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This is my point as well. It's one thing to encourage and another thing entirely to mandate a certain series of appointments related to this. Although this is an important subject, there is something to be said for personal responsibility as well. I know that I would rather spend my time treating patients than discussing legal issues that should be discussed among a patient and his or her family. I already discuss these issues with my patients briefly. I don't feel that a patient should be compelled to meet with their PCP to discuss this issue every 5 years. Furthermore, having a series of appointments doesn't automatically mean a patient will take the initiative to have an AD done.
So the point is Obama will rather allocate costs toward discussing AD's with patients rather than paying for a surgery or an imaging test that is needed? This is where your health care dollars are going to go. So I won't be able to order an echocardiogram on a patient that doesn't meet all the classical signs of valvulopathy even though my experience and insticts tells me to do but we will spend money on needless visits to discuss creating an AD.
Best example on this subject. This bill is not about quality of care.
What an idiotic post. Patients of any age should be counseled about issues related to death and dying. Newsflash: We already do this. Patients are encouraged to have advance directives, regardless of age. We have been doing this for 8 years under Bush, and even before that. It's got nothing to do with Obama, or even with politics.
You have zero credibility when you politicize issues like this, in your desperation to attack Pres. Obama.
As a physician, we never bring up death and dying unless the patient has a disease, such as cancer, that will result in thier death in the next year or two. Everyone dies. Everyone gets that. When that issue is RELEVANT, we discuss it. However, discussing negative issues on patients doing well even with chronic disease causes them to focus on negative aspects of the disease. Further, a patients are convinced that they ARE DYING when you discuss dying. If you really want to freak out a patient, bring up malignancy in thier differential diagnosis. First confirm a diagnosis and then discuss death if it relevant. Otherwise it causes undue worry in a patient and is a waste of time. Bad idea.
As a physician, we never bring up death and dying unless the patient has a disease, such as cancer, that will result in thier death in the next year or two. Everyone dies. Everyone gets that. When that issue is RELEVANT, we discuss it. However, discussing negative issues on patients doing well even with chronic disease causes them to focus on negative aspects of the disease. Further, a patients are convinced that they ARE DYING when you discuss dying. If you really want to freak out a patient, bring up malignancy in thier differential diagnosis. First confirm a diagnosis and then discuss death if it relevant. Otherwise it causes undue worry in a patient and is a waste of time. Bad idea.
As a physician, you should know that as people age, death can sneak up suddenly. I think asking, "Do you have a power of attorney?", etc can be asked in a way that doesn't get people focusing on dying. As I previously posted, my father-in-law thought he would live forever. So, in fact, did my father. Cleaning up my dad's affairs was a mess, and we paid more in taxes than we should have, had he planned properly (though that's a different discussion). Just like having a will, I think everyone should have a POA and an advance directive. If talking about death weren't so taboo, perhaps more people would be prepared.
As a physician, we never bring up death and dying unless the patient has a disease, such as cancer, that will result in thier death in the next year or two. Everyone dies. Everyone gets that. When that issue is RELEVANT, we discuss it. However, discussing negative issues on patients doing well even with chronic disease causes them to focus on negative aspects of the disease. Further, a patients are convinced that they ARE DYING when you discuss dying. If you really want to freak out a patient, bring up malignancy in thier differential diagnosis. First confirm a diagnosis and then discuss death if it relevant. Otherwise it causes undue worry in a patient and is a waste of time. Bad idea.
This may be exactly the point.
My 71 yr old husband just went to the ER.
After the intitial care and diagnosis of pneumonia the doctor (had?) to ask if he had any written directives (don't) and then went on to establish his wishes .
Thankfully, we were more embarrassed for not yet having done so than we were interpreting this as a clue that he was 'done for'.
Good grief! A conversation like this at a time like that may be enough to have caused someone else to have gone into cardiac arrest!
Do any of you really think this is what the doctor wanted to have to be doing at this time?
During this chat we did learn that if there are no directives and wishes cannot be ascertained, they MUST do everything in their power to keep one alive.
If doctors seen before emergency situations are reimbursed for doing so it may result in more primaries bringing the subject up and getting procrastinators like us to fill the paperwork out.
And, believe me, ones opinion on what measures they want taken can easily change in a 5 year period as overall health can change a lot very quickly.
As a physician, we never bring up death and dying unless the patient has a disease, such as cancer, that will result in thier death in the next year or two. Everyone dies. Everyone gets that. When that issue is RELEVANT, we discuss it. However, discussing negative issues on patients doing well even with chronic disease causes them to focus on negative aspects of the disease. Further, a patients are convinced that they ARE DYING when you discuss dying. If you really want to freak out a patient, bring up malignancy in thier differential diagnosis. First confirm a diagnosis and then discuss death if it relevant. Otherwise it causes undue worry in a patient and is a waste of time. Bad idea.
The Democrat Party is known as "The Party of Death" and for good reason. It seems they love all things death for the most helpless and innocent. hussein obama's choice of science czar is just another example of their plans for our future.
Washington, DC – As the debate over President Obama's socialized healthcare heats up, the depth of his radicalism is becoming more evident. John Holdren, Obama's recent choice for "Science Czar," provides the latest and perhaps most troubling example of extremism. In the name of population control, Holdren has advocated both forced abortion and compulsory sterilization through government-administered tainting of the water supply.
In the Obama care plan, anyone over 65 needs to meet with an appointed Dr. every 5 yrs to discuss dignity and dying decisions. They will make suggestions and recommendations for you.
This is for everyone, not just people who are sick
So for all of you 65 and over, get ready to be counseled on your "options" and have Uncle Sam make recommendations.
This is 0bama trying to see if he can convince the elderly to forgo the life saving operation, and go for that pain pill instead. I mean they are so old anyway, why waste good money on some old guy who might die next year?
Do you think they will have similar mandatory counseling for women contemplating an abortion?
Oh,BTW, I am not in favor of this current plan being pushed.
I just don't read evil into every single proposal within it and think injecting things that probably aren't and really aren't in there weakens our position ....sometimes to the point of making 'our side' look like a bunch of flaming a...holes.
My 71 yr old husband just went to the ER.
After the intitial care and diagnosis of pneumonia the doctor (had?) to ask if he had any written directives (don't) and then went on to establish his wishes .
Thankfully, we were more embarrassed for not yet having done so than we were interpreting this as a clue that he was 'done for'.
Good grief! A conversation like this at a time like that may be enough to have caused someone else to have gone into cardiac arrest!
Do any of you really think this is what the doctor wanted to have to be doing at this time?
During this chat we did learn that if there are no directives and wishes cannot be ascertained, they MUST do everything in their power to keep one alive.
If doctors seen before emergency situations are reimbursed for doing so it may result in more primaries bringing the subject up and getting procrastinators like us to fill the paperwork out.
And, believe me, ones opinion on what measures they want taken can easily change in a 5 year period as overall health can change a lot very quickly.
Well, that is a situation in which it is relevant. We ask about DNR status and family wishes of course. A "DNR" status can be damaging to the patient in the absence of personal guidance from family members. We are obligated to "do what we can" in the absence of this guidance. A "DNR" in the absence of family member directive could result in legal difficulites for the physician and possibly criminal prosection. If an individual is unable to make decisions, we rely up family members. It is not like we are throwing in invasive lines and drips in a dying patient with the family in the background pleading for us to stop. We do what they want, in the realm of what is medically reasonable.
Issues of dying and financial directives are best handled by attorneys. Why? Because they are legal experts and physicians are not. We don't know about the laws, as that is not what we do. We do not want a stiuation in which patients are coming in to discuss "dying" when they are doing well. Why would we? We have current and pressing medical problems do deal with and do not want to pestered by situations which are not currently pertient. I would further offer that a healthy 65 or 70 year old would feel a little insulted by such a discussion. Let us deal with medical issues that are relevant and leave legal counsel to attorneys.
Oh,BTW, I am not in favor of this current plan being pushed.
I just don't read evil into every single proposal within it and think injecting things that probably aren't and really aren't in there weakens our position ....sometimes to the point of making 'our side' look like a bunch of flaming a...holes.
What is being "pushed" is reimubsement for such counseling every five years. Nothing more. The physician doesn't have to offer it. The patient doesn't have to accept it. I can tell you it would have been a darn sight easier for my DH's family if some phyician had had the moxie to bring it up to my 97 yr old FIL before he got sick for the last time.
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