[Rhodes22-list] Politics - Reply to Dave's verbosity

[Tootle]

Dave:

     So you pretend to be an expert with no training.  I just got back from
an emergency room.  The ER was at a Catholic Hospital.  I got callled in to
do a cat scan of a kid involved in a MVA.  I do not pretend to know all the
answers, but all your discussion was  bullshit.

      Go back to school and get some medical training instead of foisting
loose opinions on others.  Before you predicate medical directions on others
learn how the system works.   Go work as a volunteer to gain some insite. 
Visit Anne or Will and learn some facts.

        Here is something more meaningfull.  When you saw the high water,
did you evaluate the moon phases and wind directions?   

Ed K
Greenville, SC, USA


Woten wrote:
> 
> 
> Ed,
>  
> Thank you for your response.  To reply:
>  
> Regarding emergency rooms not providing all services: Two comments:
> -  First, I think all emergency rooms provide a comprehensive, and pretty 
> uniform,  set of emergency services.  I would be interested to know of an 
> emergency  room that cannot handle wounds of all sorts, broken bones, head
> injuries,  
> poisonings, heart attacks, etc.  They may not be able to handle all
> medical  
> cases that are presented because many cases that enter the medical system  
> through emergency room are not emergencies - but they can all provide
> first  
> level medical treatment for nearly everything.  The common reasons for 
> moving 
> people to another ER facility are: lack of suitable insurance, lack of 
> bed space 
> (they are full), it’s not about the inability to deliver medical  service.  
> There are cases, for example burn cases, where a hospital will  specialize
> in 
> burn cases - in those cases the ER will render appropriate aid and 
> forward the 
> patient to the specialized facility; or even direct the ambulance 
> directly 
> to the special facility in the patients interest.  But any claim  that the
> ER 
> of an accredited hospital cannot provide the full range of emergency 
> services 
> is wrong - in my experience.  I believe there is a national  accreditation 
> agency that makes sure that’s the case (the initials escape me  right
> now).
> - Second, I am absolutely not claiming that a medical facility,  or any 
> physician, should be required to provide any service for which they are 
> not 
> completely competent.  Proof of competence for a physician is board 
> certification 
> by the appropriate liscensure authority in the jurisdiction of  interest. 
> In 
> fact I would recommend that if a physician is not board  certified  they
> should 
> only render aid outside of there sphere of  competence in extreme and 
> extraordinary circumstances (i.e. not your standard  commercial
> transaction) - this 
> protects the doctor, and it protects the  patient.
>  
> Regarding your example that pharmacies would have to carry all drugs: If 
> you 
> will re-read my post you will explicitly see that I said there are a
> zillion  
> drugs and that I would NOT expect any pharmacy to carry them all, BUT that
> if 
>  they did carry the drug, and it’s dispensation were legally authorized in 
> the  jurisdiction the pharmacy resided, I would regard any decision by the 
> pharmacist  not to sell the drug to someone because they didn’t like the
> person, or 
> they  didn’t like what the drug might be used for, as discrimination.  So
> I  
> explicitly said I didn’t expect every pharmacy to carry every drug in the 
> world  - I don’t think anyone does.
>  
> It seems to me that the practical resolution of the pharmacy/pharmacist  
> dilemma you’ve posed is: if the pharmacy doesn’t like the drug, don’t
> carry  it.  
> And if the pharmacy carries the drug, but the pharmacist working there 
> doesn’
> t like the drug, he should get another job with another pharmacy.   What
> you 
> don’t want is the pharmacist that would be dispensing the drug denying  it
> to 
> someone that needs it and giving his view of morality to the person.   I
> would 
> add that this applies to AIDs drugs, emphysema drugs, and possibly other  
> drugs.  The job of the pharmacist (the human being standing at the
> counter)  is 
> to competently and  legally dispense drugs, on a commercial basis, not 
> impose 
> his view of morality on the customer - he is explicitly licensed to 
> dispense 
> drugs and the public should expect that he perform his agreed duties or  
> forfeit his license.
>  
> Regarding Catholic hospitals: I really don’t know whether Catholic 
> hospitals 
> do abortions, I suspect they might when the mother’s life is at risk,  but
> I’
> ve never had an abortion and I’m not Catholic.  I also think policies  may 
> vary across the country.  Also, I don’t think most abortions are done  at 
> hospitals, I think they’re done at clinics - I could be wrong.  All of 
> that 
> notwithstanding,  I think you’ve mixed-and-matched apples and  oranges. 
> We are 
> talking about physicians (skilled people who have  pro-actively gone out
> and 
> secured public approval, based on their training and  skill, to execute
> specific 
> medical procedures - including abortions - on a  commercial basis) not
> hospitals 
> (facilities that are basically managed real  estate and facilities).  What
> a 
> hospital (real estate/facility) will or  won’t do is not the topic, the
> focus 
> is the physicians (persons that have  represented they will provide a
> service 
> on a commercial basis).  Physicians  are licensed and board certified to 
> provide a service, they should be  willing  provide that service if they
> have sought 
> and gained approval to  provide that service.
> 
> Regarding Indian restaurants: Restaurants  (real estate and owner) have a 
> business license - they can do what they want  with it, it’s NOT a license
> only 
> for Indian food, or any specific food or  menu.  IF IT WERE a license of a 
> specific food menu - for example if the  license were for Indian and
> Mexican food, 
> I would expect them to provide Indian  and Mexican food.  If they have a 
> license for specific foods that  liscensure agreement is with the public
> (or it’s 
> agents, the licensing  authority).  The fact that a specific food type is
> not 
> spelled out on  restaurant licenses does not mean they have to provide
> every 
> type of food and  menu, as you suggested, that’s simply not practical 
> (remember, the law is  ultimately about practicability), instead it means
> the owner has 
> complete  freedom in providing whatever menu he wants - and he can change 
> what he offers  in an instant, it’s his decision.  A board approved Ob/Gyn
> doctor 
> does not  have that flexibility.  A board approved Ob/Gyn doctor is on the 
> hook to  provide Ob/Gyn services - if he unilaterally decides to branch
> out to 
> dentistry  or podiatry, or open an Indian restaurant, on the basis of his 
> Ob/Gyn  certification, he’s in big trouble.  The Ob/Gyn doctor has made a
> deal with 
>  the public through it’s liscensure authorities (the certification board) 
> that  he/she will provide Ob/Gyn services - and he or she should.  
>  
> There’s a simple solution to all this from the physician’s perspective, if  
> you don’t want to provide the full range of services expected of you as an  
> Ob/Gyn specialist, pick another specialty.  Many Ob/Gyn doctors have made 
> that 
> choice for insurance reasons.  I imagine podiatrists, dermatologists,  
> orthopedic specialists, and psychiatrists, to name just a few specialties,
> are  
> rarely called on to perform abortions or prescribe drugs related to birth 
> control. 
>  From my perspective, what this whole deal is about is people  (some 
> physicians) trying to impose their standards of morality on the  public. 
> The reality 
> is, the public authorizes the physicians commercial  endeavor, and the
> public 
> can and should take its authorization away if the  physician, for whatever 
> reason, stops serving the public’s interest.  This  does not dictate what
> the 
> physician believes, but it does dictate how he must  act - he must serve
> the 
> public good, as defined by the public.
>  
> If doctors did not require liscensure, or if the public could get medical  
> support from anyone, none of the above would apply.  Each party could 
> behave 
> however they wanted and it would be a free market.  My whole point  is
> that what 
> makes this situation NOT a “free market” transaction is  liscensure.  The 
> public has traded off it’s freedom of choice to ensure  competency -
> that’s 
> what the licensing deal is all about.  It’s the  liscensure requirement
> that 
> limits the public’s choice as to who will serve them  - that kills the
> free 
> market, there may be 1 person in town that could help Ms  whoever, that
> requirement 
> gives the Ob/Gyn physician the right to basically  print money, but the
> flip 
> side is that he or she is on the hook to provide  service to the public. 
>  
> Again, JMO. 
>  
> Dave
> __________________________________________________
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> 
> 

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