Doctors Behave Badly; US Stillbirths Stay High; and Gun Safety

Physicians Talking: Why Doctors May Act Poorly

Physicians don’t usually behave badly at work or in public, according to a Medscape survey of doctors. But when they do, it’s because of personal arrogance or personal problems unrelated to work, according to more than half of the respondents to Medscape’s Physicians Behaving Badly: Stress and Hardship Trigger Misconduct survey of more than 1500 physicians. The survey asked about physician behavior at work, outside work, and on social media.

Most respondents felt that standards and expectations for physician behavior are at appropriate levels, but 38% said that standards for behavior outside work are too high.

Why doctors misbehave: Respondents cited job-related stress, which worsened during the pandemic and remains high because of the current healthcare labor shortage.

Patients also behave badly: Respondents pointed out that rude or aggressive behavior by patients has also increased.

Other Countries Have Reduced Stillbirth Rates. Why Not the US?

Stillbirth rates in the US have declined only slightly over the past 20 years compared with rates in other developed nations. About 21,000 US stillbirths were recorded in 2020, more deaths of children than from car accidents, drowning, fire, flu, guns, listeria, poison, and sudden infant death syndrome combined, according to data from the Centers for Disease Control and Prevention. The number has remained unchanged since a 2018 study in Obstetrics & Gynecology argued that almost one fourth of stillbirths may be preventable.

Why? Experts cite a lack of awareness about the issue, misinformation, low-quality data, and insufficient prevention strategies.

What sets us apart? The US is the only wealthy country that doesn’t have a national system to report and investigate stillbirths, although newly introduced legislation may help.

Most affected: Inequity in health care is likely the largest contributor to a high rate of stillbirths. Black women are more than twice as likely to experience stillbirth as are White women, and about half of stillbirths are Medicaid births.

‘Not in Our Lane’: Physicians Rebel at Idea They Should Discuss Gun Safety With Patients

Physicians would prefer not to discuss gun safety with patients, according to comments on a popular series of video blogs. A great majority of doctors expressed that sentiment in comments on four video blogs by Arthur L. Caplan, PhD, a New York University bioethicist and Medscape blogger, which advocated that physicians address the issue. A small minority of physician comments supported Caplan’s position.

Lacking knowledge: Most opponents of Caplan’s position argued that physicians lack the proper knowledge to discuss gun safety with patients. Others said that family members, certified firearms instructors, teachers, and others are best able to educate people about firearm safety. Respondents also said that discussing gun safety with patients involves mental health issues that many physicians may not be trained to address.

Controlling gun violence: The general public favors taking steps to control gun violence, and the margin has widened in 10 years, according to an NPR/PBS NewsHour/Marist poll. Some 59% of adults said that it’s more important to control gun violence than to protect gun rights compared with 35% who said the opposite.

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