information from this sign. <br /><br />The sign says "If you voted for Obama ... seek urologic care elsewhere." It doesn't say "I would prefer you seek care elsewhere". It's a simple if, then statement<br /><br />He SAYS that he won't turn anyone away as that would be unethical, but the sign does not support that statement.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-91135280289430137292010-04-05T17:14:28.048-04:002010-04-05T17:14:28.048-04:00I am a nurse - a neuro nurse, not that it matters....I am a nurse - a neuro nurse, not that it matters. My biggest nightmare would be that my ex- who sexually abused our daughter for much of her childhood, and who still lives in the area, turns up on my floor requiring care. No question; I'd be gone.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-54585685675190870762010-04-05T16:17:16.209-04:002010-04-05T16:17:16.209-04:00The problem with a general urologist (doubtful in ...The problem with a general urologist (doubtful in this case being in Florida and all where those rich old geezer hang out) is they often have to be referred to, so it's not like the patient always goes out and chooses whichever doc he wants to see and if there aren't that many urologists, then said patient is upppa creek. So, what's the patient going to do? Keep mum? We do have private ballots in this country..., but if the TURP turns out badly, can the patient sue on the ground of being a Democrat? <br /><br />The guy is a jerk, IF what he did was irreprehensible. Sure, it is his option to state a preference, and he doesn't have to serve, but he is taking insurance, or is he privately paid cash-only?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-61382301506324284312010-04-05T12:48:00.492-04:002010-04-05T12:48:00.492-04:00Rescuedog- I didn't say that anywhere above.Rescuedog- I didn't say that anywhere above.Grumpy, M.D.https://www.blogger.com/profile/09858110332436246760noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-32215518048256303542010-04-05T12:45:03.364-04:002010-04-05T12:45:03.364-04:00Dr Grumpy, you are refusing to see Medicare patien...Dr Grumpy, you are refusing to see Medicare patients because of low payments and you back this health care bill? That just doesn't make sense. Once this law takes full effect all of your reimbursements will drop! Hope you have an old, rich Uncle out there!Rescuedoghttps://www.blogger.com/profile/12771908533583513392noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-51614702067196791322010-04-05T07:55:18.108-04:002010-04-05T07:55:18.108-04:00That guy is a 4+ tool. I heard him blathering on t...That guy is a 4+ tool. I heard him blathering on the news about the downfall of our country. Fine dude, move the hell out.ERPhttps://www.blogger.com/profile/15973334581468131595noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-87465449722677635202010-04-04T22:43:47.218-04:002010-04-04T22:43:47.218-04:00I've most of the comments and it seems that mo...I've most of the comments and it seems that most are taking the position that the doctor is refusing to see patients who don't hold to the same political view as he does. That's <b>NOT</b> the case. HE'S NOT REFUSING TO CARE TO ANYONE. In fact, that's what he states in the article. All he has done is voice his opinion via a sign. <br /><br />We can ALL refuse to provide a service. A taxi driver does not have to transport someone if they do not wish to. If he's employed by a company, he may be required to by the employer but if he's independent, he can choose to either transport or not. <br /><br />@anonymous 6:16 A person working at a bookstore cannot refuse to sell a book per the employer's rules of employment but an independent owner CAN refuse to to carry certain books. <br /><br />A lawyer does NOT have to take a case if they don't want to. But if they are employed by a law firm, it's much more difficult to refuse to do the assigned work that they are being paid to do by their employer.<br /><br />A doctor does not have to take on a patient. In fact, I was once denied an appointment by a doctor's office. Had nothing to do with lack of insurance, payment or even being a "difficult" patient. He was my PCP at one time but since I had not needed to see him for over 15 years, my chart went to storage and he was not taking on new patients. That was his right. I was very disappointed because I liked him as a physician but that's life. He's not obligated to enter into a doctor/patient relationship with me and he's not obligated to reestablish that relationship. <br /><br />The Florida doctor has a right to voice his opinion even if people find it distasteful. State law addresses race, religion,<br />gender, sexual preference and disability as a prohibited reason to refuse service or employment but does not address political affiliation. <br /><br />While it may be highly distasteful to refuse to enter into a patient/doctor relationship based on a political choice, it's not a legally protected class. I would imagine that whoever governs physicians (the AMA?) could have their own rules and regulations that would prohibit doctors from putting up such signs.<br /><br />Even so, it's a MOOT point BECAUSE this doctor did NOT refuse to enter into a relationship with anyone based on a political choice. He's telling people before they even enter the door what he feels and patients can make up their mind to say to themselves "I don't want a doctor like that treating me." I don't know why everybody thinks he's refusing care unless they read an article that said he did refuse care that I have not seen.<br /><br />I still think it's cool that he had the moxie to do such a thing. I wish he'd bottle some of that moxie and mail it to me.bbhttps://www.blogger.com/profile/05060373657650063777noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-84920289418427286152010-04-04T22:41:24.379-04:002010-04-04T22:41:24.379-04:00Good points PC. Can't argue with that.Good points PC. Can't argue with that.Grumpy, M.D.https://www.blogger.com/profile/09858110332436246760noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-53805997421477869212010-04-04T22:34:04.156-04:002010-04-04T22:34:04.156-04:00As a pharmacist I try to look at both sides of thi...As a pharmacist I try to look at both sides of this issue. I see that as a private practioner her has the legal right to see whatever patients he chooses. If he wants to see only patients who like plaid pants, polka and oatmeal cookies, that is his right I suppose. Just because somebody WANTS to do business with you doesnt' mean that he has to accept your business. I am not saying I agree with what he is doing or that I would ever do it myself, but I would indeed DEFEND his right to do it. I have the right to allow into my home anybody I choose, but I do not have to allow anybody who comes to my door, entrance to my house. That is how i see this issue. He signs his own paychecks. I do not however. I dont have that privilege. I see all patients. I fill all legal prescriptions that meet the rules for my state/country. I am not an advocate for abortion but I dont pass judgement on some girl who comes in with a rx for Doxy and Methergine who has just had one. Its her life not mine.<br />All I am saying is HIS right to pursue his OWN business as a SOLE proprietor should be defended even if we dont necessarily agree with HOW he chooses to do it.pharmacy chickhttp://pharmacychick.blogpharm.comnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-65040295709934231062010-04-04T22:22:53.980-04:002010-04-04T22:22:53.980-04:00I read you because your posts are usually hilariou...I read you because your posts are usually hilarious - and laughter is the best medicine...<br /><br />But I like you, doc!<br /><br />You are good people - in my book anyway:)<br /><br />Even tho my grammar sucks....Phillipiahttps://www.blogger.com/profile/09547721599622181504noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-60982443978325611722010-04-04T21:16:50.882-04:002010-04-04T21:16:50.882-04:00I believe when you decide to do a job, such as be ...I believe when you decide to do a job, such as be a doctor, pharmacist or a taxi driver you either do the job the best you can even if you don't agree or get another job. If you don't want to have someone in your taxi who has duty free liquor, get another job. You don't like Plan B, GET ANOTHER JOB. I worked at a bookstore and I sometimes sold books that I found morally distasteful, but they had a right to buy them and it was my job to sell books. I don't have to like you to do my job.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-54718487216148798102010-04-04T20:16:05.502-04:002010-04-04T20:16:05.502-04:00A professional who cannot be true to his own profe...A professional who cannot be true to his own profession is not likely to remain true to his politics. Legalities aside, this Florida Doctor has no business being in the healthcare business!Swami Dilhttps://www.blogger.com/profile/03486227823610436414noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-38295810205532010092010-04-04T20:01:18.635-04:002010-04-04T20:01:18.635-04:00Medicine is being described as a business when Med...Medicine is being described as a business when Medicare patients don't bring in enough money to support the practice. <br />At the same time it is seen as an altruistic calling with universal responsibility when a physician refuses to see someone because of political beliefs.<br />Consistency anyone?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-56739242756441038822010-04-04T18:40:40.216-04:002010-04-04T18:40:40.216-04:00I was once dealing with a road traffic accident wi...I was once dealing with a road traffic accident with 3 casualties. They were all bleeding profusely and needed urgent transfusion.<br /><br />It was at a weekend when I was there alone and you can only deal with one at a time.<br /><br />There was a 6 year old boy, a motorcyclist and a drunk driver (who had caused the collision). The drunk driver was the most seriously injured and the child was the least, although all 3 were critical. It took every ounce of control for me to deal with the drunk driver first as his clinical need was the greatest but it REALLY did not sit well with me.<br /><br />Overcoming your emotions and beliefs can be really difficult.Food Addicthttps://www.blogger.com/profile/16413887520614296421noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-84550204621126463152010-04-04T17:41:17.734-04:002010-04-04T17:41:17.734-04:00Long time reader, first time poster. There is not...Long time reader, first time poster. There is nothing that this urologist did was unethical or illegal, in fact it was laudable. I am otolaryngologist with a strong interest in ethics and policy. The problem, Grumpy is that you are confusing the issue and many of your readers are having knee jerk responses and are misrepresenting the facts. By law a physician does not have to enter into a physician-patient relationship with anyone unless they work in an emergency department. Furthermore, if they are in a relationship with someone they may terminate it by providing a copy of their records, finding them a replacement or transfer of care so that their patient is not abandoned. In this case, he posted a sign outside his practice recommending voters of a particular persuasion should seek care elsewhere. He is in an elective field and simply made a recommendation and putting out information for his patients to make an informed decision. Patients judge physician on skin color, nationality, religion, political beliefs and this helps them make a decision. He did not withdraw care from anyone, ask anyone their opinions or discuss anything within his office with them unless they brought it up. I am sure if an Obama fan showed up with a torsed testicle in his office he would not ask him what his political persuasion was and treat his testicle. <br />When I am in the room with someone I treat them and their disease and I treat them as best as I can or when they are on the operating room table, even if I am Jewish and they have a huge swastika tatooed between their eyes. <br />Once we have agreed to care for someone (unless we work in the ER where we don't have a choice), all our personal feelings should not get in the way of the best possible professional care. However, forcing a physician to treat someone against their will is illegal and unethical. Of course, these laws may change and physicians will soon HAVE to take Medicare, medicaid, perform procedures they are not comfortable with. As you said, Grumpy: We'll see what happens.<br /><br />P.S. I definitely think your heart is in the right place and I understand what you meant to say but as I stated before you mixed the issues of the case. I could easily turn around and say if you don't respect the fact that your colleagues are human beings that have worked very hard to get where they are mainly at their own expense only to have it stripped from them by poorly conceived legislation and think they are bad physicians for voicing their first amendment rights then maybe you should find another profession.NozDocnoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-13248659529083647252010-04-04T16:39:46.930-04:002010-04-04T16:39:46.930-04:00Well-said. It's a good thing unprofessional do...Well-said. It's a good thing unprofessional doctors like that seem the exception, not the rule. I never discuss politics with my doctors (even though here things aren't as 'bad' as in the US right now), and I see no reason why political beliefs should matter when being treated by a doctor.Karenhttps://www.blogger.com/profile/09989730055534096822noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-6400465421386314002010-04-04T16:00:24.849-04:002010-04-04T16:00:24.849-04:00I think it's important to note the physician i...I think it's important to note the physician in question never refused to see patients.<br /><br />Its far from the most professional thing to do but at the same time the lack of unity in physicians and the inability to stand together is one of the problems in the field. <br /><br />He's taking a stand for something he believes. He's not hurting anyone (physically) and hurting someone's feelings isn't a crime.<br /><br />It's not something I would do, but I don't see the need to make such a big deal out of this as people are. Every action carries a reaction and this is this individuals.<br /><br />Maybe its just the scary thought of what could happen if physicians on a larger scale refused to participate in UHC.The Hatchlinghttps://www.blogger.com/profile/02741106169088113733noreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-84077473929819477602010-04-04T15:59:41.141-04:002010-04-04T15:59:41.141-04:00Allie and Jed,
Refusing to see Medicare patients ...Allie and Jed,<br /><br />Refusing to see Medicare patients is not the same thing at all. Medicare is cutting their payments so the doctors can no longer afford to take care of those patieents. The doctor's office has bills and salaries to pay. The doctors who stop taking Medicare would rather not have to do that, but economic reality is forcing their hand.<br /><br />The Florida doctor was refusing to see specific patients based on their ideology. That's more like refusing based on religion or race.Sandranoreply@blogger.comtag:blogger.com,1999:blog-5883634615775822475.post-3712427475597016742010-04-04T15:49:24.605-04:002010-04-04T15:49:24.605-04:00Just as Dr. Grumpy is free to refuse to see Medica...Just as Dr. Grumpy is free to refuse to see Medicare patients the Florida doctor is free to refuse to see any patient that approaches his door. Neither is a slave or an indentured servant so they should have the right to refuse service to anyone.Libertarian leaningsnoreply@blogger.com