calling all gay girls---please take a moment and read this

[wildhorses]

if you go the hospital ER for abdominal pain: would you expect to be billed for a urine pregnancy test if you are between the ages of 13-50 (child bearing years)? this test would be done without your knowledge or permission...

please comment. i need some honest input here...and if i have offended anyone in anyway i apologize. it is truly NOT my intention.

also...talk to me about the words dyke and butch...:thumbsup::thumbsdown:

should i have titled this thread homosexual women?

[sir_captain]

1. i'm not a gay woman

but I can tell you that ordering pregnancy tests for abdominal pain in women of childbearing age is extremely standard procedure, and for very good reason.

i see where you're going with this, but i honestly don't really see what the big deal is. those pregnancy tests without question saved lots of lives--ectopic pregnancies are really not that uncommon, and that's just one aspect of the issue.

[wildhorses]

5. please see post #3

thanks for your comments

[sir_captain]

12. we live in a litigious society

if a woman dies because an ER didn't run a pregnancy test, someone's getting sued, not to mention that someone died for no reason.

without knowing the specific details of a case, one cannot make generalizations about this issue. it's a medical issue, not a sexual orientation one.

[wildhorses]

24. if the woman is walking and talking

or unconscious...

there is a difference

[sir_captain]

28. I don't see your point at all

Could you try to explain what you are trying to say?

[wildhorses]

if she can TELL me that there is no reason to run a pregnancy

test...then why should i run one?

if she comes in unconscious on a stretcher then i have to rule out everything with no help from her.

[sir_captain]

38. Because she might be wrong

It's not a question of whether you believe her or not--it is a matter of confirmation to rule out an *extremely* common reason for abdominal pain.

People get pregnant without realizing it all the time.

[wildhorses]

42. should the test be run before or after the dr sees her?

is it a "standing order"? should a "tech" do it or should a "nurse" order it?

[sir_captain]

46. It's a pretty standard operating procedure

techs don't order tests. At the end of the day, the attending is responsible for the patient's care.

Certainly it would be ideal for the doc to see her first.

[wildhorses]

51. well, techs are doing them where i work...

and just because something is 'standard operating procedure' does not make it right...

as you can see 'standard operating procedure' where i work would be wrong according to what you just posted..

[sir_captain]

52. Of course the techs are running the tests

that's their job. It doesn't mean they're ordering them. That would be illegal.

[wildhorses]

56. that is where the standing orders come in to play, right?

how do your standing orders read at your hospital?

[sir_captain]

60. I'm a medical student

so I can't do anything right now without getting permission from a doctor first.

[wildhorses]

64. what about stroke protocol?

or any other type of policy and procedure?

short of breath? chest pain?

does your 'team' not have treatments and procedures automaically set in place for when these cases present?

[sir_captain]

68. Certainly they do

and I've watched residents get screamed at because they didn't do full pelvic and rectal exams on every woman who comes in complaining of abdominal pain.

I am not an ER resident, though, and I rotate through a lot of different hospitals with different protocols, so I can't tell you exactly how it ought to work in every case.

[wildhorses]

71. i guess i just heard too much screaming today--

maybe i am just getting burned out:shrug:

[sir_captain]

72. i hear you

I don't think ER medicine is for me for that very reason. It really doesn't have a very long career lifespan.

Anyway, you obviously care about the patients, so I'm sure you're doing a great job.

[wildhorses]

75. yeah, i care

but, i also question everything...

NOT good politically in this field...

better to tow the line and not make waves...

just do as you are told and follow standard operating procedure

status quo and cliques abound

i think i am ready to get a 9-5 mon-fri dr's office job

[Shell Beau]

99. She very well may be wrong. I know a girl who was

6 months pregnant and had no idea. She was in a car wreck and got knocked unconscious. When she came to, they told her they had to do an emergency C-section. She was freaking out thinking they had the wrong girl, screaming and trying to get up. Turns out, they didn't have the wrong girl at all of course. She delivered the baby and it is now in ICU with great hopes of living.

[lukasahero]

103. She may also be quite capable of knowing that risk herself

Women who don't sleep with men (to whom this OP was addressed) are not likely to be wrong when asked if there is any chance they are pregnant. Are we to assume that all women are just too stupid to know the answer to that question?

[Shell Beau]

106. True, but had they not done the test, she and her baby

would have been in grave danger. She was unconscious. So in that case, I think it should be ordered.

She knew she slept with her boyfriend, but had she been able to answer the qeustion, she would have said no to being pregnant. She was still having a "period". But if you are awake, and are 100% sure there is no chance, then I think the doc should go with what you say. Docs are also trying to cover their asses. They get sued quite regularly.

[lukasahero]

107. Ah - sorry - I missed the "unconscious" part

Way different story that.

I realize some women make mistakes. (And it truly troubles me to see so many here suggesting that women are likely to lie.) However, I also know that as a woman who stands 0 chance of being pregnant when the doctors ask, it pisses me off to no end when I see the damn cost of the test on my bills anyway. (Why ask if they're not going to listen to me?)

[sir_captain]

108. My favorite irony regarding this post

is that you probably had no idea that the majority of ER docs nowadays are women. I suppose they must be really self-hating.

Seriously--use your brain. No one thinks women are stupid (or they shouldn't)--but accidents happen and it is far better to double-check pregnancy status than it is to have a woman die because her fallopian tube exploded even though she didn't realize she was pregnant.

[LostinVA]

110. The only way I'm pregnant is if the Holy Spirit has visited me in my sleep

Or if Haruka is hiding something really scary from me.

:scared:

[HarukaTheTrophyWife]

111. Yes, Good Vibrations has teamed up with the local sperm bank to make...

the most realistic dildo ever.

I'm sorry I forgot to tell you about that.

[LostinVA]

113. OH GREAT

Now I know why I've been craving ice cream and olives...

[HarukaTheTrophyWife]

114. Dude, you always crave ice cream and olives.

Oddly enough so do I. Along with half-sour pickles. I need to pick some of those up at Whole Foods.

[LostinVA]

115. Hmmm.... true

I'm eating Whole Food olives right now. And 85% chocolate... OMG! I AM PREGNANT!!!

[HarukaTheTrophyWife]

116. Oh goody.

Let's name it Queerspawn.

[LostinVA]

117. OOOO -- love the name!

"Queerspawn Melissa Ellen Lostinva-Haruka3_2000."

LOVE IT

[HarukaTheTrophyWife]

118. Let's dress it in rainbows.

[LostinVA]

119. And little flannel shirts and Birks

[HarukaTheTrophyWife]

120. And give it a baby mullet and mini-power tools

[LostinVA]

122. *swoon* And a little wallet chain

[HarukaTheTrophyWife]

123. She'll be the hottest butch in preschool. All the straight toddlers will swoon over her.

[LostinVA]

125. Recruiting can never start too early

[HarukaTheTrophyWife]

126. I was recruiting last night at Jude's 2nd b-day. Tons of little kids.

They loved the gerbil.

[LostinVA]

127. Did you remember to play the Indigo Girls CD?

[HarukaTheTrophyWife]

128. Oh yes, we had a sing-a-long to "Closer to Fine."

[Jamastiene]

132. I've been craving pickles (sweet ones) a lot too lately.

And I haven't been anywhere near you or any men in that way. What's up with the pickle cravings, I wonder? And yes, I have already had my head checked. The news wasn't good, but I persist in being funny.

[lukasahero]

129. congratulations to you both, btw

:) Couldn't be happier for you.

[LostinVA]

131. Thanks!

Sometimes within the next year, we'll both make honest women out of each other (that's a joke... I think).

[Nikia]

104. Something similiar happened to a former coworker's daughter

Luckily who injuries turned out not to be too severe and the baby is now a toddler, but my coworker came back from the hospital shocked. She had gone to the hospital worried about her daughter only to worry about her first born grandchild who was a couple months premature.

[idgiehkt]

16. unless we believe in the possibility of spontaneous generation

then I don't think it's fair to expect a woman who knows darn well she isn't pregnant to pay for one. I have to pay for stuff like this myself, having no insurance. And the last visit to a local walk-in clinic (because I don't have a regular doctor) cost me five hundred dollars and still didn't make me any better. A hundred bucks for an unnecessary test is a lot of money for some people. A week's worth of groceries is a 'big deal'.

[sir_captain]

26. I hear what you're saying

but there are cases all the time of women who "know darn well" that they aren't pregnant who actually are. I recognize that this is unusual. I am just saying that from the point of view of an ER doctor, they are not doing their job if they don't cover all of their bases. And they are doing that for the benefit of the patient.

Who should pay for it? Well, I'm all for universal health care, so I think the government should pay for it.

It's truly a crime that you don't have insurance and have to pay such exorbitant sums for what I'm sure is sub-standard care. I really feel for you, but I stand by my assertion that this is a medical issue and that women of childbearing age with emergency level abdominal pain should be pregnancy tested in almost every situation.

[idgiehkt]

29. I would think in an

emergency situation that would be a quick rule out and they could proceed on to finding out what was actually wrong with me. :shrug:

[sir_captain]

40. Well, that's not how it works

or so medical school would have me believe.

*Confirmation* of pregnancy status is one of the first things that is run in a differential diagnosis of abdominal pain in women.

[wildhorses]

44. are you 'confirming' or 'ruling out'

or am i just arguing semantics?

[sir_captain]

47. i'd argue that's semantics

does it really matter?

[wildhorses]

54. not really

i was just getting picky

but yes, i think there is a subtle nuance of a difference between

confirming...as in a positive connotation

and

ruling out...as in a negative connotation

[sir_captain]

57. I think you're being a little overly sensitive about it

Particularly since one could argue that either word has more of a negative connotation for the hypothetical female patient if one really wanted to.

And really, as you say, it doesn't have anything to do with your original question.

[wildhorses]

66. i have admitted to being

'sensitive' about this...at this moment and time

can we agree to disagree on this minor and unrelated topic of discussion?

[sir_captain]

69. absolutely

[Jamastiene]

134. Say that next time you need stitches on your forehead and

instead get a finger up your ass.

[sir_captain]

137. Did you read what my post was in response to?

It doesn't appear you did.

We were debating the hidden meanings behind the phrases "confirm" and "rule out"

The poster agreed that this was really just semantics.

So before you take a pot shot at me, at least read what I wrote, ok?

[Jamastiene]

141. You still haven't answered my question either.

I know your type. Welcome to ignore.

[sir_captain]

142. What's my type?

Where have I been disrespectful or argumentative with anyone in this thread?

It seems to me that I am the only one being attacked here.

[Shell Beau]

144. I think you have been right on and have only been offering the info

that you know! :)

[sir_captain]

145. Thank you

I've honestly just been trying to be helpful--I don't understand the vitriol.

[Shell Beau]

147. It happens! Especially lately!

:shrug:

[idgiehkt]

45. then they can pay for it

I haven't had sex with a man in a very long time. There is no way in hell I am pregnant. Like wildhorses says, if I can tell them I'm not, they shouldn't charge a test on my bill just to make some quick bucks because we all know that is what they are doing despite how 'it' is supposed to work. I used to work for vets and I worked for good ones but there were ones in the area that would run every test under the sun just to make a quick buck. 'Standard'...yada, yada, yada.

[sir_captain]

50. ER docs work on salary

they aren't making any money off ordering that test. They are ordering it because it is a sound medical decision to do so. I don't really care if you believe me or not.

As I said in a previous post, I'm all for universal health care so that the government can pay for it. And in lieu of that, I hope some retched HMO pays for it.

[idgiehkt]

58. 'retched HMO'? Try retched HOMO, meaning my non-pregnant behind.

I don't have insurance, like I said before, and a hundred bucks is a lot of money to me. The thing that has always repulsed me about allopathic medicine is that 'sound medical decisions' need not be made with any input from the patient whatsoever. That's across the board, though, and not just limited to the discussion of whether a lesbian should be a) asked if she could be pregnant and b) believed if she answers in the negative.

[wildhorses]

61. very good points made idgie

n/t

[sir_captain]

65. I don't entirely disagree with you, actually

Every patient ought to be as empowered as possible.

[wildhorses]

59. it is frustrating isn't it??

who and how to pay for what and when...

sorry, i am a little crazy...i just came off a 12 hr shift in an ER...we were pretty busy tonight and i am tired and just trying to understand

[sir_captain]

63. hey, no worries

it's a legitimate question

[wildhorses]

37. the paticular female presented with non urgent abdomianl pain

and on the triage system of 1-5...she was a 5...

[sir_captain]

43. That's still not enough information

to make a definitive statement

As I said below, you are certainly correct that the woman should have been informed of the test, though

[wildhorses]

49. thank you--

informed consent or something (i think that is a joke somewhere)

i understand that it should be definitive negative before she goes for x-rays...i just want to determine how we get there...

[libnnc]

94. If I haven't had sex with a man in nearly 10 years...

why should I have to pay for a pregnancy test?

[Shell Beau]

98. I have had an ectopic! Very scary. That is the first thing I think they

want to rule out with a pregnancy. It is life threatening!

[sir_captain]

109. It sure is

I really don't understand why some posters can't wrap their heads around this idea.

[idgiehkt]

133. because if you don't have sex with men

you can't have a pregnancy, ectopic or otherwise. I know, it sounds crazy, but...

Sounds like you're gonna be a great doctor, by the way, you've got the paternalistic condescension down pat. :thumbsup:

[sir_captain]

140. Thanks for the compliment

coming from you, it means a lot. I have been entirely civil throughout this discussion--there was no need to bring in personal attacks. I'm not going to alert on you, but I really think your last comment was pretty low. You don't know anything about me.

[idgiehkt]

157. anyone who refers

to lesbian women objecting to paying for a pregnancy test as having trouble 'getting their heads around' such a ridiculous concept needs to be shown that his future bedside manner may leave a little to be desired. By all means, hit that alert if you are offended. That's what it's there for.

[sir_captain]

161. I did not refer to lesbian women as anything

I was specifically referring to the obvious point that it is possible to be pregnant without realizing it. Life happens--even gay women are sometimes pregnant. Anything else you took from what I said is simply your own imagination.

You don't know anything about me or how I interact with patients. That you choose to make personal attacks on me for essentially no reason reflects much more on you than it does on me.

[idgiehkt]

162. you insult

the women on this thread that disagree with you and someone points that out and you call it a personal attack? Mmmkay....

[sir_captain]

165. Who specifically did I insult?

I said i didn't understand how someone wouldn't see why a pregnancy test is important in cases of abdominal pain. I don't see how that is very insulting to anyone. I don't make personal attacks on people (or at least, I try not to.) And I certainly never specified that I was talking about female posters, so don't you dare put words in my mouth.

You attacked me directly and I have not replied in kind. That is the beginning and end of it.

How about instead of flaming me, you consider for a second that my intentions are actually genuine. I won't hold my breath.

[idgiehkt]

168. here's a nice one

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=105&topic_id=6263491&mesg_id=6264468

"seriously, use your brain" ???!!!

You don't see how smarmy and insulting something like that sounds...wow. It's even worse than your comment about women on this thread 'not being able to get their heads around' your reasoning on this topic. I suggest you spend more time on word choice and less time on whining about being personally attacked. As far as your intentions, I have no idea if they are genuine or not but so far you sound more like the problem in health care rather than the solution.

[sir_captain]

170. You're right, I shouldn't have said that.

though the post I was replying to was completely off base and ignorant.

Once again, I did not say anything about "women posters" and I would respectfully ask that you stop saying that I did.

I never claimed to be the solution to anything. I do the best that I can.

In any case, I am doubtful that you are at all willing to see this from my point of view even though I'm trying to see it from yours, so I don't really see the point in discussing it any further.

[idgiehkt]

172. here's the post

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=105x6263491#6264473

I see contrast here between you saying on the one hand people can't 'wrap their heads' around your point of view, and on the other, you saying that you are trying to see 'my' point of view.

[sir_captain]

173. Ok, I can't help myself

Did I use any sort of word that suggests I was talking about female posters? No, I didn't. You put words into my mouth, plain and simple. Are you willing to admit that?

And just because I disagree with you does not mean that I am incapable of thinking about what you have to say, which seems to be a distinction between us.

[idgiehkt]

174. lol

you continue to be insulting. You can't help it. I'm not asking you not to be, just to admit that you are and deal with the consequences when folks point it out. Btw, the majority of the posters on this thread are female.

[sir_captain]

175. Cheers

:toast:

Have a good one.

[Lex]

2. I have lots of women friends who are gay and are mothers

and have gotten pregnant and started a family while with their SO.

So, being a "gay girl" doesn't mean your ovaries don't work and you can't possibly be pregnant.

[wildhorses]

7. please see post #3

thanks for your comments

[wildhorses]

76. sorry lex...this was posted in the wrong place

i got confused...

hell, i stay confused:crazy:

[Rhythm]

3. I went to the ER recently for something like that...

Before anyone ran any tests, they asked me what kind of birth control i use.

I told them none, and that i didn't need to, because i was pretty sure that my girlfriend couldn't get me pregnant.

The nurse laughed, and told me that made one less thing to test me for.

[wildhorses]

9. were you offended?

in any way by that conversation?

[Rhythm]

22. i looked at it as S.O.P., and i have a good sense of humor...

Plus, with some med 'professionals', it's just fun to throw them off-guard with candid information like that.

I am unapologetically "out" no matter where i am... for good, bad, or whatever...
here i am... deal with me.

[wildhorses]

30. thank you...

you sound like a common sensical person with a sense of humor...very rare these days

[Rhythm]

36. Thank you...

My sense of humor is what the gods granted me in place of burdening me with movie-star good looks.

Give my best to the Tar Heel State, would you... it's been a long time sense i was home.

[Crabby Appleton]

62. ER nurses have seen and heard everything.

[wildhorses]

70. and they don't believe half of what they see and none of what

they here...

what about the 5 month old baby brought in by his parents with a broken tib/fib...(in half!! mind you) and the parents claimed he fell 3 feet from the changing table...

[blonndee]

4. Holy shit! I'm objecting to this re: medical bills right now!

I specifically told the doc there was NO CHANCE IN HELL I could be preg and STILL he ran a test (without my knowledge) that included a $96 preg screening. I find that sexist and unfair. I realize some women will lie or even not realize they COULD be preggers; however, I explicitly told him WHY I couldn't be pregnant and STILL I have to pay for this? I told him, I haven't had sex with a man in more than 3 years. I KNOW how my body works, there is NO chance I could be pregnant, there is NO NEED to run the tests. STILL I have to give up a whole day's pay because he didn't believe me. Not fair at all.

[wildhorses]

10. please post #2 and #3 in this thread

thanks for your comments

[blonndee]

14. Not understanding how posts 2 and 3 are meant to relate

but okay, whatever!

[Lex]

15. Me either!

Good, I'm glad it wasn't just me, blonndee. :)

[wildhorses]

74. i think i posted in the wrong place

i was getting confused trying to keep up with the thread, sorry:blush:

[wildhorses]

27. never mind then...

just look like they were talking from a different angle and i thought you might be intersted in another viewpoint:shrug:

just trying to keep an open discussion going...

[Jamastiene]

88. Precisely.

That's my take on that practice too. Dammit, a woman knows if she could possibly be pregnant or not. If a woman KNOWS she is not pregnant and that it is not even possible that she could be pregnant, she shouldn't have to pay for a sexist policy at any hospital. Like what I said below, how many men are forced into a prostrate exam for a severed foot or a cut on their forehead that needs stitches? None. It has been over 15 years and I still can't figure out what my last period at the time had to do with needing stitches in my lower leg. It made no sense that they stuck their cold assed gloved fingers in every hole before bothering to sew me up too. At some point, it's ridiculously sexist. Maybe it is about time doctors re-examine their SOP on medical issues regarding women, pronto.

[idgiehkt]

138. I am so sorry that happened

I thought you were just giving an example in the other post and now I see you are not. I had a doctor do a breast exam (completely incorrect procedure too, but I didn't know since I'd never had one before) on me when I was lying the bed with tubes stuck in me all over trying to recover from severe double pneumonia. In short, I was violated by him while I was deathly sick. It makes me think women should arm themselves with cameras every time a doctor comes in the room. What you descibed above sounds like such an utter and complete violation, and it makes me sick. I've heard many stories from women about being violated in some way or sexually molested by doctors and dentists. It's sickening.

[idgiehkt]

6. this made me chuckle

I think 'lesbian' might have been a good choice but what the hey...

That is a sticky situation re: the pregnancy test. I don't know what to think about that. They are assuming that the female is both heterosexual and sexually active...I would think they should ask, really. I was watching a show on discovery once where someone they thought was a male came in and they couldn't figure out what was going on til they realized that she was pregnant and had no idea (she had other children, but years earlier). She didn't look that butch to me that they would confuse her gender but they did.

The words dyke and butch are more about personal preference, whether the individual lesbian thinks they are derogatory or not. I mainly hear them used by other lesbians. When used by people not lesbian a lot of times they are meant in a derogatory way so I maybe would just stick with lesbian.

[wildhorses]

13. thanks for your comments

i am so confused:crazy:

just trying to communcuate anymore is a like walking through a landmine...

[sir_captain]

18. you might start

by actually replying rather that simply referring to other posts. i can tell you that doesn't come off that well.

[wildhorses]

78. just trying to get 'opposing' view points together

for the sake of a better debate...

i said at the beginning that did not mean to offend anyone:shrug:

idgie knows me...and would slap me down in a heart beat

and if i have offended you (again?) i again apologize as it is TRULY NOT my intention

[sir_captain]

79. No worries

I can see that you have excellent intentions. I was probably being overly defensive.

I've had a long day too. And another one tomorrow, so I should actually hit the hay.

[wildhorses]

81. me too--

3rd day in a row...

good night:boring:

[Blue-Jay]

8. I'm not sure why "gay" is important in this thread.

EVERYONE deserves equal health care, last I checked. Man/woman/gay/straight/somewhere in between/other.... Maybe I missed the point...

[Lex]

11. And women (straight or lesbian) are capable of being pregnant.

nt

[Blue-Jay]

23. Yes. That is true.

I don't mean to be obtuse here... Have I missed something?

[wildhorses]

19. well, at least i got your attention

:shrug:

please see post #3 in this thread

[Blue-Jay]

32. OK. I see now.

Please understand; I wasn't trying to agree or disagree. I just didn't quite understand your OP right away.

[blonndee]

20. Actually, as homo-unaware as your post may seem,

I agree. I think.

[Blue-Jay]

33. I * think* so too.

It just took me a minute.

[wildhorses]

82. ---

:rofl:

class, are we all on the same page now?

[wildhorses]

80. i really just think people are people and try to treat everyone

with repsect...

i sorta went with the thread title in oreder to get attention..

if you knew HOW many of my threads have sunk with NO response...

if i had titled this

a study of urine pregancy tests...this thing would have sunk like a rock

[Rhythm]

17. Does this somehow tie into how docs are now supposed to treat all women as 'pre-pregnant'...

i saw a few articles and things talking about that months ago, and it just made me shudder.

That's how a lot of folks in the medical world see women, i guess...
Just baby-making machines; some in the "on" position, some on "standby".

[wildhorses]

21. i am baffled

and scared...

if the person is coherent enough to get a medical history ...i can understand if they come in unconscious...you can't take any chances

[sir_captain]

34. Oh, come on

keeping in mind the fact that women of childbearing age could potentially become pregnant while making medical decisions is not at all the same thing as thinking of all women as baby farms.

[politicat]

25. As a sterile woman....

I would be disputing such a charge on my bills. I'm bi, but I do play with boys, too. The key for me (and the place where my situation is similar to yours) is that I'm permanently non-fertile, my husband is permanently non-fertile, and I don't play with anyone who is fertile, so when asked that question, my general response is, "only if there's a star in the east and three sheiks in the waiting room with a lexus, a stock portfolio and gold bricks." That usually gets them to listen to my actual medical records.

I have been billed for preg tests, though, and I disputed them with the hospital. The hospital ended up knocking them off my bill because I disputed. You might try that.

[blonndee]

31. I know you're not talking to me, but you've reinspired me.

I got billed for a PG test, unfairly, I think. For almost $100, it's worth disputing.

[Radio_Lady]

53. I agree. I would dispute the charge. Write a complete explanation of the situation

and refuse to pay. It's the principle of the thing.

I'm 67 years old. GYN/OB techs still ask me when my last menstrual period was. I usually say, "The last one was in the Jurassic Period." Some of them understand and laugh, but some of them don't.

You do have the right to agree to or disagree with tests that doctors order. It certainly seems like "padding the bill" with a pregnancy test if you are not sexually active with the opposite sex.

[liontamer]

96. to be fair, my mom had me after she was sterile

Mistakes do happen (in this case on her Dr's part.)

[XemaSab]

35. You can be gay and pregnant

:shrug:

[wildhorses]

39. this is true

and if you suspect you are...that is one thing...would you prefer to be asked or just have the test done without your knowledge and then billed for it?

[sir_captain]

41. One thing I will agree with you about

is that the woman should certainly be informed of the test

[XemaSab]

48. I think there is no depth to human stupidity and ignorance

and that asking women if they could possibly be pregnant isn't the right way to go.

Compare it with the fact that a huge percent of men who self-identify as straight have sex with other men. :shrug:

Also sex-ed is often poorly taught, if at all, and many young women have no clue about their own bodies and how women get pregnant. In addition, there are bad things out there like rape and drugs that make you black out. Finally, people lie in front of parents and significant others all the time.

If I was a medical professional, I would cover all my bases.

[Gormy Cuss]

102. I agree with you, but if it's CYA for the medical professional, they eat the cost.

If a woman signs a statement that she has been verified as sterile, or that she has no sexual contact with men or their sperm then saying no to the test should be her right. If the medical personnel insist, the cost is on them. Of course, if the woman is in no condition to inform them the prudent course would be to run the test.

[sir_captain]

112. A few points

A) Having one's tubes tied is not a 100% guarantee against pregnancy. A hysterectomy is obviously a different story and I cannot see any reason why a pregnancy test would be run on a woman who has had one.

B) The "medical personnel" are ultimately ordering the test for the well-being of the patient and to make them pay for it is completely absurd. It would be like asking a mechanic to pay for checking your brakes. I mean, come on. There's no other profession where this kind of nonsense would get spouted. I certainly wish that we had universal health care so that the government would pay for it and in lieu of that I really hope that the woman has insurance to pay for it. But if it's an emergency situation where the life of the woman is potentially on the line, the proper tests need to be run, no matter what. That is simply a doctor's ethical and professional obligation.

[Gormy Cuss]

121. Is it not the ethical thing to do to respect the patient's choice?

Note that I didn't suggest that in an emergency situation, with the woman unable to make a coherent statement, that the test was unwarranted. If a patient is adamant that she does not see the need for the test than your ethical obligation is to make clear the consequences of not letting you confirm that.

And comparing the diagnostics that a mechanic uses on a car is just not relevant.

on edit: taking a stand that you should do the test in spite what the patient wishes, consider how many patients are distrustful of doctors and the privacy of information to begin with, add a paternalistic attitude on top of that and you'll see more problems, not less.

[sir_captain]

124. Sure it is

you are suggesting that a worker be forced to pay for his or her services--that is blatantly in violation of how our society works. Try suggesting that to unionized workers. Gov. Schwarzenegger wants to pay for health care in CA by adding a gross income tax onto all CA doctors' incomes. Your idea is simply a smaller version of that ridiculousness. The people who should be paying for medical tests are the same people who should be paying for all other social services--everyone who makes more money than they need.

Of course doctors should respect a patient's choice. And it is certainly the patient's right to refuse tests/treatment. In that case, though, they are also waiving their right to sue if something goes wrong.

You are also absolutely correct that the best course of action is to try to explain why the test is important. If a doctor runs tests without consent, he or she should be brought up on ethics charges.

[Gormy Cuss]

149. No I suggested that when a worker does unauthorized work there is no compensation for it.

That has nothing to do with any tax that Schwarzenegger wants. I'm suggesting that patients should be informed of the nature of the tests to be conducted and that the patient should be given the opportunity to say no when the test is an utter waste of resources. Several posters have written that they were given pregnancy tests without informed consent. If the patient was not given an informed choice,the patient should not bear responsibility for that cost.

[sir_captain]

153. You're ignoring what I actually said

Nowhere in this thread did I *ever* suggest that any patient should be tested or treated against his or her own will. I have said the contrary several times. Short of a court order (or parental consent for a minor) that would be illegal and horribly unethical. If you think that's what I've been "defending" you have a reading comprehension problem.

As I have said several times now, I completely agree with you that it is the doctor's duty to obtain informed consent.

All I have been saying all along is that accidental pregnancies occur and it is in the best interest of everyone involved to confirm pregnancy status. That's it.

If I misunderstood what you were trying to say, I apologize for that.

That said, I did not attack you personally, and your implications about me and my professionalism are unfounded and childish. I wonder if you're a big enough person to admit that.

Edit: I read back over out exchange, and I suppose I can see how you misinterpreted what I said. I should have been more clear. I did not mean that tests should be run without consent. I meant that in the case of emergent abdominal pain, it is absolutely imperative that those tests get run, even if a woman doesn't think that she is pregnant. In order to do that, though, of course, it is incumbent to explain why the test is necessary and obtain consent. I hope I have made myself more clear this time.

[Gormy Cuss]

156. I did not attack you personally, and made no implications about you.

Attacking someone personally is against the forum rules and I do my best to abide by those rules.
Perhaps the syntax in post 121, where I used the informal 'you' pronoun for a generic situation rather than the less ambiguous 'one' caused confusion. Beyond that, I suppose that in the flurry of replying to various subthreads you may have confused my responses with those of others.

[sir_captain]

160. Ok, fair enough. I apologize.

I think I did misinterpret your use of the word "you" and I'm feeling a little defensive since several posters have attacked me personally in this thread.

I don't think we really fundamentally disagree, actually.

[bridgit]

55. hm, 'abdominal pain'...i would expect whatever staff to pursue any reasonable systemic...

causes & remedies for such a call; i would think other diagnosis could be arrived at via urinalysis if not necessarily pregnancy i.e. some sort of digestive, organ/gland, or reflux disruption of some kind as well though of course i am no doctor

we're good friends with an internist, and his approach seems rather systemic in the overall sense; he also puts in ER time

though if a woman states that she is a lesbian...that would seem to eliminate the need for a pregnancy test on the face of it, and as a practical matter; unless of course her & her partner are pursuing 'in vitro' means as has been known to occur, if while other considerations are still in place lesbian or no :shrug:

though beyond it all, and what seems a practical matter as well somehow; hospital ER's are understood to bill for a host of services perhaps required in their attempts to get their heads around a malady that has presented itself to them otherwise unannounced

if i were in ER distress, or a loved one i.e. hubby, i would expect the medical folk on staff to apply what is in their means to do so in order to render remedy & relief :thumbsup:

[reyd reid reed]

67. What I'd like to know

is how they justify charging 96.00 for a urine pregnancy test (I think that's the cost I read cited upthread somewhere). What do they cost when you buy one off the shelf these days (I can't remember -- seems they used to be about 10.00, but that was a long time ago)?

The whole cost of medical care has gotten ridiculous. It's assumed that insurance will pay for it, so charge whatever you want to (I know...I'm overstating) and the insurance industry will pay.

Eventually we all pay for it. And what about the poor people who are uninsured or underinsured? They still get the 96.00 pregnancy test, whether they need it or not because it's automatically requested. When I had my kids, there were things on those bills that I never even touched...it was a routine billing. And they charged as much for a single tylenol as it would cost to buy 2 BOTTLES.


And I apologize. This has nothing to do with the OP, I'm just a little frustrated with the whole medical billing process right now and I'm venting a teeny bit.

I'll hush up now and go back to my little corner and behave myself like a good li'l girl.

:hi:

[idgiehkt]

73. I used to work in a medical lab that sold test kits for

their specific tests. We had three price lists for each kit: one for if the kit was sold to the doctor, which was the cheapest, so he could charge the patient whatever he wanted for it, one for if the patient paid for the kit directly, and one for if the patient had insurance and the price for the kit was going to be billed to their insurance. So the price for a kit might look something like this

IgA test kit price schedule

A. $45.00 (doctor price) B. $200 (patient pay) C. $500 (billed to ins.)

I shit you not. It was unbelievable. And that was just a really simple test, not one of the complicated ones

[reyd reid reed]

77. I believe you.

I think it's criminal. It is. It borders on fraudulent. It's...it seems to me that that violates more laws than I can count, although I realize that it's done every. single. day.

And almost no one questions it. And that's the worst thing of all, I think.

[wildhorses]

83. actually it has EVERYTHING to do with the OP

trying to understand the maze that is our expensive health care system...

and, this scenario i presented plays a minute portion in it....

good to see you:hi:

[reyd reid reed]

84. I don't think we're ever going to understand it.

It needs to be completely overhauled, from the ground up. And that's not going to happen any time soon because they're all making money. We're paying it because so many people were raised to believe that the doctor is always right and the doctor knows what's best and that we shouldn't question him.

Or her.

Thing is, if no one ever questions, then what's to stop them from doing whatever they want and charging whatever THEY feel is appropriate. Nothing. No one.

My son just got the bill from the hospital. You wouldn't believe it.

You just wouldn't.

Or maybe you would.

I don't know which is worse....

[sir_captain]

85. My last comments of the night.

First: doctors have not set prices on nearly anything in a long time. Once upon a time they did, and they made a lot of money, and they had way too much power over what normal people paid for medical services. That is not at all how it works anymore. You are right that prices are outrageous, but those prices are set by the insurance companies and biotech companies. You are blaming the wrong people.

Also, if you think that doctors aren't constantly questioned by every patient who comes in having read WebMD and thinks that they know just as much as the doc does, I've got a bridge to sell you. Don't get me wrong--patients should obviously have as much information as they can about their own health.

And finally, if you think that doctors all make too much money, I can assure you from personal experience that's not true with the caveat that there are some docs (just like in any other profession) who get paid tons of money. That said, I owe the government what will end up being $500,000 in student loans that I will be paying off for the next thirty years (if I'm lucky) for the privilege of working hundred hour weeks for $35,000 a year once I graduate from school. You will note that's barely minimum wage.

[reyd reid reed]

86. I'm not speaking of doctors specifically...

although I suppose I do use the word when I mean the medical industry in general which is wrong. And it's like any other profession in that you have the good, the bad and the in-between. I understand that a physician's office overhead is beyond what I can wrap my mind around, but so is 10.00 for an Advil.

Most of the problems that I have with the industry aren't with the physicians themselves, more with hospitals who do standardized billing and then add what the patient actually uses to that.

You go in to deliver a baby, you're charged for x, y and z -- whether they applied to your situation or not. Seems to me that there's a LOT of wasted resources.

And hey...your student loans are only a little bit less than the bill my son got.

:rofl:

(and reading that last, I'm tempted to take it out because it sound like I'm snarking, but I'm not snarking at you. Just strikes my funny bone right now. But then, it's late.)

[Shell Beau]

101. Not to mention what you'll pay in malpractice insurance!

[Jamastiene]

89. Well said.

Your points about the cost of health care, and how the uninsured suffer from those practices and how we all pay in the end for unneccessary medical exams are so true.

[Jamastiene]

87. A woman can walk in with a severed foot and wave the foot

right in the hostital staff's face and still get a finger stuck up every hole, get asked questions about her last period and get a pregnancy test whether she needs one or not. In other words, no matter what is wrong, even hospital staff (i.e. doctors, nurses, educated people, mind you) automatically think it's a "woman thing." I have no fucking clue what is going on in hospitals, but their mentality is no better than the general public when it comes to treating women equally and fairly. For those who say it's not so, I wonder how many men go into an emergency room to get stitches for a cut on their foreheads and end up getting a prostrate exam BEFORE the doctors even look at the cut on their forehead. I'd be willing to bet none.

[NashVegas]

92. Drug Interference, etc.

At least, that's the reason I've always assumed I was asked about my last period before I went into knee surgery.

[alarimer]

95. What if we all told them it was none of their business?

Simply refused to answer questions obviously irrelevant? I mean, my own regular doc doesn't ask me that if I go in for a tetanus shot or something. But it is a good idea not to go to the emergency room if at all possible.

[idgiehkt]

135. hilarious post, Jamasteine

:rofl:

You are right and it makes me suspicious the whole thing is more about liability and the possibility of a malpractice suit than it is about concern for the female patient.

edit: and reading further on down the thread, I see that is exactly what it's about. Covering the hospitals/doctor's ass. So much for all the righteousness about concern for the patient. It is just cunning and mercenary instead.

[NC_Nurse]

90. If it's not urgent - don't go to the ER.

If it is, expect to be ruled out for LOTS of things and to be charged a LOT.

I've had experience on both sides of this question.

Part of the problem too, is that there are plenty of people who LIE about their status because they don't want their S.O. to find out they've been cheating,
or they don't want to admit drug use, or whatever. Some tests are ordered standard based on that fact.

ER's are misused for all kinds of non-urgent complaints because so many are uninsured and show up there because they can. There aren't enough offices that will see uninsured patients.

[idgiehkt]

136. this sentence is a toughie

"ER's are misused for all kinds of non-urgent complaints because so many are uninsured and show up there because they can. There aren't enough offices that will see uninsured patients."

It's such a sad state of affairs. My only response is God bless the people that show up there thinking that health care a basic human right.

[NC_Nurse]

143. I believe that health care is a basic right.

But try working in an ER and you will feel differently about people who feel *entitled* to emergency care when they don't really need it.

[idgiehkt]

158. lol

I worked in a surgery hospital for animals when I was younger...kind of an E.R. for dogs and cats. Nothing bothered me then but there is no way I could do it now, I don't have the stomach for it. I don't know, if I were getting paid I hope it wouldn't matter to me. But like you said, I really haven't been there. With animals it is different; if the owners can't pay, they get put to sleep. At least we don't do that to humans (yet). Or I should say, at least we don't do it actively. We pretty much do practive passive euthanasia with our healthcare system.

[NC_Nurse]

177. Animals appreciate everything.

I think that's one major difference.

That said, I think you are right about the passive euthanasia thing. And it's really sad that it depends on MONEY, not prognosis.

[La Lioness Priyanka]

91. that happened to me once at a doctors clinic after insisting that i

hadnt had sex with a man for years (2-3) by then.

i like both the terms dyke and butch. i think people shy away from using butch only because it is used as an insult in mainstream culture. butch is a description of a particular look and an attitude. i describe myself as a dyke but not butch (because i am not).

[hippywife]

93. Having read all the posts in this thread

so far, I can agree that a test should not be given without informed consent when it is possible to obtain it. I have never gone into an ER with a physical injury (broken bone, etc.) and been given a pelvic exam so I don't know where that is coming from in Jamastiene's experience. I would raise holy hell before I would have even let that occur, to be sure.

The other thing to consider is that in the case of women, it is always important to ask whether they are or possibly could be pregnant as course of treatment, regardless of initial complaint, could involve drugs or diagnostic tests that could have an adverse effect on a pregnancy. I've often given a similar response as ThinkBlue1966: "If I am someone better contact the Pope!"

[liontamer]

97. I would expect a pregnancy test

true story: my friend is an ER doc. she had a patient come in with abdominal pain who claimed to not be sexually active, but who was actually in active labor.

Some patients lie, some patients are confused, and heck, some could have been raped while blacked out and really have no idea. :shrug: I think it's obnoxious, and really more applicable to teenage girls than adult women, but for someone in the ER it's better to be safe than sorry.

[crim son]

100. I don't know what the protocol is. But what I do know is that

patients will lie or otherwise deny the truth. My father is a retired OB/GYN who was sued while practicing in Canada because he believed it when a patient told him there was no possible way she could be pregnant. Long story short, she was and the baby died. Fortunately in Canada my father videotaped all his face-to-face consultations and the suit failed. For my father, lesson learned.

Just because somebody is a lesbian doesn't mean they can't be pregnant, obviously.

[mduffy31]

105. Wild, I am nurse not a doc but I can say this

I have worked with many docs in both ER and general practice that do have Dr. House's theory of medicine, Everyone Lies. Run the tests, your malpractice insurance is high enough already.

[cwydro]

130. GREAT question wildwoman

Haven't got time to read the rest of the thread right now... but if I come into the hospital and tell someone that there is NO WAY I am pregnant, I would hope they would believe that.

My fave question if I go to an unfamiliar doctor is when they say are you sexually active? Yes.

What do you use for birth control? I sleep with women.

The responses are quite comical sometimes.

[mentalsolstice]

139. What is the SOP for hysterectomies or elderly women?

Do all women over a certain age get a pregnancy test? What if you're young but you respond that there is no way you could be pregnant b/c of a hysterectomy? What if you're 70 years old?

In the case of a hysterectomy response, couldn't that be a lie inasmuch as replying that you're a lesbian? Wouldn't this be discrimination if one response was respected and the other not?

[UncleSepp]

146. Man, I hope I don't have to go to an ER... ever...

When I was 14, I went to the ER for what seemed like it could have been appendicitis. There was a huge argument over whether they were going to do a pregnancy test. I gave them the Jesus/You better call the Pope answer, as I had never had any kind of sex with any kind of person.

Now, I want to get a prescription for Accutane. Being that I have still got ovaries and a uterus, they're going to have to do a pregnancy test before writing the prescription, and one every month thereafter. I have been on testosterone for almost a year, haven't had a period since last March, and haven't had sex with a man since around July. There is no way I could be pregnant, but if I want to get a scrip for this painful nasty cystic acne that hurts so bad that it makes it hard to sleep except flat on my back, I will have to also get pregnancy tests. It's not quite the same as the ER situation, but it's similar.

[mentalsolstice]

151. Certainly, many could get stuck with the extra cost

Transexuals, definitely, as with any other woman. How are they going to know you're not lying if you tell them you're not having sex with men, or you don't have the requisite parts (or they're not functioning). However, I'll be damned if I'm going to get stuck with the cost of a pregnancy test...

[liontamer]

154. that's odd

my dr give me medication without running a pregnancy test. Granted it wasn't accutane, but lot's of meds can cause birth defects. Weird.

[sir_captain]

167. Accutane causes especially severe birth defects

though I can certainly imagine how constantly being tested for pregnancy would seem violating.

[mduffy31]

152. I do believe that it was a question of women of childbearing age

and a woman in her 70's is not someone of childbearing age.

[Left Is Write]

148. How about this one - going in to the ER bleeding profusely, presumably undergoing a miscarriage...

and being asked by the attending personnel if I was "sure" I was really pregnant to begin with.

Yes, thank you, the blood test confirmed it.

[Xithras]

150. Three words: DATE RAPE DRUGS

My little sister was raped years ago and had no recollection of it. No soreness, no symptoms. Fortunatly for her, Mr. Perv Rapist was a friend of a friend and had both a big mouth and a thing for taking pictures. Word got back to her, she put two and two together, and called the cops. Cops found the photos, and he ended up spending 3 years in prison.

Had it not been for his big mouth, she'd have never known they'd had sex. Lesbians get raped just like hetero women do.

[idgiehkt]

159. what a pleasant reminder

the truth its, this all boils down to lawsuits and the hospital avoiding liability. Period.

[sir_captain]

163. Yes, well, I suppose with the way malpractice

works in our country, you could say that about every part of every single patient interaction, couldn't you?

[idgiehkt]

164. I'm sure the bases

are covered, just like this one is.

[sir_captain]

166. Well, as I said, there's an element of truth in that

but it is also true that definitively determining pregnancy status is simply a good *medical* decision.

Can we at least agree about that?

[idgiehkt]

169. If I'm conscious and they ask me

and I am not believed, I'm gonna be insulted and I'm not gonna pay for the test. I don't believe it's about a medical decision, I believe in this case it's about medical malpractice liability. That is how I feel. We can agree to disagree, is how I see it.

[sir_captain]

171. My last post

Believe it or not, I can see why you would feel insulted, and if I were you, I'd probably complain too.

I will simply say for the last time that wanting to run the test is not at all because anyone thinks a woman is lying.

I'm sorry you don't believe it has anything to do with actual medical reasoning--as you say, we will have to agree to disagree on that point, and i'm fine with that. Just so you know, in most emergency rooms, as opposed to in a private doctor's office, the doctor is on salary and the hospital covers malpractice, so decisions tend to be made more with medical reasons in mind.

Anyway, have a good night.

[idgiehkt]

176. I've not said it's because they think she's lying

I've said it's because they are avoiding the possibility of a malpractice suit. Lol, thinking she's lying is actually a step up from implying she might be and not even know.

[Dastard Stepchild]

155. Short answer: Yes...

Mind you, I am bi, but I generally don't proclaim that to the doctor or nurse. So if I went in with abdominal pain and was asked to give a urinalysis, I wouldn't necessarily guess that I would be getting a PG test, but it wouldn't surprise me to find it on the bill after the fact. Since, as you mention, I am a female of childbearing age and did not disclose the gender of the last person I had sex with, I would think that this would be almost standard procedure for a woman presenting with abdominal pain.

And, if it bothered me after the fact I would dispute it on the bill. I'd let them know I was in a same sex relationship and that there is no way I could have been PG, so I want the charge removed from the bill.

[bridgit]

178. short answer yes...