Doctor didn't adhere to mask mandate.
March 10, 2022 7:52 AM Subscribe
My doctor removed his mask during my appointment, and I don't know whether I should continue to see him.
I recently had a first-time appointment with a physician who has a reputation for being quite skilled. There is a mask-mandate in my state. As he was speaking to me during my appointment, he removed his mask. Isn't wearing a mask a significant means of helping to prevent the spread of covid? I don't know whether I should continue to see him. What would you do?
I recently had a first-time appointment with a physician who has a reputation for being quite skilled. There is a mask-mandate in my state. As he was speaking to me during my appointment, he removed his mask. Isn't wearing a mask a significant means of helping to prevent the spread of covid? I don't know whether I should continue to see him. What would you do?
The benefit is only negligible if you know how much virus is in the air, which, no one really is capable of knowing because it's invisible. I would have just asked him why he took it off, he might have had a good reason (maybe the office has really good air filtering and no one in his office has ever gotten sick ) or maybe it was a bad reason - nobody here can speculate on what he was thinking. If you're not sure if you want to see him again I'd just call the office and ask about their masking policies and see if it makes sense.
posted by bleep at 8:04 AM on March 10, 2022
posted by bleep at 8:04 AM on March 10, 2022
For me, it would be a combination of things. The not adhering to the mandate - I'll take you at your word that it was applicable in this setting in your area, in which case "but HE knows he doesn't have covid!" is irrelevant. But equally, it would be pretty jarring for me that he didn't ask me first if I would be comfortable with him removing his ask, or offer any information he might have and you didn't about why it would be safe. That would tell me that he's not thinking about my agency or my preferences, and our doctor-patient relationship is not likely to involve a lot of him listening to my concerns or opinions.
So I'd probably go ahead and nope out of seeing this person again unless, as your post somewhat suggests, I were dealing with some sort of unusual issue for which I really needed his expertise. And in that case I'd go in prepared with a "please keep your mask on" next time
posted by Stacey at 8:09 AM on March 10, 2022 [32 favorites]
So I'd probably go ahead and nope out of seeing this person again unless, as your post somewhat suggests, I were dealing with some sort of unusual issue for which I really needed his expertise. And in that case I'd go in prepared with a "please keep your mask on" next time
posted by Stacey at 8:09 AM on March 10, 2022 [32 favorites]
Yeah like let's not all go around spreading misinformation that it's possible to know how much virus is present around us. You can spread it before you know you have it, that's why it's so good at spreading.
posted by bleep at 8:10 AM on March 10, 2022 [20 favorites]
posted by bleep at 8:10 AM on March 10, 2022 [20 favorites]
I don't think the risk of transmission is the significant issue here. The issue is his poor bedside manner. He did something that made you uncomfortable, seemingly without thinking about it and without explanation.
You will need to decide how to weigh this poor interaction against his reputation for expertise and skill. Sometimes you want the best treatment, even if the person giving it is an ass. Sometimes you want someone who makes you feel comfortable, even if their treatment decisions require some review.
Again, I don't see his action as a poor medical decision, but as a poor human interaction.
I would be inclined to cut medical professionals some slack at this point in time. They have been under tremendous stress the last few years. They have worn masks much more than the general population. They have worked under traumatic conditions. Ultimately, though, you need to see a doctor you are comfortable with.
posted by Winnie the Proust at 8:14 AM on March 10, 2022 [8 favorites]
You will need to decide how to weigh this poor interaction against his reputation for expertise and skill. Sometimes you want the best treatment, even if the person giving it is an ass. Sometimes you want someone who makes you feel comfortable, even if their treatment decisions require some review.
Again, I don't see his action as a poor medical decision, but as a poor human interaction.
I would be inclined to cut medical professionals some slack at this point in time. They have been under tremendous stress the last few years. They have worn masks much more than the general population. They have worked under traumatic conditions. Ultimately, though, you need to see a doctor you are comfortable with.
posted by Winnie the Proust at 8:14 AM on March 10, 2022 [8 favorites]
I wouldn't go back, but I'm immunocompromised, covid could kill me, and my doctor would know that. Seems like a lot of amateur epidemiologists on the internet think that masks are negligible or that somehow this doctor is omnipotent and is able to definitively know if he has covid even though false negatives and asymptomatic spread exist but whatever. We know for a scientific fact that masks work against spreading covid, and this is especially important in a medical setting. I would never go back.
posted by twelve cent archie at 8:23 AM on March 10, 2022 [18 favorites]
posted by twelve cent archie at 8:23 AM on March 10, 2022 [18 favorites]
This is a really chatfilter-y question that no one can answer but you. If this is a dealbreaker for you, it’s a dealbreaker, and that’s okay.
I will add that covid rates in many parts of the US are becoming negligible IMO, as well as in the view of many others. I am a teacher that just stopped wearing a mask in the classroom this week. We have not had a covid case in our school in a month.
posted by gnutron at 8:46 AM on March 10, 2022 [4 favorites]
I will add that covid rates in many parts of the US are becoming negligible IMO, as well as in the view of many others. I am a teacher that just stopped wearing a mask in the classroom this week. We have not had a covid case in our school in a month.
posted by gnutron at 8:46 AM on March 10, 2022 [4 favorites]
What is the policy of the hospital (and let's face it, where do you live, "red" or "blue" culture)? Do they permit this? Does "no mask mandate" mean "everyone can do whatever they want now?" Because if the hospital isn't nitpicking it, I'm not sure what leverage you have. I don't get why a doctor would take it off out of nowhere either unless someone couldn't be understood talking with it on.
I remember early on in the pandemic I saw the front desk people taking their masks off and complained about it to the nurse, and they have been enforcing at the place I go to since. Last I heard from my HMO over email, they said masks are still required there.
I think putting in a complaint and/or getting another doctor is totally reasonable to do, though. What Stacey said.
posted by jenfullmoon at 8:50 AM on March 10, 2022 [2 favorites]
I remember early on in the pandemic I saw the front desk people taking their masks off and complained about it to the nurse, and they have been enforcing at the place I go to since. Last I heard from my HMO over email, they said masks are still required there.
I think putting in a complaint and/or getting another doctor is totally reasonable to do, though. What Stacey said.
posted by jenfullmoon at 8:50 AM on March 10, 2022 [2 favorites]
Ultimately only you can answer this.
Personally, I would go back for another appointment and if he removed his mask I would politely ask him to put it back on. If he agrees then everything is fine; if he refuses, THAT’S when I would get uncomfortable and stop seeing him. But he has no way of knowing your preference if you don’t express it. People have very different levels of comfort around COVID.
That said, it would have been polite of him to ask first.
posted by mekily at 8:53 AM on March 10, 2022 [4 favorites]
Personally, I would go back for another appointment and if he removed his mask I would politely ask him to put it back on. If he agrees then everything is fine; if he refuses, THAT’S when I would get uncomfortable and stop seeing him. But he has no way of knowing your preference if you don’t express it. People have very different levels of comfort around COVID.
That said, it would have been polite of him to ask first.
posted by mekily at 8:53 AM on March 10, 2022 [4 favorites]
A colleague in grad school did a long case study of (pre-COVID) mask-wearing in dental hygiene work and found that despite many many procedures in place and much education, practitioners still removed their masks when they wanted to make a connection, completely unconsciously. Since COVID, I've witnessed the same phenomenon over and over again and I even did it myself once, on an airplane, when a flight attendant startled me awake to ask me a question. As others have said better than I, it's up to you.
As someone who hase immune comproised family members, I'm comfortable wearing a mask, telling other people to mask, and even walking out of situations where others are unmasked indoors, and I do it repeatedly. If you're not comfortable doing any of that, yeah, I'd change doctors. At least now. Though mask mandates have started to wither away, that doesn't mean COVID is gone yet and I'm waiting for case rates to go down before I take risks.
posted by Peach at 8:56 AM on March 10, 2022 [7 favorites]
As someone who hase immune comproised family members, I'm comfortable wearing a mask, telling other people to mask, and even walking out of situations where others are unmasked indoors, and I do it repeatedly. If you're not comfortable doing any of that, yeah, I'd change doctors. At least now. Though mask mandates have started to wither away, that doesn't mean COVID is gone yet and I'm waiting for case rates to go down before I take risks.
posted by Peach at 8:56 AM on March 10, 2022 [7 favorites]
Agree this is chat filter because you ask, "what would you do?" I personally wouldn't care, but I'm not immunocompromised or living with people who are, and I'm a bit more skeptical about the integrity of the CDC and its conclusions than many people. But you have the right to prefer a doctor who is conservative about masking! Going to the doctor is painful enough without an added layer of discomfort.
posted by redlines at 9:18 AM on March 10, 2022 [4 favorites]
posted by redlines at 9:18 AM on March 10, 2022 [4 favorites]
Like some other commenters, what would bother me would be the absence of communication about it rather than the mask removal per se. Whether I kept seeing the doctor or not would depend on the other options available and what I was there for. I probably wouldn't want this person as my PCP if there were other decent PCPs around, but if it was a specialist with really niche knowledge that I'd be dealing with in a more limited context to resolve one particular issue, I might. Sort of like how I'd put up with poor bedside manner from a surgeon more than for someone I would be seeing for a chronic condition that required regular visits and good communication to manage.
posted by needs more cowbell at 9:24 AM on March 10, 2022 [3 favorites]
posted by needs more cowbell at 9:24 AM on March 10, 2022 [3 favorites]
When the masks are those disposable surgical masks, there's negligible benefit.
Surgical masks aren't as effective as N95s, no, but to say they have "negligible benefit" is baldly not true. Surgical masks are leaky around the edges, but they do filter a lot of the wearer's exhalations and direct what aerosols do escape away from the people the wearer is facing. Especially in an environment with good ventilation or filtration (like some medical spaces), that's pretty good.
In order to spread covid you have to have covid and it may be that he is certain he does not.
One cannot be certain of this, unless one has just exited a true, extended quarantine. If he tested negative yesterday, he could be infectious today. If he tested in the morning, he could become infectious by the afternoon. The more recently one has tested the less likely it is they are positive, but certainty is not actually possible.
In addition, it is believed that even with an infected, unvaccinated person, it takes prolonged exposure (upwards of 15 minutes) to create enough viral load for an infection.
This is outdated information and not accurate for the currently most-circulating variants, which are much more easily and quickly transmissible.
To actually answer your question, OP: I would not continue to see a doctor that removed their mask during an appointment with me, not so much because it is against "the rules" but because I expect my doctor to make my health their priority during my visit. Doctors can be notoriously flagrant with their own health (which, that's their choice), but not being flagrant with mine is, uh, really their only job, as far as I'm concerned.
posted by CtrlAltDelete at 9:37 AM on March 10, 2022 [34 favorites]
Surgical masks aren't as effective as N95s, no, but to say they have "negligible benefit" is baldly not true. Surgical masks are leaky around the edges, but they do filter a lot of the wearer's exhalations and direct what aerosols do escape away from the people the wearer is facing. Especially in an environment with good ventilation or filtration (like some medical spaces), that's pretty good.
In order to spread covid you have to have covid and it may be that he is certain he does not.
One cannot be certain of this, unless one has just exited a true, extended quarantine. If he tested negative yesterday, he could be infectious today. If he tested in the morning, he could become infectious by the afternoon. The more recently one has tested the less likely it is they are positive, but certainty is not actually possible.
In addition, it is believed that even with an infected, unvaccinated person, it takes prolonged exposure (upwards of 15 minutes) to create enough viral load for an infection.
This is outdated information and not accurate for the currently most-circulating variants, which are much more easily and quickly transmissible.
To actually answer your question, OP: I would not continue to see a doctor that removed their mask during an appointment with me, not so much because it is against "the rules" but because I expect my doctor to make my health their priority during my visit. Doctors can be notoriously flagrant with their own health (which, that's their choice), but not being flagrant with mine is, uh, really their only job, as far as I'm concerned.
posted by CtrlAltDelete at 9:37 AM on March 10, 2022 [34 favorites]
I've had several encounters lately with nurses and other medical professionals who've said things to the effect of "You can take your mask off if you like. The ones they make you wear here do nothing."
It's always surprising how many professionals (in any profession) can be ignorant of (some) things you'd expect them to know.
Even cloth masks do more than nothing, and surgical masks do more than that, and kf-94 and kn-95 and ffp2 do much more, and n95 or higher do the most. I've heard of a hospital that actually forced its employees to wear surgical masks rather than anything better, but unless that's the case at your doctor's office, there was no reason for him not to wear a mask that does way more than "nothing".
I expect my doctor to make my health their priority during my visit. Doctors can be notoriously flagrant with their own health (which, that's their choice), but not being flagrant with mine is, uh, really their only job, as far as I'm concerned.
To me that's the main point. I wouldn't even like it if he asked if I was okay with him removing his mask, because it would put pressure on me to say "yes" (I once had a doctor ask if they could smoke during the appointment (!) who was visibly not pleased when I said no) and because, unless the room had great ventilation, my decision would potentially affect the next few patients too.
posted by trig at 10:24 AM on March 10, 2022 [2 favorites]
It's always surprising how many professionals (in any profession) can be ignorant of (some) things you'd expect them to know.
Even cloth masks do more than nothing, and surgical masks do more than that, and kf-94 and kn-95 and ffp2 do much more, and n95 or higher do the most. I've heard of a hospital that actually forced its employees to wear surgical masks rather than anything better, but unless that's the case at your doctor's office, there was no reason for him not to wear a mask that does way more than "nothing".
I expect my doctor to make my health their priority during my visit. Doctors can be notoriously flagrant with their own health (which, that's their choice), but not being flagrant with mine is, uh, really their only job, as far as I'm concerned.
To me that's the main point. I wouldn't even like it if he asked if I was okay with him removing his mask, because it would put pressure on me to say "yes" (I once had a doctor ask if they could smoke during the appointment (!) who was visibly not pleased when I said no) and because, unless the room had great ventilation, my decision would potentially affect the next few patients too.
posted by trig at 10:24 AM on March 10, 2022 [2 favorites]
I can only imagine what other rules this doctor is willing to bend and what other boundaries he's willing to overstep. I would not only not see him anymore, I would file a complaint with his employer and the state medical licensing board. With a state-level mask mandate in place this is really not a grey area.
I'm a physician and I practice in a state where there is a mask mandate in healthcare facilities. Since the pandemic began I have never removed my mask while seeing a patient; the power imbalance is vast and even doctors can't "know for sure" that they aren't transmitting COVID. My job is to promote the health of my patients. Potentially exposing them to a deadly respiratory virus should never be part of that.
posted by telegraph at 10:57 AM on March 10, 2022 [16 favorites]
I'm a physician and I practice in a state where there is a mask mandate in healthcare facilities. Since the pandemic began I have never removed my mask while seeing a patient; the power imbalance is vast and even doctors can't "know for sure" that they aren't transmitting COVID. My job is to promote the health of my patients. Potentially exposing them to a deadly respiratory virus should never be part of that.
posted by telegraph at 10:57 AM on March 10, 2022 [16 favorites]
If I had a long-standing relationship with a doctor and trust had been established and they informed me that they had *just* tested negative and asked if they could remove their mask and the room was well ventilated, I'd likely be OK with it. But, a brand new doctor who didn't even ask? Presumably, they're taking off their mask all over the place with various patients if they're doing it with me and that would be an absolute no for me. I would not see them again. If they have such reckless practices and don't value consent, I just wouldn't be able to trust them to make good decisions with my care.
If they're a part of a hospital or clinic group, I'd also consider making a formal complaint about it.
posted by quince at 11:56 AM on March 10, 2022 [3 favorites]
If they're a part of a hospital or clinic group, I'd also consider making a formal complaint about it.
posted by quince at 11:56 AM on March 10, 2022 [3 favorites]
I am hopeful that I would've been able, in the moment, to say something like 'I'd feel more comfortable if you kept your mask on.'
If I wasn't able to do that, I would probably mention it at the next appointment. Or, depending on how much time had passed and how they behaved at our next appointment, maybe I wouldn't.
(I seem to be an outlier here, but, well, you asked what we'd do.)
posted by box at 1:59 PM on March 10, 2022 [2 favorites]
If I wasn't able to do that, I would probably mention it at the next appointment. Or, depending on how much time had passed and how they behaved at our next appointment, maybe I wouldn't.
(I seem to be an outlier here, but, well, you asked what we'd do.)
posted by box at 1:59 PM on March 10, 2022 [2 favorites]
Do you have a remarkably impassive poker face? For most people, I would think the surprise and discomfort would show in body language, which tells me he chose to ignore your feelings.
And whether you showed or hid a reaction, he made a choice that's clearly outside of the norm where you live (or he wouldn't have had a mask on in the first place) and he didn't care enough about your feelings to bother preemptively explain his choice. That's disrespectful.
Personally I do my best to avoid consent-based relationships with anyone who, y'know, demonstrates that they don't care to solicit my consent - which can be as simple as GLANCING at me to read my reaction. The bar is pretty low.
Agreed that you should complain. It's a political act to complain about things like this. Think of all the people who have less privilege than you - perhaps they are less web-literate, less-resourced, less culturally-comfortable, less fluent in English, have trauma histories, can't afford to switch clinics, more immunocompromised, etc etc etc, than you. Leveraging your ability to complain protects them too.
posted by nouvelle-personne at 4:20 PM on March 10, 2022 [5 favorites]
And whether you showed or hid a reaction, he made a choice that's clearly outside of the norm where you live (or he wouldn't have had a mask on in the first place) and he didn't care enough about your feelings to bother preemptively explain his choice. That's disrespectful.
Personally I do my best to avoid consent-based relationships with anyone who, y'know, demonstrates that they don't care to solicit my consent - which can be as simple as GLANCING at me to read my reaction. The bar is pretty low.
Agreed that you should complain. It's a political act to complain about things like this. Think of all the people who have less privilege than you - perhaps they are less web-literate, less-resourced, less culturally-comfortable, less fluent in English, have trauma histories, can't afford to switch clinics, more immunocompromised, etc etc etc, than you. Leveraging your ability to complain protects them too.
posted by nouvelle-personne at 4:20 PM on March 10, 2022 [5 favorites]
It's hard to know without knowing the * this is the only doctor that can help me with my problem * calculation.
I would think seriously about not going back to this doctor. If my medical problem was serious and I felt pretty sure I was risking my health by not going to this particular doctor, I would probably go back to him, but it would certainly make me doubt his integrity.
If this is to be a one off procedure to do something significant and necessary, for example, I might just decide it's worth the risk (not so much of Covid exposure, but of asshole doctor exposure) and go back to him.
If this is a long term thing where I'd have to rely on his guidance over many visits, I'd be very uneasy.
I live with an essential worker constantly exposed to Covid so for me it's not so much the actual Covid risk (he's more at risk from me * hollow laugh*) but that it's a example of unprofessional conduct that might point to him not being the right doctor for me .
posted by Zumbador at 7:37 PM on March 10, 2022 [1 favorite]
I would think seriously about not going back to this doctor. If my medical problem was serious and I felt pretty sure I was risking my health by not going to this particular doctor, I would probably go back to him, but it would certainly make me doubt his integrity.
If this is to be a one off procedure to do something significant and necessary, for example, I might just decide it's worth the risk (not so much of Covid exposure, but of asshole doctor exposure) and go back to him.
If this is a long term thing where I'd have to rely on his guidance over many visits, I'd be very uneasy.
I live with an essential worker constantly exposed to Covid so for me it's not so much the actual Covid risk (he's more at risk from me * hollow laugh*) but that it's a example of unprofessional conduct that might point to him not being the right doctor for me .
posted by Zumbador at 7:37 PM on March 10, 2022 [1 favorite]
Since you didn’t say anything to him at the time I think it’s a fair guess that you’ll have trouble calling him on it in the future. For that reason I would move on to a different practitioner.
posted by Tell Me No Lies at 10:44 PM on March 10, 2022 [1 favorite]
posted by Tell Me No Lies at 10:44 PM on March 10, 2022 [1 favorite]
This thread is closed to new comments.
posted by Umami Dearest at 8:03 AM on March 10, 2022 [21 favorites]