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Why is a female patient seeing a gynecologist entitled to a same-sex chaperone but not a male patient / client being evaluated by a female urologist?


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Anything inappropriate doesn't tend to happen so much with female doctors. A male gynecologist groping a woman is the start of a law suit. A female urologist groping a man is the start of a porn film. Did you ask about a same-sex chaperone? I don't see why they would deny such a thing. I agree that you should have one if it makes you feel more comfortable, and it's wrong if it's really not allowed. I don't personally see how having a man in the room staring at my todger would make me feel more comfortable. Crying sexism seems a bit over the top though. Proclamations of naivete are astonishing. Yes we're all supposed to be equal but it hasn't quite happened yet, and maybe it never will in some ways because it's hard to imagine a world where women can be as sexually threatening to men as men often are to women. That's not a good thing to feel superior about. This might sound like it's going a bit off topic. You should be allowed a chaperone if it makes you feel more comfortable, and I don't know why that wouldn't be allowed, but this feigned ignorance is surely bullshit isn't it? But what if she sexually assaults me? Is a question that you've probably never had to ask if you're a man.

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I agree it wouldn’t be right to refuse it. I guess I would be clear in advance I wanted a chaperone provided, although some offices don’t have any men working, so that’s another issue. When I was young,  almost all GYNs were male. I didn’t like them even with a chaperone, so I sought out the rare female GYNs. One thing, and I realize you weren’t asking about this, would it help to bring a friend/advocate as your own chaperone—I’ve had that suggested but for me, I don’t have that type friends so it’s not helpful advice, probably not for most people. Certain exams can definitely be problematic. 

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Dammit this has been bugging me. Sexist? Yeah like this is evidence of the preferential treatment women receive. When will men be treated as equals? This is just a bizarre conclusion to reach. I wasn't aware that women were offered a same-sex chaperone but it's pretty obvious why. Rather than seeing this as evidence of prejudice against men I thought it was evidence of what a depressing and fucked up world we live in where women feel unsafe seeing a male doctor alone. To see this as sexist towards men is just incredible. Yeah aren't women lucky! I understand that seeing a female urologist might be uncomfortable and embarrassing, but you aren't afraid of being molested by her. You remember hearing about the female urologist who was struck off after sexually abusing male patients? No you don't. It's really not difficult to understand and crying sexism is just utter bullshit. I don't like the "suspected immorality" either, but that's the fault of arseholes like Harvey Weinstein. This is all due to some men not being able to keep their hands to themselves, and while you may never have done anything of the sort it doesn't take much empathy and intelligence to comprehend why women feel like that. End of rant.

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It's not that hard to understand the rationale, actually. It's all about the perception of power structures in society and that fact that they remain unequal and tilted toward males.

For females, being exposed and vulnerable to a male physician generally, and a male gynecologist particularly,  presents a highly unbalanced perception of power for many people, and can lead to feelings of intimidation or being threatened, even if there is no such intent.* Having a female chaperone in attendance is not unlike adding weight to balance a scale; it levels out the disproportionate sense of power in the room, and relieves a sense of threat. This is not to say, by the way, that all females experience an unbalanced perception of power in the same way, and some may feel no discomfort at all, but it is safe to say that the experience is common, otherwise the question of chaperones would not arise. 

The molestation of women by their male physicians is an uncommon occurrence, yet it unarguably occurs. The fact that it does conflates with women's legitimate concerns  about the greater prevalence of male aggression in society overall. Even if for professional, moral and ethical reasons a male physician is unlikely to pose a threat to a woman, there is still a case to be made for the woman to have a chaperone if she desires one.

Males, on the other hand, are far less likely to experience a sense of power deficit when the social roles are reversed, even though they are the ones physically vulnerable. Society has so deeply entrained a sense of a specific power dynamic that, regardless of the actual individuals in an encounter, certain power parameters are often assumed. A male is unlikely to experience the same sense of threat or intimidation from a female urologist that his female counterpart would experience (this may change if the doctor picks up a scalpel), and in what may be considered a regrettable worst-case, he may even take a certain satisfaction in being examined by a female, even though she is a consummate professional working in utter detachment. (I know. But these men exist.)

The difficulty with providing the man with a male chaperone is that it doubles down on the unequal power dynamic. This has the effect of potentially insulting the professional, now presented with the tacit accusation that she could be a man-molester 🙄, or, less likely, leaving her with her own sense of threat or intimidation as the power dynamic is tilted more heavily in the other direction toward the gender with the greater record of aggression.

Put more simply, by and large, women don't molest men at anything approaching the rate that men molest women. Empirical evidence provides a rationale for female chaperones, but not for male chaperones, and there are reasons to believe male chaperones would cause problems that would call their usefulness into question.

 

*I have my personal opinion about whether someone becoming a 'victim of his or her own feelings' makes him or her an actual victim - or the other party guilty of any offense whatever - but I will not elaborate here.

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I would assume you would get one if you truly wanted one.  I agree that the gender breakdown of the office may mean that you need to tell them in advance.  And that having a friend come with you might make more sense.

I had a friend come to me for a first appointment with a gynecologist/endocrinologist and a dermatologist.  Both were situations where I was physically safe but where, because of past medical trauma, I was not emotionally safe on my own.  Having someone there who could talk when I couldn't talk and who could make suggestions about what would help and what would hurt was invaluable.

I can now see both doctors on their own (fwiw, they're both female, so it's not a gender thing), though a full body skin exam was quite rough and threw me out of sorts for the remainder of the day until I got to my therapist's office that night. 

I'm not sure how much another person in general (as opposed to another person who I know) would make a difference. 

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On 5/22/2020 at 4:53 PM, Fluent In Silence said:

Anything inappropriate doesn't tend to happen so much with female doctors. A male gynecologist groping a woman is the start of a law suit. A female urologist groping a man is the start of a porn film. Did you ask about a same-sex chaperone? I don't see why they would deny such a thing. I agree that you should have one if it makes you feel more comfortable, and it's wrong if it's really not allowed. I don't personally see how having a man in the room staring at my todger would make me feel more comfortable. Crying sexism seems a bit over the top though. Proclamations of naivete are astonishing. Yes we're all supposed to be equal but it hasn't quite happened yet, and maybe it never will in some ways because it's hard to imagine a world where women can be as sexually threatening to men as men often are to women. That's not a good thing to feel superior about. This might sound like it's going a bit off topic. You should be allowed a chaperone if it makes you feel more comfortable, and I don't know why that wouldn't be allowed, but this feigned ignorance is surely bullshit isn't it? But what if she sexually assaults me? Is a question that you've probably never had to ask if you're a man.

Collectivist mainstream tribe argument. You are just assuming because of your expectation that most heterosexual males would be aroused by being touched by a female urologist that all of them do so the laws favor the expectation. Regardless of expectations of behaviors being different between the sexes, it still shouldn't determine how this area of preferential treatment is given unilaterally in favor of females like it is in most places of society. Based on what I see and hear, despite the fact that we obviously still exist in a patriarchal society which dictates why medical professionals with so-called ethics where women arbitrarily get preferential treatment compared to men 10 out of 10 times, you still see a ton of women on the news and all over the streets complaining about injustices related to gender trying to acquire more preferences while most men sit back and do nothing because of self-hatred and fear of how they will be perceived and taken and most likely if enough men do not jump on board with any hypothetical movement defending their sex, then their sub-collective such as MGTOW is seen as sexist, backwards, and inherently unattractive and they fear that women will stop having sex with them for joining it and supporting it. What I am basically pointing out is that because the female sex is obviously generally seen as more physically and emotionally attractive and that goes into this. In almost all parts of society and social situations, it is seen as more inherently attractive when a woman complains about a societal injustice over a man and when a man does it, then it's perceived as immature, unattractive, and gets him nowhere and he winds up going home and sleeping alone. How dare he open his mouth and voice a concern / opinion in defense of his sub-species right? Regardless of how asinine and clutching at straws you think my claims are, it is still sexist and if the whole thing was in favor of men you would probably be able to turn on the evening news and see a story about a group of women accompanied by some men doing something to change it.

And based on the way that you are saying life is, then why do people still arbitrarily have the desire to procreate children and bring them into an existence with a by-the-motions, arbitrary species that doesn't try to suppress gender, generally doesn't like to view it as socially constructed and acknowledge it as a separate entity from sex, and even after the late 20th century assault on traditionalism, there are still scumbags out there willing to perpetuate late 1940's, full 1950's, and early 1960's traditionalist archaic gender norms after World War II which make situations like this surrounding sex even worse. Why would anyone want to procreate with all of this underlying collectivist, cookie-cutter shit probably still going on by the time the child reaches age 18 because the mainstream tribe cannot change or takes to long to change or their biology simply keeps them on an existential leash? Why not just go extinct and not arbitrarily so much like the instance of having children in the year 2020 has become, but go extinct to question why a creator would ever design something with so much potential fucking sexual and gender dimorphism that it goes beyond just keeping them on a biological leash and also creeps into their specialists offices? Even in a urologists office, half of the waiting room is made up of females because they almost arbitrarily care more about maintaining their health, caring about and maintaining themselves, or simply have more time to do it while men die slaving away on dangerous construction sites and have never seen a urologist in their entire lives while the average woman who lives down the street sees a urologist for a routine exam 3 times a year and she's never even had any bladder problems. Why not just go extinct and demand that the creator everyone to be a equivalent hermaphrodite or we will not exist? I know that's what I'm doing. All problems solved. Half or more of all conflicts and arguments on the internet erased and the internet can be used to educate rather than battle other collectives. Everyone can focus more on their individuality and never be a victim of any kind of collectivism which bypasses that such as gender norms and societal trends based around gender like all young girls expected to only wear leggings and not own a pair of pants in the year 2020 after Marilyn Monroe was already wearing pants in 1961. And don't turn around and tell me that hermaphrodites would still be hanging from the trees. There has never been a human one to be given the chance to prove that it could start piling up boulders and carve rocks.

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5 hours ago, Fluent In Silence said:

Dammit this has been bugging me. Sexist? Yeah like this is evidence of the preferential treatment women receive. When will men be treated as equals? This is just a bizarre conclusion to reach. I wasn't aware that women were offered a same-sex chaperone but it's pretty obvious why. Rather than seeing this as evidence of prejudice against men I thought it was evidence of what a depressing and fucked up world we live in where women feel unsafe seeing a male doctor alone. To see this as sexist towards men is just incredible. Yeah aren't women lucky! I understand that seeing a female urologist might be uncomfortable and embarrassing, but you aren't afraid of being molested by her. You remember hearing about the female urologist who was struck off after sexually abusing male patients? No you don't. It's really not difficult to understand and crying sexism is just utter bullshit. I don't like the "suspected immorality" either, but that's the fault of arseholes like Harvey Weinstein. This is all due to some men not being able to keep their hands to themselves, and while you may never have done anything of the sort it doesn't take much empathy and intelligence to comprehend why women feel like that. End of rant.

End of rant? Its comments like this that aggravate my existence and my illness which is related to being incompatible my respective environment. This is how statments like "we may never become equal" keep being perpetuated. You decidedly declare my topic a rant and want to use your patriarchal influence and manner to put a premature end to it, not allow it to evolve or go anywhere, and in any way possible, and I'll repeat, just keep things like the collectivist, cookie-cutter, black and white crap that they are and go on arbitrarily getting married, having children, building the metaphorical arbitrary picket-fence which has no practical value and bringing the kids into and raised through hynosis and brainwashing into a world knowing that by the time they are 18 that one of them will be recommended to have a same-sex chaperone if seeing a male specialist and the other would be laughed at, ridiculed, and mocked for wanting the same thing while seeing a female specialist of the same kind or even just wanting a chaperone while seeing a male specialist. And I could also go into how a male is rarely ever questioned if he wants to undergo a vasectomy at a young age and is seemingly in good health but a female is turned down 9 out of 10 times if she wants tubal ligation surgery in her 20's or 30's if she hasn't had any children yet because of the false ethics system which is really just trying to prevent young women from being more in control over the eventual extinction of this species and the fact that young females in good health are seen as having significantly higher and more unique reproductive value than a male the same age and also in good health. Essentially, young men's reproductive health is seen as more disposable, generic, and might as well just sterilize him to profit off of the insurance companies to lessen the competition while young female's reproductive health is viewed as having incomparable value like nothing else and if too many of them proceed with tubal ligation then enough young men which are sex hungry and want the cookie-cutter arbitrary nuclear family will suffer for it. Well that's just too bad. If you don't like it then go seek help and talk with a female therapist since that's the same thing people like you tell me for not accepting that most of the world is like this. And were you saying what patriarch?

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45 minutes ago, SheltieUnderdog said:

End of rant? Its comments like this that aggravate my existence and my illness which is related to being incompatible my respective environment. This is how statments like "we may never become equal" keep being perpetuated. You decidedly declare my topic a rant and want to use your patriarchal influence and manner to put a premature end to it, not allow it to evolve or go anywhere, and in any way possible, and I'll repeat, just keep things like the collectivist, cookie-cutter, black and white crap that they are and go on arbitrarily getting married, having children, building the metaphorical arbitrary picket-fence which has no practical value and bringing the kids into and raised through hynosis and brainwashing into a world knowing that by the time they are 18 that one of them will be recommended to have a same-sex chaperone if seeing a male specialist and the other would be laughed at, ridiculed, and mocked for wanting the same thing while seeing a female specialist of the same kind or even just wanting a chaperone while seeing a male specialist. And I could also go into how a male is rarely ever questioned if he wants to undergo a vasectomy at a young age and is seemingly in good health but a female is turned down 9 out of 10 times if she wants tubal ligation surgery in her 20's or 30's if she hasn't had any children yet because of the false ethics system which is really just trying to prevent young women from being more in control over the eventual extinction of this species and the fact that young females in good health are seen as having significantly higher and more unique reproductive value than a male the same age and also in good health. Essentially, young men's reproductive health is seen as more disposable, generic, and might as well just sterilize him to profit off of the insurance companies to lessen the competition while young female's reproductive health is viewed as having incomparable value like nothing else and if too many of them proceed with tubal ligation then enough young men which are sex hungry and want the cookie-cutter arbitrary nuclear family will suffer for it. Well that's just too bad. If you don't like it then go seek help and talk with a female therapist since that's the same thing people like you tell me for not accepting that most of the world is like this . And were you saying what patriarch?

That wasn't the response I was expecting. I thought you'd just tell me to fuck off, which I guess you sort of did. I know this is going to sound patronising but you seem like a troubled guy. I don't agree with what you're saying but you don't seem dumb, just sort of using your intelligence to say dumb things. I didn't mean that as an insult, though it probably sounds like one. I saw another post you made and I thought you sounded so wounded and unable to accept any sort of kindness. You probably won't appreciate me saying this. It would've been a hell of a lot easier if you'd just told me to fuck off. By the way, Cerberus explained what I was talking about far more intelligently than I managed.

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15 minutes ago, Fluent In Silence said:

That wasn't the response I was expecting. I thought you'd just tell me to fuck off, which I guess you sort of did. I know this is going to sound patronising but you seem like a troubled guy. I don't agree with what you're saying but you don't seem dumb, just sort of using your intelligence to say dumb things. I didn't mean that as an insult, though it probably sounds like one. I saw another post you made and I thought you sounded so wounded and unable to accept any sort of kindness. You probably won't appreciate me saying this. It would've been a hell of a lot easier if you'd just told me to fuck off. By the way, Cerberus explained what I was talking about far more intelligently than I managed.

My intelligence is in the average range (possibly due to a speed processing disorder and a 7th grade math level dragging it down), however I feel as if I am dealing with a polar mirrored opposite of myself the same way you are describing me from your end. Like I was literally just saying to myself as I responded, "How the fuck do all of these traditionalist 1-bit types possess such seemingly high intelligence and knowledge when they regard things the way they do?" "I think it's safe to say that the world would be a better place if they used their knowledge and intellect to fight for whatever equality can be achieved for the so-called human race and / or blending and eradicating cookie-cutterism." "Or if they just weren't intelligent at all, that would make proclaiming my views on gender expression inside of a Methodist church and getting my point across much easier." That is literally what I was saying to myself as I was responding to you. And normally Cerberus puts me into a fit of rage also except this time he didn't thus I chose not to argue any further points with him but you said that my post was bugging you and then I encountered your blog which mirrors what my blog would ever look like if I had one.

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25 minutes ago, Fluent In Silence said:

That wasn't the response I was expecting. I thought you'd just tell me to fuck off, which I guess you sort of did. I know this is going to sound patronising but you seem like a troubled guy. I don't agree with what you're saying but you don't seem dumb, just sort of using your intelligence to say dumb things. I didn't mean that as an insult, though it probably sounds like one. I saw another post you made and I thought you sounded so wounded and unable to accept any sort of kindness. You probably won't appreciate me saying this. It would've been a hell of a lot easier if you'd just told me to fuck off. By the way, Cerberus explained what I was talking about far more intelligently than I managed.

You basically encountered someone who thinks that females should be able to grow full beards and that if they could that it should be accepted in the mainstream. And not just the small amounts that they typically wax off of their upper-lip and sides of their face. That becoming a reality would however jeopardize my fantasy of marrying a bearded woman in a traveling circus and getting away without having to contribute anything to society by being a stay-at-home or behind the scenes rather hermaphroditic husband who doesn't do any work and travels the country with her financially benefiting from her virility and good genetics.

 

The proverbial Adam and Evelyn were androgynous. She had 49% of his strength and he had 49% of her beauty. After that it was all downhill from there for this species.

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25 minutes ago, SheltieUnderdog said:

You basically encountered someone who thinks that females should be able to grow full beards and that if they could that it should be accepted in the mainstream. And not just the small amounts that they typically wax off of their upper-lip and sides of their face. That becoming a reality would however jeopardize my fantasy of marrying a bearded woman in a traveling circus and getting away without having to contribute anything to society by being a stay-at-home or behind the scenes rather hermaphroditic husband who doesn't do any work and travels the country with her financially benefiting from her virility and good genetics.

 

The proverbial Adam and Evelyn were androgynous. She had 49% of his strength and he had 49% of her beauty. After that it was all downhill from there for this species.

Seriously man. I'm not going to argue with you or insult you. Are you seeing a therapist or a counsellor or something? I know you might see this as an insult but I really don't mean it that way. We all have our problems and I've had my share. Not mocking or joking.

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4 hours ago, Fluent In Silence said:

Seriously man. I'm not going to argue with you or insult you. Are you seeing a therapist or a counsellor or something? I know you might see this as an insult but I really don't mean it that way. We all have our problems and I've had my share. Not mocking or joking.

No I am not and I'm not interested in ever seeing one either. They put you on a timer and I assume that they would have a gender and that there would be secondary aspects of gender expression in there also and for that reason I am not inclined to ever see any type of therapist or counselor ever again. I feel like I am not their species therefore anything they tell me based on being a functioning human-being will not be relevant. I do, however, take Latuda 40mg at the moment to prevent hallucinations and psychotic episodes from taking place. Sertraline 50mg is from my female urologist (not a false narrative from me) but I eventually will not need that as I am planning to become castrated in the next few years for physiological reasons (inflammatory disease of the scrotum and failed scrotoplasty) but also to come as close as possible in any way to representing self-reproductive hermaphroditism before I transfer to an oasis where there is no gender or possibly even sex and I exist as a hermaphrodite humiliating myself before the creator for sustenance. All I need is a different chromosomal arrangement, the presence of male and female gametes, a thoroughfare of fast food restaurants, the ability to fornicate with myself and grow hair, and picturesque sand and palm trees making therapy and counseling even more irrelevant for myself than it is now.

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  • 11 months later...

How odd. I wrote my previous response to this thread, above, almost a year ago to date. At that time, I reflected on the likely experience of a man seeing a female urologist, and for some reason made no mention of the fact that I had myself had that very experience only a year or so prior. What makes it doubly odd is that I have an appointment with my urologist on Friday - an appointment which had been scheduled for earlier by his office, but I asked that it be deferred until Friday because at the earlier appointment I had been scheduled to be seen not by the doctor but by the nurse practitioner working in his practice

Who is a woman.

A little background.

A have been seen by this nurse practitioner before, at my last visit to the practice. I was not advised in advance, indeed not even until she entered the room, that the doctor himself would not be the one to examine me. She simply shows up and explains that she will be taking care of my appointment that day. The appointment concerned a rather personal matter involving my nether regions, and the examination ended with her inserting a gloved finger into my anus and probing about.

I maintained a detached attitude of clinical practicality. So did she. It was a matter of medical business and necessity, was executed efficiently, and the entire affair was over quite quickly.

Actually, rather more quickly than it probably would have been had I been seen by the doctor, because I did not feel inclined to ask her questions that I might otherwise have asked the doctor. I felt distinctly uncomfortable throughout, and was never able to shake it. The question is: To what degree did it have to do with her being female? Two other factors were at play. First, given the nature of the condition being dealt with, I was taken aback at being faced with having to discuss such a personal matter with a complete stranger without warning the moment she entered the room. And second, I do not see Licensed Nurse Practitioners if I have anything to say about it. A LNP is not a doctor. I do not consider a LNP an acceptable stand-in when I have come to see a doctor and am paying to see a doctor, regardless of whether that LNP is male or female. So the combination of those two things definitely set me back. But I'm not absolutely certain I can say with honesty that I did not feel at least a small amount of discomfort at not being given a choice as to whether a woman was going to examine that particular aspect of my anatomy.

I have no issue whatever with female doctors in general. I see a number of specialists who are women, and a doctor's gender isn't normally a factor I consider when deciding to see one. This case, however, well. Like I say. Odd.

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17 hours ago, Cerberus said:

How odd. I wrote my previous response to this thread, above, almost a year ago to date. At that time, I reflected on the likely experience of a man seeing a female urologist, and for some reason made no mention of the fact that I had myself had that very experience only a year or so prior. What makes it doubly odd is that I have an appointment with my urologist on Friday - an appointment which had been scheduled for earlier by his office, but I asked that it be deferred until Friday because at the earlier appointment I had been scheduled to be seen not by the doctor but by the nurse practitioner working in his practice

Who is a woman.

A little background.

A have been seen by this nurse practitioner before, at my last visit to the practice. I was not advised in advance, indeed not even until she entered the room, that the doctor himself would not be the one to examine me. She simply shows up and explains that she will be taking care of my appointment that day. The appointment concerned a rather personal matter involving my nether regions, and the examination ended with her inserting a gloved finger into my anus and probing about.

I maintained a detached attitude of clinical practicality. So did she. It was a matter of medical business and necessity, was executed efficiently, and the entire affair was over quite quickly.

Actually, rather more quickly than it probably would have been had I been seen by the doctor, because I did not feel inclined to ask her questions that I might otherwise have asked the doctor. I felt distinctly uncomfortable throughout, and was never able to shake it. The question is: To what degree did it have to do with her being female? Two other factors were at play. First, given the nature of the condition being dealt with, I was taken aback at being faced with having to discuss such a personal matter with a complete stranger without warning the moment she entered the room. And second, I do not see Licensed Nurse Practitioners if I have anything to say about it. A LNP is not a doctor. I do not consider a LNP an acceptable stand-in when I have come to see a doctor and am paying to see a doctor, regardless of whether that LNP is male or female. So the combination of those two things definitely set me back. But I'm not absolutely certain I can say with honesty that I did not feel at least a small amount of discomfort at not being given a choice as to whether a woman was going to examine that particular aspect of my anatomy.

I have no issue whatever with female doctors in general. I see a number of specialists who are women, and a doctor's gender isn't normally a factor I consider when deciding to see one. This case, however, well. Like I say. Odd.

Cerberus- does the objection to NPs include psych NPs who see their own patients? Just curious 

 

12 hours ago, Gearhead said:

There’s no way I’m trusting my lady parts to a male doctor, full stop, and I wouldn’t take my car to a mechanic who didn’t drive, either.

When I was pretty young, like 12, my regular doctor was out and I had a woman doctor do a genital exam.... when you add in the fact that 12 year olds are often pretty body shy, it was extremely uncomfortable for me. Since then I don’t really have any issues with the gender of doctors (or NPs) unless they’re doing ...personal... exams 

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6 hours ago, Iceberg said:

Cerberus- does the objection to NPs include psych NPs who see their own patients? Just curious 

My only experience with mental health care providers who are not full Psychologist PhDs or Phychiatric MDs are the Licensed Clinical Social Workers my Ex insisted on engaging for our children when we first started looking for mental health care for them. I found every one of them useless in being able to assist two children on the edge of the Autism spectrum and coping with the beginnings of depression, anxiety, social phobia and ADHD. They were not, however, psychiatric NPs. My daughter sees my pdoc now, and I pay through the nose for it, even though I'm on a pension. Worth every penny.

Nonetheless, yes, if my pdoc were to tell me one day that he was referring some of his patients out to a NP and I would be seeing that person (of either gender) I would reply, Au contraire, mon frére. I pay his fee out-of-pocket (he does not take my insurance) in order to pick his specially-educated brain, and I will accept no substitutes. The same would be true for any professional's services I engage.

The proliferation of LNPs is occurring as a result of a growing shortage of fully qualified doctors - or rather, of a burgeoning population that is growing faster than the number of doctors available to service it. By necessity, these less-qualified people are taking up the slack because otherwise the need will be unmet. Governments are allowing qualification requirements to edge downward in order to meet the public need. In other words, it's a crisis. An argument will be heard that NPs are qualified to diagnose and prescribe. Yes - but they are not as qualified, and that is both inarguable, and the point.

That doesn't mean people need a lesser quality of care, nor that medicine has become any easier or less complicated to practice. It takes roughly 11 postsecondary years to earn an MD. It takes 6-8 to become a LNP. Do I wish to trust my personal health to someone with 11 years of training and experience, or someone with as much as 5 years less training and experience? I'll take the 11-year package, please and thank you. It may be a bit more expensive, and I may have to get in line, but I don't mind paying for quality. It's my health, after all, and if you don't have your health - as they say - you don't have anything. I'm not going to settle for second-best when it comes to my physical and mental health. Perhaps it's because I came so close to nearly dying, and have medical incompetence to thank for it.

(Actually, following on Gearhead's comment above, I'm much less selective about auto mechanics. I don't really see how a mechanic's driving ability would affect his engineering skills. The vast majority of people who work on passenger airliners aren't pilots, yet we still board aircraft. My maternal grandfather repaired military aircraft during World War II - and he couldn't fly a paper airplane.)

I had a conversation with my daughter today on this very subject. She enjoys playing the Devil's Advocate, or at least enjoys needling me, I'm not sure which, but she said, "You realize you're not special, don't you? You're not better than all of the other people who would like to see the doctor, and he can't see everyone, so some people have to see the Nurse Practitioner. Why do you get to see the Doctor and they don't?" [Note: "You're not special" from one's own daughter - 20 years of therapy down the tubes in one fell swoop. How sharper than a serpent's tooth...]

Because, I told her, I'm willing to wait my turn for it, pay extra for it, but above all, because I'm going to insist on it - in a modern medical environment where there are too many patients and not enough doctors, it becomes imperative that you become your own best advocate for your medical care. If you don't, you'll get walked over by someone else with more chutzpa, and they'll get the better medical care, they'll get the better treatment, and they'll be the ones to thrive while you simply cope.

Would a psych NP have had the prescribing experience to have given me relief from my refractive, tenacious Double Depression a decade ago? I highly doubt that. My pdoc is a very experienced prescriber, and until him, no other pdoc had ever laid a glove on my condition. Why would I think that a NP with years less experience in diagnosis and practice would be able to do as well as this very seasoned professional? I wouldn't. No sensible person would, and there would be no sensible reason to. I recognize, mind you, that there are a number of reasons that our members here see psych NPs rather than full pdocs or tdocs, and it's not my place to say that that's a bad decision for them - if it's working, if they are satisfied that they are getting the best care available, then more power to them. It's just not the choice I would make for myself.

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It sounds like you are not the “target audience” for NP care becuase you have the means and the resources to attain private pdoc care, and I think that is totally within your preview (as you reasonably pointed out). But I will say that as someone who has experienced good psych NPs and bad doctors, I do think there are legitimate roles for Pnurses that are not necessarily borne of crisis ... handling student visits at schools for example, or dealing with community practices where pdocs might theoretically be available but not in the budget (etc with other financial motives). Also, I think that the government (at least in the US) has if anything been trying to raise the qualificatIon standards for providers... the expectation is that NPs on their own will need a doctorate degree sometime in the future (although the first time the nursing bodies tried to make that change, people just decided not to listen - so that may never happen). That said, I am not questioning your personal decision, but as a psych major this issue comes up over and over and I find people’s opinions interesting 

Edited by Iceberg
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@Iceberg - I say ‘crisis’ in a broad societal sense, but really what it amounts to is the NPs becoming a first line of triage of the mental health care on a community level because the problem is growing too large, by volume, for the doctors to manage it at their level. But MI doesn’t lend itself to triage in the way physical injury might, both because of the complexity of human psychology, and the scientific unknowns about the nature and function of the brain. You can’t ultimately set a brain like you would a broken arm.

I’m not sure I entirely fit your description of me as a consumer of psychiatric care. Yes, I am able to pay to see my pdoc, but that ability comes at a significant cost to me - I live frugally on a government pension and I very consciously and deliberately do without some things in order to set aside the money for my psychiatric care. This is not really something I have an option about; without this level of care, my depression will kill me. It’s as simple as that.

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