Well, doctors are willing to do a lot of things but won’t actually bestir themselves to do it. And the gatekeepers at many doctors’ offices won’t even let the question get to the doctor.
As an example: My husband had half a dozen surgeries this year, and was constantly on antibiotics. He became pretty sick, and we went to Urgent Care. The doc there said he suspected pseudomembranous colitis. He talked to my husband’s internist who said he wanted to see my husband the next day. But when we called to get an appointment, the office wouldn’t let us in. We told the receptionist what the Dr. had said, and she said, “Our doctors don’t know their schedules.”
When my husband went back to the urgent care for followup, that doctor called his doctor and his doctor told off the receptionist who called us to schedule the followup.
I do think there should be a law requiring me or my company to disclose that when someone signs up for internet access, not waiting until someone calls for help with their connection. A doctor should be required to tell a patient when the patient starts seeing the doctor (or, if the doctor has a change of heart, when that happens) if they will not prescribe emergency contraception. That way, if the patient thinks she might want emergency contraception someday, she can look for another doctor. But that disclosure shouldn’t be happening when the patient is seeking emergency contraception- she should know a long time before that if she needs to find another doctor if she wants emergency contraception.
An advantage to OTC Plan B will be that you can keep some on hand, so you have it if you need it. Then there’s no mad rush to get it within the 72-hour window.
Even if the rule you propose were in place, it wouldn’t have changed the situation related in the OP. The woman’s doctor’s office was closed. They referred her to the ER. The ER docs were the first to refuse her request “on the merits,” as it were. The next were the local Urgent Care clinics, and next “every hospital in every surrounding county.” Planned Parenthood was, like her physician, closed, not a rejection on the merits.
Obviously, that doc did need to have a talk with his receptionist about priorities. IMO, a doc that will not make an effort to squeeze a patient with an emergency into his schedule is more reprehensible than one who doesn’t want to prescribe Plan B for religious reasons.
I agree, and the rule you propose makes sense. A person is entitled to assume her doctor is willing to dispense medicine which is legal and medically prudent. If a particualr doctor has restrictions on top of that, he should inform his patients when they become patients or, as you say, when he has the change of heart that modifies his position, and let them choose other providers if they wish.
More reprehensible? I don’t agree. Equally? Perhaps. But a doctor can’t know what she doesn’t know. If the emergencies don’t get seen and the doctor never knows, that’s not reprehensible at all, though it’s probably laziness on someone’s part. (My husband’s situation wasn’t a true emergency, to be clear. Just something requiring followup.)
I agree with this…Docs need to be upfront about this. I have never believed that medical professionals should be forced by law to perform procedures or prescribe drugs that they believe violate their oath, but there is no reason not to fully disclose the nature of their practice to new patients.
On the other hand, if I were a person who might want Plan B available to me, I would make darn sure I knew in advance what I needed to do to get it, and not wait until it is literally an emergency situation before I start making calls. Better to take charge of the situation now, and not be sorry later.
Even as a pro-lifer, I personally think it is strange that such a big deal has been made over Plan B. There is some concern (even according to the manufacturer), that it may prevent implantation of a fertilized egg. But this is how IUDs work, and they have been legal for years. I think you would be unlikely to find a pro-lifer who would use an IUD as birth control because of this (if they understand that this is how they work), but I don’t tend to hear about them much in terms of controversy or talking points. I also don’t tend to hear complaints from women that they have had trouble finding a doc who will insert them. Are IUDs just not used much anymore?
Well, I think that having a moral objection to something is quite different than simply not bothering to move a schedule around or miss lunch. I can respect a moral choice, even if I don’t necessarily agree with it. I can’t respect a physician whose golf game is more important than his patients.
Certainly, the receptionists are responsible for making the appointments, but the docs are the ones who set office policy. There would be nothing stopping a doc from telling the receptionist “if anyone calls here and says they need to get a Plan B prescription, we need to figure out a way to get them in ASAP, or refer them to an emergency room where they can get it immediately.” Even the receptionist has a certain responsibility to patients. Medical office personnel really can’t be lazy when it comes to emergency situations.
Other BC also prevents implantation, if I remember correctly, though it’s not the main purpose of any of them aside from IUDs (and the IUDs with hormones are like other BC I think).
Not necessarily. I think that doctors joining a group are probably joining an office with a set policy.
Also, most doctors’ offices hear “emergency” and immediately say, “Go to the emergency room.”
My husband is disabled, so I’ve had many many experiences with trying to get appointments for potentially serious problems that don’t reach ER standards. The lack of urgent care is huge and widespread and it’s in every aspect of health care that I’ve ever interacted with. So, we can say that doctors really should do X, but it’s not happening with any aspect of health care–not just Plan B.
And I don’t think it’s just a matter of doctors playing golf and blowing patients off. Many doctors are swamped, especially around here in BFE.
I don’t think this makes a difference. It should be office policy, then.
Which is fine, as long as they refer to an emergency room that will prescribe Plan B.
You are right, and it’s terrible. Several years ago, I was in the middle of having a miscarriage and couldn’t get an appointment at my OB/Gyn. But you CAN go to an emergency room, for any illness. People without insurance do it all the time, because the ER has to take them. As I said, if a doc can’t take an emergency patient, they need to be referred to an ER that will prescribe Plan B.
I wasn’t really serious about that…I was just trying to illustrate the point that when you are a doctor, patients need to come first. A simple referral to an ER really shouldn’t be beyond the capabilities of a medical office.
I don’t think this is as easy as you think. How is the doctors’ office to know? Do you think the official policy of the ERs is that they won’t? I doubt it. And I would be that there would be denial denial denial on the parts of these ERs no matter how accurate the blogger’s claims are.
The doctors most likely assume that the EC prescription is available. And I assume that it generally is.
The solution to me isn’t insisting that the doctors know who will prescribe it. It’s to make the drug available without a prescription OR to get rid of anyone who would interfere with someone obtaining a prescription for a legal drug. It looks like the former will eventually be the case.
I think the former would be the best way to handle it, although I do have issues with men or underage girls getting a hold of it, and I’m also not sure how safe it is in terms of regular usage, and whether or not it would be dangerous for people to have unfettered access to it (thinking that concerns about becoming pregnant may trump health concerns for many women.)
Because men who are having relationships with underage girls can get it and use it as a tool in their exploitation.
I don’t know about the health risks, either…I’m just speculating based on the fact that it is basically a high dose of the Pill, and there are people who are not supposed to take the Pill at all due to health issues.
I would actually really appreciate it if you could find some academic citations on the subject. What I know about the subject is not based on having examined the medical literature - I got this from Dr. Drew on Loveline who insists that the medical literature shows that actually blocking the implantation of a fertilized egg, if it happens at all with emergency contraception, is extremely rare, and that its actual effect is due entirely to blocking ovulation. I’ve never examined the medical literature personally, and I wouldn’t even know where to start - and while I’ve heard before that it blocks implantation of a fertilized egg, there’s so much confusion in most people’s minds between emergency contraception and medical abortion (as JohnBckWild demonstrates above) that I’m reluctant to believe it. Dr. Drew could easily be off-base (it’s happened before) but listening to years of him insisting quite explicitly that the medical literature shows that emergency contraception works by preventing ovulation has made me suspect that perhaps the actual medical research shows something vastly different from the common assumption that it prevents implantation of a fertilized egg.
But if the state provides a small group a monopoly to practice a certain profession - like, say, by licensing doctors or pharmacists - it’s perfectly reasonable for the state to insist on heavily regulating that field and establishing rules obligating medical professionals to treat patients who need that treatment. Actually, if memory serves, such rules actually exist! Medical professionals are routinely required to treat patients that they might not want to, as the alternative is considered a violation of basic medical ethics and can result in one’s license to practice medicine being revoked. So obligating doctors and pharmacists to provide a legal, safe drug like emergency contraception in order to practice the profession they’re being given special monopoly status in by the state seems pretty reasonable to me.
Which says nothing of the new laws being enacted in many states specifically exempting doctors from the responsibility to provide family planning-related services; I’m no expert, but my assumption is that those laws actually due require their employers not fire them (as I’m not sure what other purpose there could be to such laws.) Perhaps you could enlighten us further on that subject.
The trouble is that I can’t respect certain moral choices. Describing something as a “moral choice” as a justification seems like an awfully facile way to evade responsibility for it. People make choices they believe to be morally correct all the time, under the influence of crazy beliefs (or just plain ol’ fashioned psychotic delusions). I don’t think someone who shoots an abortion provider - though indeed they’re making a “moral choice” - is due any special leniency. I don’t think someone who straps dynamite to themself and blows up a bus is making a legitimate or defensible moral choice.
The problem here is that (possible exaggeration by the author of this piece aside) women are demonstrably facing extreme difficulties in getting access to emergency contraception. I’m not sure why this is; it’s not particularly difficult to get a hold of condoms, even in heavily religious areas. There’s a particular religiously-motivated hysteria and a concerted, organized effort to block people’s access to this perfectly legal, perfectly safe medication - even when (as you point out) access to IUDs is not similarly restricted for most women. The inconsistency of this position is evidence to me that this is not really a legitimate “moral choice” but rather the result of considerable efforts by a very small portion of the population to convince people that the morning-after pill is an abortifacient (again, witness JohnBckWild’s confusion between emergency contraception and RU-486 above.) It’s really disturbing to me how many people seem to think the two things are the same - and I’ve been wondering for a long time whether extreme pro-life organizations are deliberately working to confuse two entirely separate things, post-coital contraception and medical abortion, in the public’s mind.
But no, I don’t think this is a legitimate matter of “moral choice”. I think it’s a choice predicated in many cases on ignorance, on confusion, and on a subtle but well-organized, extremist, and terrifying effort to hamper all access to contraceptives. What’s truly disappointing to me is to see the Catholic Church and Catholic organizations in many cases joining in this crusade, one started mostly by the Theocratic (and Protestant) Right, simply on the basis of the Catholic Church’s opposition to birth control. It’s an unusual and depressing slide into politicking and extremism by an organization that, politically, has traditionally been led by rationalism and a rejection of the theocratic (and ultimately counter-Biblical) leanings of the Fundamentalist Christian crowd. It’s a new situation for the Catholic Church to be joining in efforts to use the law to force religious practices on others; that practice is, in my opinion, inimical to both the Bible and to the fundamental workings of a modern society. I have to think that these strange bedfellows are going to experience a falling-out eventually; Catholics would do well to remember, before joining in with the Theocratic movement, that most of those they’re throwing their lot in with don’t like them any more than they like ol’ fashioned atheists like me.
