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Old July 26, 2014, 01:10 PM   #1
Glenn E. Meyer
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Florida Docs and Glocks law

http://www.politico.com/story/2014/0...03.html?hp=l15

The Florida law restricting what doctors can tell patients about gun ownership was deemed to be constitutional Friday by a federal appeals court. It regulates professional conduct and doesn't violate the doctors' First Amendment free speech rights.

Quote:
By a 2-1 decision, the appeals court upheld the law as a protection of patient privacy rights and said that the limits imposed by it were "incidental."

"The act simply codifies that good medical care does not require inquiry or record-keeping regarding firearms when unnecessary to a patient's care," U.S. Circuit Judge Gerald Tjoflat.
The article has discussion of gun rights vs. free speech vs. professional conduct.

Are doctors prevented from giving patients critical truthful information? No. Your doc could tell you if you are a parent to secure household chemicals to prevent Junior from eating them.

The issue seems to be that the doc would ask if you had guns and that would be on some record that would be promulgated through various data bases.

That is different from saying you should use a seat belt and don't give Junior bleach to drink.

Safety warnings are different from record keeping.
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Old July 26, 2014, 02:08 PM   #2
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That's good news.

So if I understand this correctly, a doctor can legally provide general recommendations to a patient about the prudence of following reasonable safety precautions with regard to firearms (for example to prevent firearms from being accessed by unauthorized persons/children) but can't legally ask the patient if the he/she owns firearms.
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Old July 26, 2014, 02:31 PM   #3
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Quote:
Howard Simon, executive director of the ACLU of Florida, was surprised with Friday's ruling. Simon's organization had filed legal briefs in support of the legal challenge.

"We are astounded that a court would allow the legislature to override the free speech rights of doctors and medical personnel," Simon said in a statement. "It's a sad day when judges tell doctors what is in the best interest of their patients."
It's also a sad day when a patient goes to a doctor for a head cold and the doctor refuses to continue the patient as a patient if the patient won't talk about gun ownership. Mr. Simon, freedom of speech cuts both ways -- you can't (legitimately) claim that doctors (who generally know zip about firearms) have a right to quiz patients about guns while maintaining that patients have NO right to NOT discuss guns.

Unfortunately, my state does not have such a law, and probably never will. So far, none of my doctors have asked me about guns in the house. If they do so in the future -- I quit shooting many years ago.
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Old July 27, 2014, 07:25 AM   #4
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In Iowa they ask about ownership at Drs. office

Just last month I was in to see a doctor and the nurse (an RN) taking my vitals and history asked about gun ownership. She was very cool about it though. She stated something along the lines of " I am going to ask the next two questions and you do not have to answer yes or no". She asked the question if I owned firearms and then asked how I had them stored.
I looked at her with a surprised look and she said "I know, I know it is none of their business". I asked why she had to ask. She stated the federal government gave them grant money to record the info. LOT"S of grant money was her reply.
She said she was going to leave those questions blank on my chart and had done so many times before with other patients. She also said she had been reprimanded already for leaving the questions blank. But would continue to do so until she was fired.
I thanked her and told her she was doing the right thing.
It sure makes me think that gun ownership is being tracked in several different ways by the government. To what end is the scary part.
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Old July 27, 2014, 07:57 AM   #5
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Have never had a doctor in Florida ever ask about gun ownership, and wouldn't give him or her a truthful answer anyway. It is NOTDB.
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Old July 27, 2014, 09:42 AM   #6
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Quote:
Originally Posted by J A
Just last month I was in to see a doctor and the nurse (an RN) taking my vitals and history asked about gun ownership. She was very cool about it though. She stated something along the lines of " I am going to ask the next two questions and you do not have to answer yes or no". She asked the question if I owned firearms and then asked how I had them stored.
I looked at her with a surprised look and she said "I know, I know it is none of their business". I asked why she had to ask. She stated the federal government gave them grant money to record the info. LOT"S of grant money was her reply.
She said she was going to leave those questions blank on my chart and had done so many times before with other patients. She also said she had been reprimanded already for leaving the questions blank. But would continue to do so until she was fired.
You were fortunate, but we can't count on getting a nurse or PA or doctor who is willing to buck the feral government and risk being fired over not "properly" completing a mandatory form. In general I do not approve of lies but this is one area where I believe it is morally justified and tactically advisable to just say, "No." IMHO it's entirely likely that many over-zealous types would interpret a refusal to answer as a "Yes" and enter that as the response, especially if they face a reprimand for not filling in the space.
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Old July 27, 2014, 10:13 AM   #7
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A doctor giving me advice on proper storage and handling of firearms is akin to me giving the doctor advice on diagnosing diseases. They're out of their level of expertise and training.
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Old July 27, 2014, 12:27 PM   #8
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Just say no.
If someone has no right to hear the truth, are they entitled to it?
Any different than not telling a robber where the valuables are?
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Old July 28, 2014, 06:58 PM   #9
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The opinion is available (for now) at http://media.ca11.uscourts.gov/opini.../201214009.pdf. The majority opinion is 65 pages long and the dissent is 96 pages long. I'm not reading the whole opinion but it's there if you want to.
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Old July 28, 2014, 07:05 PM   #10
Jim Watson
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If my doctor or dentist asks about firearms, they are comparing notes with their own collections, hunting, and shooting.
The periodontist seems vaguely horrified by the notion. But he doesn't keep notes on my stuff.
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Old July 28, 2014, 07:47 PM   #11
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The infantilization of the American public continues.

I suppose it's too much to expect adults to be able to man up and say, "None of your business," when asked a nosy and irrelevant question by a healthcare professional?
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Old July 28, 2014, 08:14 PM   #12
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docs asking questions

The Veterans Hospital primary care and especially the phyc.doctors for ptsd are asking how many weapons are in your home,and are they secure.My doc told my all her patients lie to her,including me,they don't own none.I told her it's none of her business or anybody's elses what the veterans owns.I told her how many policemen out there carrying weapons that have ptsd ,but that's ok.The president is behind that trying to take away the veterans weapons.
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Old July 28, 2014, 09:38 PM   #13
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I'm going through treatment for a retinopathy at the moment. Needless to say, this is really important to my shooting, so everyone knows I have guns. So far, nobody's batted an eyelash. In fact, we've compared notes on how shooters with various visual limitations deal with them.

Now, if my dentist or chiropractor were to start bugging me with that arched-eyebrow expression, I'd simply say I don't have guns.

It's one thing to lie about, say, smoking. That may be exposed during diagnosis or treatment. But guns? They don't need to know.
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Old July 28, 2014, 11:29 PM   #14
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Quote:
I suppose it's too much to expect adults to be able to man up and say, "None of your business," when asked a nosy and irrelevant question by a healthcare professional?
Supposedly, the instigation for this law was just such an incident as you describe. Upon being told that no answer would be given, the doctor dropped the person as a patient.
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Old July 29, 2014, 03:53 AM   #15
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Unprofessional...

Quote:
Originally Posted by JohnKSa
Supposedly, the instigation for this law was just such an incident as you describe. Upon being told that no answer would be given, the doctor dropped the person as a patient.
So long as a doctor doesn't drop me as a patient in the middle of, say, open heart surgery, I'll be glad to be rid of someone so unprofessional...
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Old July 29, 2014, 05:05 AM   #16
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@JohnKSa: If we were talking about a law concerning denying service, that's one thing, but this law apparently restricts what a doctor can *say* to a patient. That's really unacceptable.

I appreciate the sentiment of the people who backed this legislation, but in my opinion, it's a little hypocritical for folks in our movement to claim that the meaning of the phrase "the right of the people to keep and bear arms shall not be infringed," is clear and obvious if at the same time we ignore the fact that in the preceding amendment, the Constitution states that the government "shall make no law...abridging the freedom of speech...."
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Old July 29, 2014, 11:37 AM   #17
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But just like the 2A, the 1A is subject to some restrictions. Here, the doctors' 1A rights of free speech head butt patients' constitutional privacy rights and, indirectly, their 2A rights. Many gun owners would feel pressed upon to answer these questions and, in at least some instances, doctors have refused to examine or treat patients who exercise their rights. All Florida did was to narrowly limit the 1A rights of doctors in the course of examination or treatment of a patient unless medically necessary.
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Old July 29, 2014, 12:32 PM   #18
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Quote:
...this law apparently restricts what a doctor can *say* to a patient. That's really unacceptable.
As far as I can tell, it does not restrict what the doctor can SAY, but it does restrict what he can ASK.

There's a very important difference. He/she is still free to give advice or express views or opinions but can no longer, in an official capacity, demand information unrelated to the business transaction the patient and doctor are engaged in at the time.
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Old August 4, 2014, 07:57 PM   #19
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Like the lawyers... I'm not your physician nor am I giving you advice.


My specialty is not primary care.

I never could think of a time when asking about firearms ownership satisfied "government" criteria for an encounter or insurance claim. There is a plethora of demographic and similar information that is sometimes sought like anything else but that does not compel anyone to answer, much less truthfully.

I have worked at a VA and they do not demand an answer to the question. Inpatient psychiatry maybe a little different, but I don't do that. There have been some psychiatric cases where knowing that information would have made some decisions easier but that is an isolated instance.

"Declined to answer" satisfies just about everything in a record.

If I ask, it's because I want to talk about something we have in common. I might get vintage Winchester envy.

Just talk to your doc. If you spend 5 minutes talking pistols, that's 5 less minutes talking about your cholesterol.
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Old August 4, 2014, 08:14 PM   #20
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Quote:
Originally Posted by Mr. X
I have worked at a VA and they do not demand an answer to the question. Inpatient psychiatry maybe a little different, but I don't do that. There have been some psychiatric cases where knowing that information would have made some decisions easier but that is an isolated instance.

"Declined to answer" satisfies just about everything in a record.
I don't work at a VA, but I am a Vietnam veteran and I have been going to the VA hospital for my medical care for more than ten years. I can tell you with absolute, 100 percent certainty (because it has happened to me) that the patient has no control over what a doctor or nurse or PA writes down, and it isn't all correct.

Just a few months ago, at a routine appointment with my primary care doc, the discussion came around to something that had happened (at the VA) a couple of years ago. She scrolled through her screen and finally said, "There's nothing in your record that mentions that."

"That" was a severe allergic reaction to a medication prescribed by a resident. Because the resident was a know-it-all, when I told him I had stopped taking the medication due to a reaction, he got mad and called in his supervising staff doctor to chew me out. The big man asked why I had stopped, I told him I had had an allergic reaction, and the boss man turned to the resident and said, "He did exactly what he was supposed to do. We WANT patients to stop taking medication if they have an allergic reaction."

The resident was Korean, and he was acutely embarrassed that he had been chewed out (mildly) by his supervisor in front of a patient. He lost face. So he didn't enter the allergic reaction into my record, which resulted in a different resident prescribing it again a couple of years later. Fortunately, I remembered the name and looked at my own, personal records before I started using the prescription.

That was a case of malicious omission of important information. On the issue of guns, "Patient declined to answer" is probably not one of the choices on the form, and there probably isn't room to write it in. One interviewer might simply leave it blank, but they are almost certainly under pressure to obtain that information because, you know, every veteran now has PTSD and is a walking time bomb. My guess is that any time a patient declines to answer, the interviewer is going to check the "Yes" box.
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Old August 4, 2014, 08:35 PM   #21
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AB

Appreciate you sharing that experience, I would say every single chart at the VA contains at least one error.... usually more. It is a function that most charts are "free-written" and very very subject to human error - deliberate and unintentional. It is very difficult to "carry forward" information error-free. I make them too. Sorry that happened to you and the resident.

There is a PTSD screen for most visits because the VA very much wants to identify vets who may be interested in help and the stigma is somewhat lessening and a solid 20+ vets I know finally - just - went to start seeing groups etc. It is usually done by nursing at the onset of the visit. Same with depression. Those results are not explicitly recorded by your physician unless they want to.

Not all VAs are the same, each VISN has it's own protocols, enhancements/ tools in the base software. Our usual templates and "reminders" which have click-select options just don't have a firearms question.
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Old August 5, 2014, 06:24 PM   #22
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Quote:
Originally Posted by Mr. X
There is a PTSD screen for most visits because the VA very much wants to identify vets who may be interested in help and the stigma is somewhat lessening and a solid 20+ vets I know finally - just - went to start seeing groups etc. It is usually done by nursing at the onset of the visit. Same with depression. Those results are not explicitly recorded by your physician unless they want to.
You are correct about there being PTSD screens for most visits. I started to be aware of them about two years ago. However, I strongly STRONGLY disagree with your assessment that "the stigma is lessening." The VA health care system doesn't have enough money to fulfill its obligations. The .gov is willing to throw money at the VA to treat PTSD, so the result is that the VA is trying it's hardest to classify as many people as possible as having PTSD.

The problem with that is that those people may get some help with their PTSD, but they also get reported to the .gov and classified as people who can't possess firearms. And once you get stuck in the pigeonhole it's almost impossible to get reclassified as "safe." They tell the vets that "the stigma is lessening" in order to convince more people to sign on for PTSD therapy, but they don't tell those people they may be giving up their constitutional RKBA for the remainder of their lives by so doing.

Catch 22.
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Old August 11, 2014, 10:29 PM   #23
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Won't deny that being a catch 22.

I will confess my ignorance that I do not know the exact mechanism by which a mental health employee of the VA makes an attestation that can lead to an adjudication or NICS report that temporarily or permanently would revoke rkba. Based on all the other things that need a formal written attestation or declaration it would seem to have to be greater than the "chart" or "note" said person may write or results of a PTSD scene designed for sensitivity and not specificity.

I don't know how transparent the NICS reporting mechanisms are for criminal judgments, much less mental health ones. Maybe our legal colleagues have more experience with that. Still appreciate your thoughts on this process.
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Old August 12, 2014, 02:54 PM   #24
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I have a good rapport with my Dr. and we are both gun people. as a matter of fact I just traded a box of 45LC for a box of 45ACP with him.
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Old August 12, 2014, 10:31 PM   #25
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It was my understanding that the feds were requiring this sort of inquiry as part of Obamacare mandates, which means to me they're keeping records. No one asked me at my last physical, but it was a question on a form I got along with a couple others like seat belt use. I put "none of your business" for all of them and no one ever mentioned it again.

A friend gave me a warning this was coming. Her kid's pediatrician started in on her about it. She switched pediatricians over it. My guess is, particularly when you have a small child, it's a dangerous question to answer truthfully if you do have guns. After all we live in a society that takes kids away from people who let them go to a park.
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