a complete history is a complete history. as you say, you're only a first year, so you really have no clue what you're talking about here.
LOL, and you're a second-year, a veritable expert in clinical practice.
the purpose of a complete history is to learn everything you can about a patient and fully understand not only the disease that is affecting them but how it may be affecting them.
there's a lot of touchy-feely crap out there that can be a hassle as a first year to trudge through, but taking a complete history isn't part of that. it also isn't some crazy liberal concept either.
maybe you have a 75 year old patient with hypertension - his medications are causing impotence. this in turn is causing depression because he had a healthy sex life before these medications interfered. you determine that his problem is hypertension, so you talk to him about his diet, take his blood pressure and avoid talking about sex because it makes you uncomfortable or it's too "liberal" to talk about such things. you have done a huge disservice to your patient by ignoring his sex life and how a seemingly unrelated condition is having a larger impact on his life.
you ask everyone about every aspect of your life. that is your job is a physician. if you don't like the job description of being a physician, there are thousands of people waiting to take your spot.
oh, and for the record, your 75 year old with hypertension can be straight, gay or bi. and regardless, i'll bet he likes sex. turns out, it's a lot of fun.
I see you've drunk the Kool-Aid on this one. Believe me, I've heard it already. Our liberalism seminar actually had a session on sexual histories which included a lecture on what a shame it is that many doctors don't take a sexual history and what a disservice they're doing to their patients. The idea was not that you could miss risk factors for disease; it was that you're somehow providing incomplete care because maybe the patient isn't happy with their sex life but they're too embarassed to bring it up, and you as their doctor should bring it up because then you'll discover that they need Viagra to be happy or whatever.
It's good that you used this example, because it makes it easy to see how this is really motivated by liberalism. We're not talking about the supposed need to grill a seemingly normal, happily married, suburban white man about whether he has gay sex because if we don't we might not find out that he's at increased risk for HIV. We're talking about the idea that it's a doctor's job to help his patients become sexually fulfilled, and not only is it his job, it's his job to such an extent that even if his patients don't care to mention that they're not sexually fulfilled, he must broach the subject and continue prying until he's satisfied that they are sexually fulfilled. That is a liberal idea, coming straight from modern liberalism's emphasis on sexual fulfillment as the apotheosis of human happiness.
This can be seen in your little barb "turns out, it's a lot of fun." Liberals are always making comments like that, trying to show that those who believe in traditional morality are naive and if we only had proper knowledge, we'd come around to the liberal point of view. If you were motivated only by the desire to catch risk factors for disease, there would be no reason to say something like that. You could even say "I agree with you, the norm for our society should be that sex is reserved for marriage, and there should be strong taboos and social stigma against other sexual practices to keep them to a minimum, BUT at the same time we know that these other sexual practices are out there, so in order to provide the best medical care we must inquire about them. I'm not advocating that frank and open discussions of homosexualilty or of sexual activity among unmarried teenagers become publically normal in our society, but we as doctors have a special dispensation to deal with these things in private, behind closed doors, one-on-one with our patients, just to make sure we have complete knowledge of their medical history." But you don't say that; instead, you sarcastically inform me that sex is "a lot of fun."
MattD said:
I don't really believe you're a first year student, and if you are, you're probably failing your clinical medicine course. You obviously have no comprehension of the purpose of the review of systems and past medical history. Your discussion with your patient should NOT be limited to the chief complaint. The point of the review of systems is to uncover problems the patient may not realize he has. Part of this is GU and sexual history. It is ALWAYS relevant to ask about this, regardless of the CC.
I am a first year student, and I'm not failing my liberalism seminar. I'm well aware of the purpose of the review of systems and prior medical history. We had it drilled into us from day 1 that it's really important to start with open-ended questions, and to always ask "what else is bothering you" so as not to miss anything. In fact, we were told that it was so important that we should NOT ask "is there anything else" but rather "what else," because the former gives the patient an easy opportunity to say no while the latter forces them to think about whether there's anything else. That's how important we were taught it was. Believe me, I've heard it before. I just don't
agree with it.
I'm getting really sick of liberals constantly implying that conservatives are naive or ignorant.
By the way, don't you see these liberal practices as their own form of paternalism? When we're taught these things, there's definitely an air of "the patient doesn't know what's best for him, and you have to do what's right even if their ignorant naive right-wing tendencies get in the way" about it. For example, pushing someone to talk about his sex life when he doesn't want to just so you can find out if he needs some Viagra, grilling a teenage girl about whether her father "makes her uncomfortable" when you have no reason to suspect anything, implying that a patient will violate his own beliefs (I was once asked by an NP whether I was sexually active, and upon hearing my answer of "no, and I wouldn't be unless I were married," she still made sure to ask "but you know you need to use condoms if you do, right?") Those aren't examples of paternalism?
Law2Doc said:
The law is not a stagnant thing. Your only concern as a physician has to be what will get you in hot water for malpractice TODAY, not 50 years ago. Adolescents have legal rights today that they didn't have 50 years ago. Physicians have legal obligations (eg. HIPAA) that they didn't have 50 years ago. Science has also changed in the last 50 years, making certain information now useful to know, that may have been thought irrelevant back then. (And NONE of this has any relation to liberalism of med schools BTW). Unless you own a time machine and plan to go back and practice in the 60s, your argument is weak.
Could the law change again? Sure, but the way law works it is much much harder to take away rights than to grant them, so it's probably folly to think this will be undone during the course of your career. And again, your med school would be doing you a disservice if they didn't teach you what you needed to do to satisfy the obligations you have today (not 50 years ago or 50 years hence). That isn't them being liberal, that is them giving you the tools you need to practice in today's landscape.
See my response to jbrice1639 above. It's not as though the school is teaching us "we don't agree with the law, but it's the law and you must follow it" or "we do not take a position on whether the law is good or bad, but it's the law and you must follow it." My school
deeply believes in this stuff. It comes across constantly in the way it's presented, and I shouldn't need to say anything more than that the person in charge of it is a social worker. And the people who believe in this stuff--the administration of my school and the vast majority of my classmates--are the people who vote in governmental elections, the people who join and influence professional societies, the people who lobby Congress, the people who are ultimately responsible for the fact that the law has changed, that our policies have changed, that the way society looks at these issues has changed. So you can't separate the law from people's beliefs about morality. That social worker who heads the liberalism seminar is going to go into the voting booth and pull the lever for John Edwards.
SocialistMD said:
There isn't a liberal conspiracy at your school; they are just trying to teach you how to be a good physician.
Why do liberals always accuse conservatives of thinking that there is a liberal conspiracy? I never said it was a conspiracy. That would imply I that I believe there's something secretive about it. There's no secret; it's just liberalism.
Also, since you mentioned the "good physician" issue, I will take the opportunity to ask all in this thread who have expressed similar sentiments: do you believe that in the past, all doctors were bad doctors because they did not routinely ask all patients whether they had homosexual sex? That until this became common practice, there was no such thing as a good doctor? Please note, that is a yes or no question.
To answer your question: yes, you are a Nazi. People like you are trying to turn Christianity into some sort of political right wing fascist agenda. You despise minorities, despise women, and advocate that the federal goverment actively persecute law abiding, tax paying citizens because of their religion. 
