Thursday, August 19, 2010

15 Secrets Your Patients Won't Tell You

DEAR DOCTOR AND NURSE:
15 SECRETS YOUR PATIENTS WON’T TELL YOU

by Doug Capra © 2010

Earlier this year, Reader's Digest published an article titled "41 Secrets Your Doctor Would Never Share." The article had some interesting insights. All patients should read it. Certainly, it's good to know what's on doctors' and nurses" minds, thoughts they won't say out loud to us. But from my perception, some of these thoughts, or perhaps it's the way they phrase them, seem presumptuous, even paternalistic. How about the chiropractor from Atlanta who writes: "I was told in school to put a patient in a gown when he isn't listening or cooperating. It casts him in a position of subservience." That's a good piece of information for a patient to possess.

Perhaps it’s time for patients to speak up and reveal some “secrets” they don’t often tell their caregivers, and the reasons why. Perhaps it's about time doctors, nurses and patients start really talking with each other -- talking about those "elephant in the room" subjects that tip toe with heavy thuds through hospitals and clinics.

Sometimes, a deep chasm seems to separate patients from their caregivers in our suffering health care system. Both caregivers and patients have a role in bridging this gap. But, as Dr. David H. Newman writes in his book, Hippocrates’ Shadow, “…there is a phenomenon within the culture of modern medicine that guarantees the widening of this patient-doctor chasm."

What is this phenomenon? “Secrecy,” Newman claims. “Doctors have secrets, and we have lots of them.” The culture of hospitals and clinics is quite mysterious to many patients.

Newman hopes, and I agree with him, that acknowledging these elephants in the room is essential for more healthy and open relationships between doctors, nurses and patients. He has great respect of his profession; for, the essence of medicine, he writes, is a “profoundly human, beautifully flawed, and occasionally triumphant endeavor.”

But then there’s the other side: “The truth is,” he writes, “the real secrets of modern medicine are protected by tradition, group-think, and system constructs that punish inquiry and self-examination. They are embedded in the presumptions and thought patterns that we are taught to embrace during our indoctrination and on which we come to rely. They originate at the highest levels and trickle down; physicians are often merely bit players in a systemic – and systematic – dishonesty stemming from these secrets. These are the secrets and lies that shape the practice of modern medicine.”

I embrace his primary solution to this problem. Better communication. Getting these “secrets” out in the open. So…doctors, nurses, various assistants and tech’s – Let’s communicate.

If you’re a doctor or nurse reading this article, it may anger you. You may not agree with some of what’s here. But I can assure you that the thoughts I’ve listed below are on the minds of a significant number of your patients. And most won’t tell you what’s written here, unless you gain their trust, give them your time, and open your hearts to their feelings and what’s really on their minds.

Talk with us.

  1. If we made an appointment with you, we trust you. We may not feel comfortable telling the most intimate details of our private lives or revealing our naked bodies to your unlicensed medical assistants or even your licensed nurses or their assistant. On the other hand, if we’ve developed a relationship with them as well as with you, we may be just fine. Talk with us.
  1. Get rid of your paper and flimsy cloth gowns. Get some that really cover your patients. Better than that – find alternatives to gowns when possible and let patients know about those alternatives. If you do tell us to put on a gown, be specific about whether we can keep any underclothing on. Unless it’s obvious, don’t assume we know exactly what you want. Talk with us.
  1. We’re scared. Actually, hospitals and clinics intimidate some of us. It’s like a different world. Some of us don’t even understand the language. When you ask us questions, we won’t consciously lie to you, but we may not be thinking straight. Look us in the eye and try to read our emotional state. Talk with us.
  1. If you’re a male and we’re a female, we may neither feel comfortable talking with you about intimate matters nor with you examining us in an intimate way. Unless we specifically chose you as a caregiver, ask if we’d prefer a female to do the procedure or exam. The same goes for male patients who prefer same gender care. People have different values. We know. To some of you, there are no male or female doctors or nurses, only doctors and nurses. You’ve been taught that your world is gender neutral, that it doesn’t or shouldn’t matter. Maybe that’s true in a perfect world. But the world we both really live in is not gender neutral when it comes to the most intimate parts of our bodies. You see naked patients every day. To you it may not matter anymore. To some patients it does matters – and it’s not up to you to judge their personal values. Don’t take this personally. It doesn’t mean we never want a male or a female to take care of us. It doesn’t mean we hate men or women. Our choice may depend upon how intimate the exam may be. Respect that choice. Walk in our shoes. Consider what your personal gender preferences might be for intimate procedures. Consider how you would want your mother or father, brother or sister, son our daughter treated. Talk with us.
  1. Let’s talk about men. Some men have problems with their perception of how their modesty is treated by some in the medical community. Many of these men will not speak up and tell you what they prefer – which would be for same gender intimate care. They may appear arrogant, angry, sarcastic, silent or compliant. Speaking up and asking for same gender care is as or more embarrassing or humiliating to them than as is having a female nurse or technician conduct an intimate procedure. You can say, “Oh, they’ll get over it.” But many won’t. They take these unresolved negative feelings home from the hospital with them, and it influences their attitude toward medical care and the system in general. They may feel their dignity hasn’t been respected. “How dare they!” you may be thinking. “I treated them with dignity.” Were they asked about their preferences? Did they get a chance to define their dignity, or did you define it for them? Talk with us.
  1. If you need a chaperone, don’t pretend it’s only for your patient’s comfort. Acknowledge that it’s for your own protection. In our culture, there’s no denying that this may be necessary. But be upfront about it. Many man are unexpectedly faced with a female doctor who then brings in a female nurse or assistant as a chaperone. How often does a male doctor bring in a male nurse or assistant as a chaperone when conducting an intimate exam with a female patient? This is a double standard that needs to be changed. Does your hospital or clinic have a written chaperone policy? Does it insure that patients will be asked if they want a chaperone? Does it insure that same gender chaperones will always be offered? Many studies show that most men don’t want chaperones regardless of the caregiver’s gender. They don’t want an audience. The same is true for some women. Always ask and respect those choices. Talk with us.
  1. We like you and trust you, but some of your staff may be distant, rude and/or unfriendly. We may not feel comfortable telling you this, but you’re responsible for their behavior. If we suddenly stop using you as a provider, or request another caregiver, you may never know why. So why not find a way to make us feel comfortable giving you this valuable feedback. Talk with us.
  1. “Privacy” doesn’t just refer to paperwork and speech. It also refers to patient respect and dignity – and that involves how we feel about our bodies. Drape patients properly, keep doors and curtains closed, don’t “pop in” when another caregiver is working intimately with a patient. Always ask permission (when patients are fully dressed) to bring in a student or observer, especially when intimate exams or procedures are involved. We know – you’ve done this a million times, and “seen it all.” But it’s the first time for some of your patients. Talk with us.
  1. Don’t tell us how many other patients you have or how busy you are. That may certainly be true. And if you’re in a rush, don’t be obvious about it or tell us. When we’re naked, perhaps frightened, vulnerable and sick, we don’t want to hear that. At that moment, the moment we’re in your hands, as far as we’re concerned, we’re your only patient. And we expect you to treat us that way. Talk with us.
  1. Even if we have a valid request or complaint, we may be afraid to state it. Why? Because we may be afraid that you may take it the wrong way, label us as a “bad” patient – and that may negatively affect our care. We realize you may find this absurd or even insulting, and we’re not saying this feeling is necessarily rational. But just because feelings aren’t always rational doesn’t mean we don’t feel that way. So, don’t tell us we don’t feel that way. Respect our feelings and prove to us wrong. Talk with us.
  1. Most of us want to be good patients. We understand about being polite, respectful and not overly demanding. But hospitals operate under all kinds of “under the radar rules” that are unknown to inexperienced patients. There are many “elephants” stomping around in hospital rooms. You live with those unspoken rules day after day, month after month, year after year. You know them by heart. We don’t, and we’re not given a list of them upon admission. Most of the time, you don’t tell us. You expect us to figure them out. Talk with us.
  1. Be careful about using the following expressions in response to patient requests: “Don’t be silly.” -- “I do this all the time. You don’t have anything I haven’t seen before.” -- “We’re all professionals here.” You may have good intentions, but these may seem insulting and disrespectful to some of us. These kinds of expressions are not meant to open up discussion. They’re designed to shut down communication. If you use one of these expressions, and your patient shuts down, don’t assume everything is just fine. We know. You’re busy. But we don’t see ourselves as just another “job” to get done so you can move on to the next one. Talk with us.
  1. We know. You sometimes need to vent. But be very careful. Venting used to be mostly done behind closed doors, whispered in break rooms and over lunch among professionals. Now it’s become more public – blogs, Facebook, at parties, in corridors – sometimes even within patients’ hearing. Don’t underestimate how this public venting can damage the credibility of your profession and destroy patient trust. And remember, patients sometimes need to vent, too. Talk with us.
  1. We know. You know what it’s like to be a patient. Some of you have been hospitalized before. But you’re missing an important point. You don’t know what it’s like to be a patient who doesn’t know what you know about medicine –a patient who doesn’t understand the culture of a hospital, who doesn’t speak the language, a patient without any medical training at all who has rarely or never been hospitalized. You may have known that point of view before you became a doctor or nurse. But you can’t unlearn what you know now. You’ll never see being a patient the same way again. Try to recall how you felt way back then. Talk with us.
  1. Don’t forget -- You have the primary responsibility to open up communication with us. Sometimes we’re tired, frightened, vulnerable, naked, intimidated. Often we won’t say anything, even if we feel uncomfortable, embarrassed or humiliated. Sometimes we’re just too tired and exhausted to fight with you. Don’t assume that everything’s okay just because we don’t speak up. I realize that this may be risky business for you. Asking a question might get you an answer that you don’t like or want. You may know the answer but not want to really hear it. But do ask. Communicate. Talk with us.
Realize that at heart most of us do trust and respect you. We put our lives in your hands everyday. We make incredible leaps of faith. We know we don’t know more than you do about the science of medicine. But we do know our own bodies and our own values – and many of us want to have a critical role in the details of our care. We can bridge this chasm between patients and our health care system.

Talk with us.

NOTE -- I've tried to summarize my ideas within 15 items. What are some other thoughts you as patients would like to tell doctors and nurses (and CNA's and medical techs) that you hesitate to mention? Let's hear from the patient perspective.

20 comments:

Anonymous said...

This is excellent. I think the challenge becomes how do we get this out to the people who need to see it. One option would be for us as patients to send the link or a copy to our providers. Another might be to have someone forward it to the provider or facility. If this came from an outside source would it have more wieght than coming from a patient. My thought would be if there would be a web site listing the name of the facilities that had recieved a copy of it and offer them a chance to post a response or acknowledgement...it might spur them to consider it a bit more if they think it is possible other paitents will see it, if its out there on the net other patients might be effected by it. We all hate negative pubicity. If they recieve one of these and THINK someone may see it and think they have a problem it might make them think. Perception is more important than reality in these instances. If they get it from a 3rd party web site might feel the need to take it beyond the patient advocate because if it does cause issues, and it was known they had previous notice....appreciate the effort you have put into this. I would be willing to help financially with a web site to achieve this. I think at least the appearance of an larger organization would get peoples attention. A section or certification of "patient friendly" facilities might also help reinforce the positive things we encounter...thanks again

Joel Sherman said...

Excellent suggestion. Don't know fully how to do it, but here at least is the URL for Doug's article:

http://patientprivacyreview.blogspot.com/2010/08/dear-doctor-and-nurse-15-secrets-your.html

Hexanchus said...

I agree great article.

What's the odds of getting it posted as a guest article on the kevinmd site?

swf said...

Doug:
Wonderful job compiling a
"TOP 15". Inserting a separate area relating specifically to men was relevant and timely.
I assume a few of the 1-15 will be special topics later?
I think #2 would not only be good for opening common-ground communication (even medical staff hate the gowns!) but could also provide information on the wide varity of choices.
Good job.

swf said...

"Let's hear from the patient perspective."
In the spirit of opening communication, I would like to ask caregivers:
Why the (general)hesitancy to discuss the issue?
Is it embarrassment of the caregiver? Is it an attempt to suppress the issue and therefore make it a non-issue? Is it a reluctance to take the mystery and secrecy from the medical arena?
Is it an avoidance in considering any type of ethical dilema built within certain job proceedures?
None of the above perhaps....
Until we talk, we are only left with guesses and assumptions, which may not properly relect either side's emtions or motives.

Anonymous said...

To swf
From: Doug

-- Good questions. Let's look at them one by one.
Is it embarrassment of the caregiver? Could be. But I think most caregivers get used to naked patients and doing these procedures.

Is it an attempt to suppress the issue and therefore make it a non-issue? That I think is closer to the truth. Many have been taught that by even asking the question, you may create a problem where one doesn't exist. The contention is that patient silence is consent. So why ask? Asking may just get patients to think about it.

Is it a reluctance to take the mystery and secrecy from the medical arena? I don't think that's a conscious ploy most of the time. Remember, they don't see it as a mystery. Only the inexperienced patient is ignorant as to what will happen. Granted, though, it is easier to just get things done if you can move people along quickly without a lot of questions.


Is it an avoidance in considering any type of ethical dilema built within certain job proceedures?
Frankly, I think a good part of it is just plain, simple habit, custom, tradition. This is how we do it. After a while, some caregivers learn to either not even see patient discomfort, or regard it as not really relevant. The old end justifies the means.
We're helping you. We're curing you. We're making you better. That becomes the driving issue (not that it isn't essential) and it's easy to put everything else on the back burner.

María said...

The end doesn´t justify the means. I seem to state the obvious, but often patients trust too much even unqualified medical personnel despite disrespect, abuse, and even malevolence.
The old excuse "we're treating you" just doesn't wash, is a teenage assistant giving a male a bed bath is not "curing him".
Actually intimate care is many times not only unnecessary but harmful as well, it can produce significant damage to well-being and even physical health.
It is true that while many men don't want to be cathetherized, many females don't, either. I for one, refused the procedure once myself, on the understanding that, it is for the convenience of the caregiver and not the patient . On the cntrary many of them, especially females, end up with UTIs because lazy nurses won't be bothered to hand us a bedpan.
As for the "you don't have anything i've not seen before, it is actually not even true, every single person's genitalia is different form everybody else. If a patient is really intelligent this one always backfires: if you have seen so many naked women before (this is a very sensitive topic as I'm female) you REALLY DON'T NEED TO SEE ANOTHER ONE.
Do they think I'm going to be impressed by that???I find this profoundly disrespectful to the patient, and I've taken care that whoever says that stupid thing to me never cares for me again. If i'm not special to you and you, I have all the more reason not to trust you and get naked for you.
and in developing countries the treatment of women by males is appalling and the medical field is no exception. I happen to be a young, attractive women, do male doctor's big ego take a little tumble of the cliff because I won't strip for them.
But one of the most compelling reason to refuse cross-gender intimate care (and possibly even same gender care if not necessary or desired) is that their "gender doesn't matter" mentality doesn't know the difference between sexuality and sexual intent. Dr. Mengele certainly had no sexual feelings or intent towards the women he practiced forced internal gynaecological exams on, yet he was one of the most despicable persons you can image. The truth is that we never will be able to desexualize the patient without also dehumanize him/her, and possibly his spouse or other family members as well.

Anonymous said...

Thanks for your comments, Maria. On at least one point, I think we'll have to agree to disagree. You say: "The truth is that we never will be able to desexualize the patient without also dehumanize him/her, and possibly his spouse or other family members as well."

I think this depends so much on the individual caregiver. There's one strategy I haven't covered yet in the series I'm writing about JUST BODIES. I'm not implying, and neither is the study, that there are no good strategies for dealing with this issue. There are caregivers who have tremendous empathy, exceptional communication skills, and an authenticity that is immediately picked up by the patient. Some of these elements are strategies, too, but more than strategies -- they are part of the caregiver's character, make up, personality. But some of this can be taught, too.
Now, I'm not saying that even these positive strategy will work for everybody. They won't. And I'm not judging your point of view. You are, of course, free to feel and believe as you choose and determine your medical care based upon that. But I still believe that most patients are ambivalent about gender, and depending upon the context and how they are approached by the caregiver, can go either way. If the patient feels safe and respected, gender may not play as important role for some. What caregivers need to realize, among other things, is that patients determine the definitions of "safe" and "respected" in different ways.
Doug/MER

Anonymous said...

Pretty good list. I'd like to print this up (after making a few changes, I won't tolerate intimate care from women but I would like to be polite about it) and hand it out to every healthcare worker I encounter during a visit to the doctor or hospital.

Depending on the attitude of a woman telling me "I've seen many naked men before you..." my usual response would be "well guess what, I'm married and I've watched hundreds of movies during my life, so I've seen a lot of naked women, so you might as well take your shirt off too."

Clinical, non-clinical, it's all the same to me. 3 - 24 months at the community college doesn't give anyone a free pass to our nudity, as far as I'm concerned. Any (medical) woman that has less education than me doesn't have enough education to impress me enough to strip for her.

Sorry for the rant, I had to get that out. I think what you two and Dr Bernstein are doing is great. Other contributers such as swf, Hexanchus and alan are much appreciated as well. I may complain a lot but I've really learned a lot from these blogs. To know that I'm not the only guy that politely (at first) puts his foot down in defense of morality, dignity, ethics and equal rights makes me believe that maybe my stubbornness and possible sacrifice might actually help others.

GR

Anonymous said...

if you're male and we're female, remember that you're not married to us. this may sound very rude, but you're not entitled to anything, and our spouses may very well put you in your place. As for you "I've seen it all before", or worse, "you don't have anything I haven't seen", if that's the case, then you should have no problem in seeing one person less. And if we're attractive, and you throw a temper tantrum because we're not stripping for you while you neglect the infirme, wrinkled old lady before us, I'm sorry, but I'll be more than a little suspicious.
If you're female and we're male, we also have modesty. The permission society, (although increasingly less so) gives the healthcare worker to wiew and care for patients of both gender may not extend to all males. You are asking a particular man, not society, to take his clothes off, and he has every right to refuse you.... At least, as much as females do. Then again, of you really overstep boundaries and a violation occurs, no matter how common and trivial you think it is, her partners may make sure you're sorry for what you've done.
You may think patients are gender-neutral (bull.... to make us behave the way it's fastest and convenient for you), but I assure we're not...

Anonymous said...

I think quite simply that we as people are programmed from the time we are very young that genders have separate bathrooms,changerooms,and such. If I were to walk out in front of my house nude I would probably get taken away by the police.

Now suddenly after society programs us to feel uncomfortable about the opposite gender seeing us naked we are blackmailed by our ailment. At a time when we feel crappy and weak we get a double whammy of hospitalization and exposure to opposte gender care.

Doug Capra said...

Thanks for your comment, anonymous. In my experience, most facilities will try to accommodate for gender choice. Some may not be able to. The key is patient advocacy. Ask questions. Make informed choices. If you can't or feel uncomfortable advocating for yourself, have an advocate. Don't accept anything but the best dignified care. Speak up. Be polite but firm. Make sure your expectations have been communicated. It won't take a majority of patients to do this. A vocal minority can help reach a tipping point where the industry and profession will hear more clearly and embed these values into their daily care.
MER/Doug

Anonymous said...

I'm a 50 year old man with 2 genetic diseases that have really made my quality of life poor. What makes it even worse is the female doctors and nurses seem to be so insensitive to guys that are embarrassed wben epected to take everything off,even for a foot x-ray or above the neck procedure. The humility that I have felt is a strong part of why I recuse intimate exams,I've never had a complete exam,no doctor has ever asked if I have ever had a complete physical,or even when my last on was. I don't intend to have one,notning below tbe belt anyway. I've had as many as 11 medical appointments a year,now recently 2 is tne most I keep...last year none. I search the internet for medical advise and possible remodies. And learn all the secrets doctors and nurses don't want patients to know. Believe me,there are no more medical secrets. Anyone can easily find tbe lists that open patients'eyes and let tbem know everythind that goes on in hospitals and exam rooms. My respect for caregivers lessens every time I read a nurse's or doctor's confession that just does not support correct behavior,respect towards patient needs,propper conduct between male and female doctors and nurses. I know of only 1 doctor that will dicipline fellow caregivers.correcting tbeir behavior,attitude,remarks and anything else that is negitive for a patient's feelings or care. My respect for him is very high. And if all doctors had his lev of patient respect and compassion,I wod have no problem making and keeping appointments. As a medical professional he is the absolute best there is. Maybe if other caregivers realize how patients feel about and respect a doctor that expects and enforces proper behavior,compassion,dignity respect and no intimidation towards patient's when they are nervous..even frightened...they just might try to help us in ways that work.



Anonymous said...

In his December 22nd post, anonymous stated, "What makes it even worse is the female doctors and nurses seem to be so insensitive to guys that are embarrassed when expected to take everything off, even for a foot x-ray or above the neck procedure."
I can't conceive of any medical reason why completely disrobing in these situations would be necessary so I would be curious to find out how the medical staff involved can justify this exposure. I suffered a foot injury last year and only had to remove my shoe and sock for an x-ray to be taken.
Unless there are circumstances I'm unaware of, I would advise anonymous, if asked, to refuse to undress for such procedures and then begin looking for more respectful health care providers. Remember, you have ultimate control over your body and have the absolute right to refuse any medical procedure you feel uncomfortable with.
MG

Anonymous said...

I'm a male patient tbat has tried several times to make needed medical appointments. In calling the hospitals I have found they do not have male nurses in surgery or they do not even return my calls even when they say they will. My past experiences with female nursing care have been too embarrassing to let it continue. I have refused to make appointments for surgery upon knowing female nurses,scrubs and anesthesiaologists will be in the room. I can't have anything on for the procedures I need. I called my PCP to get copies of medical records and the nurse asked to make me a wellness checkup appointment, To aviod female nurses,I refused. Doctors and other hospital employees have not shown any progress in arranging my procedures to be done with only male caregivers. I've spent hours reading the posts on many male modesty sites and I feel like medical care and male modesty is not going to improve unless it is required by law to accomodate patients with same gender care upon request. That will mean greatly increasing the hiring of male nurses,scrubs and techs.

Doug Capra said...

Thank you all for your recent comments. The OR situation is a difficult one to solve, but not impossible. As has been brought up on other threads, scheduling takes into consideration skill level and expertise. You don't want same gender care from someone who isn't as skilled as he should be -- do you? Perhaps that would be acceptable to some. But in hospital OR's, skill level will trump gender in scheduling. But that doesn't mean that modesty issues can't be addressed at all.. Yes, the problem is there are not enough males in nursing, but that seems to be improving. But, getting back to the title of this article -- let's not keep these issues secret from providers. Let them know your concerns Of course, the risk is you'll get ignored -- don't accept that; or even worse, ridiculed -- don't accept that either. Those are risks we need to take. At the very least, medical professionals owe you an honest, open discussion about your concerns. And, if they deny your request, they owe you a direct denial and reasons why.
As I've said before, in a perfect world, medical professionals would be the ones to address this issue up front with their patients. But this isn't a perfect world. Thus, patients must assume a more assertive stance and not be hesitant to bring this issue up and make their expectations clear.

Anonymous said...

I have posted a couple times in these catagories concerning my poor healthcare. Inapropriate nudity for med students and nurses which has turned me against female nurses,doctors,techs and scrubs and any other female caregiver. I'm sure there are female caregivers that are fully capable and care for all patients compassionately and as best they can. But the few that have humiliated me,have me turned me against all female care...maybe time will change the way I feel. I've posted about my genetic disease F A P, and in the past 10 years I have found medical care can be incompitent,neglectfull,uneducated,embarrassing and pure humiliation at times. And some progress is being made, from patients reporting the problems in the surveys that are sent to them after appointments. I have explained severel unexcusably poor experiences . That were not in medical reports and denied by medical staff. But I explained the obvious medical errors and negligence in the surveys and mailed them back to the sender. Medical errors are not getting covered up . The government and patients and some caregivers are hopefully making healthcare safe for patients. Signed, WHY !

Anonymous said...

I've walked out of a doctors appointment due to #12.

Anonymous said...

I'm another male patient that requested all male hernia surgery care... the nurse said that there could be a male with me as much as possible, just not in surgery. Sounded like she thinks I want a male companoin or maybe she had the idea I like men more than women. I felt offended , I am very introvert . I cancelled my inguinal hernia surgery and am not seeking care for the hernia . The old response "The nurses there are very professional." Is just something every receptionist and nurse tell any patient for any hospital or medical facility.
Look, I don't want male nurses or female nurses, it's just that male nurses just embarrass me slightly less. I don't have the solutions , and my insurance severely restricts where they will cover my medical needs... they show little concern if that actually contributes to preventing me from getting medical care.
Signed WHY .

Anonymous said...

My husband had same. No choice and a nurse who told him he had better pee because she was leaving at 5 . At which time she was shoving a catheter up hisome penis. He has had some rude ones. And the uneducated (in my book no high diploma, 3 to 6 weeks computer training) does not give a cna or ma the right to touch my husands genitalia. These things need to change. For TURP the doctor nor anyone else told us what to expect except he may pee better. No real discussion on how procedure was performed and with all female staff. No one told of complications or that a catheterwould be inserted and go home with him. At least I removed it at home for him. Hospitals and doctors need to stop thinking they are GOD. Give us info. Let us choose same gender caregivers. Hospital we go to told me would be discriminating of female nurse to have male nurse for his upcoming colonoscopy. Where are patients rights So embarrassing and against our real GOD'S word. Also on to the scribe. Get them the heck out of our exam rooms. Talk about loss of patients privacy. I amfighting against them and refuse treatment if they or or cna or ma of opposite gender in when I am in exam or procedure room.