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Doctors put into the middle of gun control policies

Discussion in 'Legal & Political Archive' started by Gaust, Jan 7, 2016.

  1. Gaust

    Gaust Portland Member

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    In a tearful address to the nation on Tuesday, President Obama sought to deliver on a promise he made to the American people in the wake of the horrific Newtown, Conn., shooting in 2012 by taking executive action for stronger gun control laws.

    Part of the plan for what the Obama administration calls “common-sense gun safety reform” involves enabling health care providers and certain state agencies to report the identities of patients suspected to have mental health issues to the National Instant Criminal Background Check System (NICS) without violating the Health Insurance Portability and Accountability Act, or HIPPA, which has been the law of the land in medicine for quite some time

    The rest of the article:
    http://www.foxnews.com/health/2016/...iddle-gun-control-policies.html?intcmp=hplnws
     
  2. bolus

    bolus Portland Gold Supporter Gold Supporter 2015 Volunteer 2016 Volunteer

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    I went though most of the policy changes here
    https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-33181.pdf

    You still have to have a "federal mental health prohibitor event" to be reported. Such as an involuntary psychiatric hospital admission where 2 physicians have to certify the risk and then a judge signs off on it.

    Some states are not reporting this information because they dont want to or because they were worried about HIPAA. This policy says that the states should not worry about HIPAA

    Not a big deal from the medical side at this point. I dont have a way to report someone to NICS even if I wanted to.

    What we should be vigilant about is what is defined as a "federal mental health prohibitor" so this is not changed to something very minor like being on a psychotropic medication or even a voluntary hospital admission.

    As I mentioned before, if anything ever happened that required me as a physician to report or record or support gun control in any way I'd let everyone here know right away.
     
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  3. etrain16

    etrain16 Oregon Bronze Supporter Bronze Supporter

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    Sure is nice to have a resident physician on board here at NWFA. We sure appreciate your time and input on matters like this, as well as your fight for the 2A.
     
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  4. clearconscience

    clearconscience Vancouver, WA Well-Known Member

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    Problem is too many people, especially Vets are already afraid to get help because of the stigma and worse losing their guns. Or people risking getting their guns taken because they have a crazy kid thats mentally defective.

    They need to address the mental illness in America. But they are too PC to actually do any good. So they will just oush more useless laws.
     
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  5. Peak_oil

    Peak_oil Member

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    I work in psych. When I worked in inpatient, there was one vet I would have reported to the system. Angry, unpredictable, way too confrontational, constantly threatening violence, and bipolar. The guy was sick. The other vets on the unit were constantly complaining about him and wanted to know "what are you going to do about him?" At the same time, there was another patient I would not have reported to the system who wound up killing a nurse. He was a great guy on his meds and I only knew him when he was on his meds. When he went off his meds... it was bad.

    The guys who have PTSD or got a little too used to killing people were generally pretty reasonable and they could get over it. Same thing with depression. Lots of depressed vets with PTSD are good guys who just have a lot of problems, it's manageable and they can get better. For them... no way. The exception to that rule is EXTREME substance abuse with accompanying psychosis. They need a break from firearms for a while, at least until the psychosis is over.

    Once somebody has had a suicide attempt that would have been fatal if they hadn't been found, or they use a method like shooting themselves in the head and missing their brain by a little bit (yes, it happens) or self-electrocution, or driving their car into/off something, I would report them. Service or no service. These people are generally admitted direct to the ICU, they're not coming to see me on an outpatient basis.

    The thing that informs my decisions about this is the London coal gas switch, which you can read about here.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC478945/

    When London switched from coal gas to natural gas and that easy and painless suicide method was gone, the suicide rate in London dropped 30% and never came back. A similar thing happened in the state of Washington when suicide barriers went up on one specific bridge. The 2-3 suicides per year that used to happen on that bridge stopped and were not done in some other way.

    It IS possible to prevent suicide by removing the means. Then again, nobody knows the future, so there are no perfect answers.

    Part of the reason I'm posting this is to get some feedback from people about what I've said. I had a patient who just tried to kill herself while under my care. I was surprised when I heard, but in hindsight it should have been obvious. I raised a little Cain at the hospital where she is staying and told the staff that the last three times they discharged her she tried to kill herself again, and this last one was designed to be her last attempt. It's not so much that her blood is on their hands, but her brains might end up on their shoes. They're taking it more seriously this time.
     
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  6. DuneHopper

    DuneHopper Douglas County. Well-Known Member

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    I think as was mentioned in another thread, Doctors and even software many EMR systems were updated to have the question, " are there any firearms in your home" as part of a new patient and yearly questionnaire. These questions become a permanent part of your electronic records. Anyone not familiar with the EMR system it allows an medical related business to access your records. This includes Drug and Alcohol facilities, Doctors offices, hospitals etc. One own office may not practice this asking but none-the less it would be on record any place that has a minimum of a licensed clinical staff member registered in the medical field to evaluate medical and mental conditions. Its a very slippery slope, one I do not have the great answers for. We want to stop the insane level of mental cognitive deficiencies, but how does one do this without vioalating rights.
    I have worked awhile in the medical field but I am not a medical doctor however I stayed in a Holiday Inn Express once.;)
     
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  7. Jamie6.5

    Jamie6.5 Western OR Well-Known Member

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    The problem is one of a lack of due process.
    Take it to court so the subject has some recourse, and some path to have his/her rights restored should the mental/emotional issue be resolved at some point.
    This notion that a single doctor, with nothing more than a recommendation should have the power to remove someone's constitutional right(s) is ludicrous.
    The fact that it may take thousand of dollars worth of second and/or third opinions, and no appeal system, to have those rights restored is just as bad if not worse.
     
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  8. Caveman Jim

    Caveman Jim West of Oly Springer Slayer 2016 Volunteer

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    Exactly, now anyone on SSA who cannot pay their bills are deemed not responsible people and will have their rights taken away!!!!
    That really chaps my hide!!!!!:mad::mad::mad:
     
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  9. bolus

    bolus Portland Gold Supporter Gold Supporter 2015 Volunteer 2016 Volunteer

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    With all due respect, you'll have to list the EMR's who have dedicated database fields for firearm information that can be easily queried to convince me this is happened. I work with the EMR "EPIC" which is the major EMR for all of the large hospital organizations in Portland. I count 101 more large organizations who use EPIC in oregon that I can easily see from my office connection but there may be more. I've also worked with another huge EMR Centricity in the past and I built patient registry databases off the Centricity oracle database it runs on. There is no required or dedicated field in EPIC that Ive ever seen. I went online today and searched in user help and see no details about recording firearms. I'm also a physician trainer for EPIC so I train other physicians on its use. There has never been one mention in any of the hours and hours of EPIC training I've done that mentions firearms.

    That being said, even if the EMR recorded it Medicare/Medicaid/VA gets its data about health specifically from ICD-10 codes. There is no code in ICD-10 for firearm ownership. There is no way for anyone at CMS to know if a patient has a firearm. We are also regularly inspected by the Joint Commission and there are very high risks to the organization if we do not ask patients the right questions. They dont require any firearm questions. We also dont send codes to Medicare when you have a private insurance or no insurance. Another huge chunk of medical information that the government does not see.

    there is no way that there is any sort of coordinated effort to record firearm possession in the medical industry. There is no standardized way to report it to Medicare (ICD-10). There are no dedicated and standardized way to enter firearm information across all the EMR's either.

    as a profession, we dont spend a lot of time reporting even illegal activities. I had a patient last week who nearly killed herself with Meth. She had meth on her drug screen. Neither myself or the ER doc or the hospitalist who had to take care of her are going to report a clearly illegal behavior with ironclad proof to the police. If you threaten suicide or harm to someone else or child or elder abuse, yes we will report it. But we are not a profession of snitches. My job is to take care of the patient, not report there medical information to the government.

    If your doctor asks you about firearms say "no, I dont have any" and you are done. There is no secret plan to record fiream information for the government in medicine.
     
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  10. Salps

    Salps Down by the river…. Well-Known Member

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    Caveman Jim likes this.
  11. erudne

    erudne The Pie Matrix PPL Say Sleeping W/Your Rifle Is A bad Thing? Bronze Supporter

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    DoctorsTrial.jpg
    As noted in 'The Gestapo by Le Rue' the National Socialists found it easy to enlist doctors into the Party by offering them enticements of endless research grants as well as elevated respect via ego stroking and high paying govt jobs. There was also a cash bonus for those DRs who enlisted additional DRs.
    Obama has expanded upon this by having his regime take control of all Student Loans making him a giant loan shark w/ the ability to crush any dissenting loan holder, not as if there would be many after attending 8-10 years of University indoctrination.
    th?id=OIP.M788eab649e3275397b5fc9ecd0efda8fo2&pid=15.1&P=0&w=243&h=183.jpg

    DoctorsTrial.jpg

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    Last edited: Jan 10, 2016
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  12. nammac

    nammac I-5 Corridor - West of Portland Silver Supporter Silver Supporter

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    Our doctors have quit asking, each incident was met with, "what in heavens sake does that have to do with this office visit today?"

    Seems perhaps they have either gotten the message, that my family offers no additional
    Information for their records... Or perhaps have listed us as combatants...:rolleyes:
     
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  13. erudne

    erudne The Pie Matrix PPL Say Sleeping W/Your Rifle Is A bad Thing? Bronze Supporter

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    valerie.jpg

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