You don't need no stinkin' surveyor . . .

[hellsangle]

Oh the things you find . . . when after-the-fact . . . they want a survey!

Planning agencies are accepting site plans SHOWING BOUNDAIRIES(!) without benefit of our profession.

Is the attached a planners "out"?!

OH! And I suspect the property is worth about $ 10 million.

Have a good weekend all

Crazy Phil - Sonoma

[LS_8750]

Life in the Bulls Eye...

I feel like I've seen those same notes before......

[Ric7308]

Phil, are there dimensions shown between existing improvements and the property lines? If so, file a complaint.

[hellsangle]

Smart architect . . . goes right to the line . . . but doesn't cross it.

Boundaries are dimensioned but no ties to his buildings. ( And no on-the-ground monumentation. How the hell do they know they are building it on the right parcel?!)

This architect does absolutely drop-dead gorgeous work! Works of art!

So . . . I guess the guy is innocent huh, Ric?

Crazy Phil - Sonoma

[Ric7308]

Phil, I would submit the complaint. Someone had to orient that boundary to the existing topography and improvements. Its is worth looking at.

[Jim Frame]

TOPOGRAPHIC ELEVATIONS BASED ON NAD83 VERTICAL DATUM

So...ellipsoid heights?

[Timothy J. Reilly]

Those plan notes are admissions of guilt every. single. time.

The problem is that, with few exceptions, the building/development departments for local agencies have little interest in genuinely protecting the public, namely the adjoining property owners (to a building permit applicant) who might be adversely affected by the issuance of a permit. Instead, the building/planning officials are usually under pressure by city councils/boards of supervisors to expedite development with as few delays as possible. Issue permits first…ask questions later!! Rather than consider the rights of an adjoiner (rights that might be trampled upon), local agencies are more interested in appeasing builders. The ONLY thing that’s important is avoiding complaints from a builder who has their county supervisor on speed dial. What is it that runs downhill?

This is all old news. The CA Building Code already requires construction documents submitted for permits to be based upon an accurate boundary line survey. It also gives the building official authority to modify or waive that requirement when warranted. To me, that implies use of discretion in special cases. And there are cases where the Building Code requirements should be waived or modified. However, in my jurisdiction, the local agency broadly waives the accurate boundary line survey requirement in EVERY case believing it is a burden on the applicant. In fact, the planners actually advise applicants how to circumvent the Code. Again, there is little to no consideration for a person who might be harmed by the agency blindly accepting a defective site plan as reliable. Examples of structures constructed across property lines are manifold.

I’m all for filing complaints against the architect, engineer, or the guy with a cad program working out of his garage for practicing land surveying without a license. I’ve filed several complaints. But those hacks are only keeping up with the other hacks when there is no real oversight. If we are dependent upon lawsuits filed by persons harmed by a local agency’s wrongful issuance of a permit, there will never be meaningful change. To my knowledge, there are no repercussions in the Building Code for agencies who knowingly and willingly facilitate violations. That is the real problem.

We can obey to the speed limit all day long. If it’s common knowledge that there is no enforcement, where is the disincentive from going 80mph in a 35 zone? There isn’t any.

When local agencies start enforcing the site plan requirements of the building code, we’ll probably see a dramatic reduction in submittal of garbage plans, with or without notes on plans admitting guilt. Unfortunately, I don't see those agencies making changes willingly.

I hope there are exceptional agencies. There has to be. However, I haven’t discovered any yet. If anyone knows of one, please share your applause when given the opportunity. It much easier to offer praise than criticism.

8710.1…the protection of the public shall be paramount.

[LS_8750]

Looks like this is going the the direction of .........

viewtopic.php?t=8319

[hellsangle]

To my knowledge, there are no repercussions in the Building Code for agencies who knowingly and willingly facilitate violations. That is the real problem.

One of the goals of the Marin Chapter is meet with planning directors/staff and educate them employing BPELSG's brochure "Engineering & Surveying Guide for City & County Officials".

Overboard Example: One Marin town had a engineer that knew the project surveyor had to file a Record of Survey map. He held up the permit. The surveyor, on behalf of his client, complained to BPELSG. BPELSG set the town engineer straight - they cannot require that. Filing was the duty of the surveyor and, rightfully, should not hold up a project. (This was at a time when it might take six months to a year to get a Record of Survey checked 'n recorded.)

Timothy got it right . . . until the planners require a signed/stamped site plan by a licensed professional - we'll just continue chasing our tails.

Have a good week . . .

Crazy Phil - Sonoma

[Mike Mueller]

Issue permits first…ask questions later!!

I thing many of those folks understand there there shouldn't be so many permits in the first place and since the moral high ground is not on their side they generally let many of the "little things" pass. In my experience when someone at an agency is enforcing the letter of the law they are either a persnickety petty tyrant or a zealot that is using the laws as a cudgel to achieve the greater aim of their beliefs. IE many of the environmental folks are quite zealous in their "protection" of the environment even when it results in silly, nonsensical outcomes, since the real goal of many of the folks applying the environmental rules is to stop all development. NIMBY/BANANA stuff.

Big picture, this is why we as surveyors need to embrace preparing cheaper siteplans. This allows us to compete in satisfying the need of our community, and gives us the chance to explain to a client when they REALLY need to spend the money on a proper boundary survey to underlay on their siteplan, rather than the GIS non field survey work product that is really just a box checking exercise.

Mikey Mueller, PLS 9076
Sonoma County

[Jim Frame]

this is why we as surveyors need to embrace preparing cheaper siteplans. This allows us to compete in satisfying the need of our community, and gives us the chance to explain to a client when they REALLY need to spend the money on a proper boundary survey to underlay on their siteplan

So, prepare a site plan that negligently fails to meet the standard of care for a boundary survey, charge less than a proper boundary survey costs, and hope you don't get caught? Hard pass for me.

[LS_8750]

Same.
"... embrace preparing cheaper siteplans....."
Life in the Bullz Eye...........

[DWoolley]

this is why we as surveyors need to embrace preparing cheaper siteplans. This allows us to compete in satisfying the need of our community, and gives us the chance to explain to a client when they REALLY need to spend the money on a proper boundary survey to underlay on their siteplan

So, prepare a site plan that negligently fails to meet the standard of care for a boundary survey, charge less than a proper boundary survey costs, and hope you don't get caught? Hard pass for me.

+1 Jim.

Actually, I think he was kidding. The problem with the written word is the absence of the voice inflection sometimes loses intended sarcasm or tongue in cheek.

No standards site plans do not require land surveyors, but are worthless in most jurisdictions. The providers will get away with it, who would sue someone or file a complaint for a $200 nonsense site plan? $200 is the "platinum" plan, top the line. To be clear, that is not a tongue in cheek, no voice inflection joke.

I have been working on videos to help the fire folks navigate rebuilding. The first video is done. I have been percolating on it. I address site plans, hiring California professionals (hard pass on out of state service providers), setbacks (consider not maxing them out), etc. In a live setting I googled "site plans" to see what they'd see and walked through what the public will encounter. I explained the downstream issues they will encounter after sitting in the building department only to realize they have to start over because of a nonsense site plans.

My latest claim to fame? I am part of the team that got building permit #1 in the fire footprint of the Palisades fire. The fire was January 7th and the first permit was issued Friday, May 2nd. Poured footings on Saturday. It was a SEAL team operation - experienced operators with years of hyper challenging project experience working together in the neighborhood - helping close friends that lost their home. No plans on returning. One and done.

He was kidding, right?

DWoolley

[hellsangle]

. . . this is why we as surveyors need to embrace preparing cheaper siteplans.

Then are you condoning the business practices of CROWNHOLM AND CROWN CAPITAL ADVENTURES, INC., Mikey?

Please say no . . .

Crazy Phil - Sonoma

[Mike Mueller]

this is why we as surveyors need to embrace preparing cheaper siteplans. This allows us to compete in satisfying the need of our community, and gives us the chance to explain to a client when they REALLY need to spend the money on a proper boundary survey to underlay on their siteplan

So, prepare a site plan that negligently fails to meet the standard of care for a boundary survey, charge less than a proper boundary survey costs, and hope you don't get caught? Hard pass for me.

I am not advocating for negligent boundary surveys. I AM advocating for surveyors to prepare "minimum standard siteplans" sufficient for pulling basic permits that are within the tolerances of the job. Consider a venn diagram, boundary surveys are just one circle on that diagram, along with Topo maps, El Certs, Control networks, Tentative Maps, LLAs, Easements etc. Is every project I ever do within that boundary circle? Is every work product that shows a boundary within that circle? I would say no.

Consider a chain of title where I highlight an AP map to show the location of a set of deeds going back 80 years. If every job is in the boundary survey circle described above, then I should be doing a "proper boundary survey" of each of those deeds in the chain of title so that I can ensure the planner at the County reviewing the chain of title for a Cert of Compliance understands where the last hundreth belongs?

If a client owns a section(640 acres) that has no recorded map, so it triggers 8762(b)(4) wants to put a barn in the middle, why should they spend 40K to resolve the boundary correctly so I can make a siteplan to demonstrate that a 30 foot setback is being observed when the nearest boundary is AT LEAST 1000' away? How am I "protecting the public" by adding 40K to that persons cost to improve their land? Who is harmed? I am confident that I am able to read a topo quad map, or review a google earth image and understand the difference between 30; and 1000' and provide a paperwork check for the permit process. Maybe some of you aren't that confident?

Would it be nice to have a section surveyed and monumented? Yes. Should that homeowner be forced to pay those costs to build a barn in the middle of their land? I do not believe so. Do any of you think its a "good" thing, or "better for the public" for that single homeowner to pay 40K so they can prepare a siteplan that adheres to Mr. Frame's thinking?

Should a "mimimum standard siteplan" that does not reflect a property boundary survey be prepared for a new house on a 50' wide lot? Clearly no. Are they frequently used by architects, designers, civils, landscape architects, homeowners etc? The answer is clearly yes. More siteplans are made by non surveyors than surveyors. The biggest reason is the cost.

Getting a chance to explain to that homeowner why a proper boundary survey is a relatively cheap cost in some cases compared to the pain of getting it wrong is a benefit to the public. I don't get that chance if everyone thinks that surveyors always cost thousands of dollars for every siteplan.

The entire reason that surveyors should be in the business of preparing a "minimum standard siteplan" is so that we are part of the conversation with clients and can convince them when a boundary survey is actually needed. When a surveyor won't prepare the cheap version and explains why, then its a human being making a clear eyed choice. Then its the same as all those folks building ADUs without permits, or downloading pirated software, or Air BnBing their home with a permit, or cheating on their taxes or any of the other parts of our society where folks are breaking the law for reasons they find valid.

The difference between me and Crownholm is that I will not prepare a minimum siteplan for anyone who walks in the door. I use my judgement to evaluate if that tool will accomplish the job, and explain why when it doesn't. Understanding there is nuance and shades of grey are the entire reason we are professionals. Believing that a surveyor has to always provide a "proper boundary survey" is essentially the same as Crownholm, just on the other side of the line.

For those who think its wrong or illegal to prepare a GIS only siteplan, answer me this: When was 8762 changed to include the caveat "field work"? Hint, it was during the licensed lifetime of most of the posters on this forum. What was the debate and reason for that change to 8762?

Mikey Mueller, PLS 9076
Sonoma County

[hellsangle]

If a client owns a section(640 acres) that has no recorded map, so it triggers 8762(b)(4) wants to put a barn in the middle, why should they spend 40K to resolve the boundary correctly

Mikey . . . you might want to read the Headwaters Case . . . a substantial(!) difference-of-opinion. So much so, that your barn might be on the wrong property. (Taking short cuts to save the "poor"(?!) owner of 640 acres?)

Providing "cheap" . . . and all you will have are cheap clients . . . (and my experience with cheap clients: they don't pay their bills promptly.)

A CLSA motto used(?) to be in part " . . . to promote and maintain the highest possible standards of professional ethics and practices . . . " Personally, I don't see how "cheap" coincides with high standards . . . Shouldn't we be doing our "best"? Quantity & cheap over quality may be a business-model for the GIS-mills - but shouldn't be our profession. Would you "shop" for a dentist, lawyer, structural engineer, etc. that is cheap? Would you feel comfortable boarding a plane where their maintenance was performed on the cheap?

Sorry to seem harsh . . . but cheap is a dirty word in a profession such as ours.

Crazy Phil

[Mike Mueller]

Mikey . . . you might want to read the Headwaters Case . . . a substantial(!) difference-of-opinion. So much so, that your barn might be on the wrong property. (Taking short cuts to save the "poor"(?!) owner of 640 acres?)

The wealth of my client is immaterial to the situation I am discussing. They could be worth millions, billions, or tens, and I would still not want to stiff someone out of $40K when I can accomplish the same thing for $500. In regards to mixing up where something is, well that is part of being a competent professional isn't it?

Would you "shop" for a dentist, lawyer, structural engineer, etc. that is cheap? Would you feel comfortable boarding a plane where their maintenance was performed on the cheap?

Yes. I have shopped for cheaper attorneys. I have shopped for cheaper house designers. I have shopped for cheaper structural engineers. Effectively we are all shopping for cheaper airplane maintenance when we pick the cheapest flight cost. I had to go cheap on a dentist a few times as well when I was young. Capitalism is based on the market choosing the cheapest thing that satisfies the need and letting the inefficient (IE spending $40K on a proper boundary survey for the barn setback permit described above) practices go the way of the dodo.

Sorry to seem harsh . . . but cheap is a dirty word in a profession such as ours.

Perhaps think of it as practical then? Or affordable? Or efficient? I know its a rose by another name, but that is exactly why I wish we could have a phrase to describe a cheap, paperwork checkbox site plan that clearly states it is not the highest quality and should only be used in a the narrow uses outlined on the map. One size fits all is not the realm of a professional. If your flow chart has no branches, its not a flow chart, its a path. If your venn diagram only has 1 circle, its not a venn diagram.

The nature of the word cheap is that its generally used pejoratively. However I think unless it is describing the same thing in the same context it loses some of its value (hehehe).
Is a $1 candy bar cheaper than a $1,000,000 house? Yes. But since they are different things that comparison is not very useful.
Is a $1 candy bar cheaper than the same candy bar sold at an amusement park for $5? Yes, but I have still bought the $5 version for my kiddo.
Is a $1 candy bar sold right next to the same candy bar being sold for $2 by another vendor cheap? Or is it a good deal?
Is a $5 disposable rain poncho cheaper than a $200 REI rain jacket? Yes, but I have still used both happily.

Have you ever used a disposable paper plate and when you tried to wash it in your sink, you got upset that it wasn't getting very clean?
Have you ever used a GIS site plan and then got upset when your new house was built over the line?
Wouldn't it be great if we could get the public to understand that both disposable paper plates AND fine china are useful in different circumstances?


Mikey Mueller, PLS 9076
Sonoma County

[Timothy J. Reilly]

If a client owns a section(640 acres) that has no recorded map, so it triggers 8762(b)(4) wants to put a barn in the middle, why should they spend 40K to resolve the boundary correctly so I can make a siteplan to demonstrate that a 30 foot setback is being observed when the nearest boundary is AT LEAST 1000' away?

This is a prime example of when the building official should waive or modify the site plan requirements of the Building Code. Now codified at section 107.2.6. My guess is that if the building official was consulted proactively, he or she would agree.

As part of the code of professional conduct for land surveyors, we are obligated to comply with the laws, codes, ordinances, rules, and regulations applicable to our projects. Board Rule 476. That would include the accurate boundary line survey requirement of the Building Code, unless waived. If successfully waived, you just saved the client $40,000.00, you look good, you probably picked up the immediate work, and will probably be the first candidate when they do need a boundary survey in the future.

If we can find agreement with building official when the Building Code requirement seems absurd, we might later find their consideration when it should be held rigidly. It’s possible that asking the official for a site plan modification/waiver in writing (and I would request it in writing) it could lead to greater appreciation of land surveyors and the protection of the public that we provide. The glass is half full, dammit.

[DWoolley]

.
...
As part of the code of professional conduct for land surveyors, we are obligated to comply with the laws, codes, ordinances, rules, and regulations applicable to our projects. Board Rule 476. That would include the accurate boundary line survey requirement of the Building Code, unless waived.
...

Truth. +1. Precisely my thought. Apparently, he was not kidding.

Upton Sinclair was right when he said "it is difficult to get a man to understand something when his salary depends on his not understanding it."

It's in our blood - our Benson blood. Wallet full, still stealing candy. Not need—just muscle memory. Winona Ryder adjacent.

DWoolley

[LS_8750]

Life in the Bullz Eye....

A game for you:
Fast-Quality-Cheap.............. You can only pick two at the exclusion of the third.............

[Mike Mueller]

This is a prime example of when the building official should waive or modify the site plan requirements of the Building Code. Now codified at section 107.2.6. My guess is that if the building official was consulted proactively, he or she would agree.

I agree.

However it is my experience that requesting waivers generally requires a complete submittal package that allows the reviewer to understand the situation sufficiently well to feel safe granting the waiver. Trying to get something in writing before the application is submitted will likely take hours of explanation (which would make getting the letter more expensive than the siteplan) and days to weeks of delay as the official reviews it and asks for more information so they have sufficient CYA information in the file.

If someone is experienced with the culture of an area they know how to submit documents in ways that conform to the expectation of the reviewers. Many locales have requirements that are not enforced. Many have "rules" that are really just the personal belief of a particular planner. I am reminded of of how some CS reviews think they can tell a surveyor how to resolve their boundary... ( I will save time and point out that this is not me advocating for bad boundary resolutions because I live in an area that was the center of economic activity during the gilded age, it is pointing out that some bureaucrats interpret laws in interesting ways)

The result of the above is that I submit a narrowly focused siteplan and if that particular reviewer feels like the situation warrants more, they generally ask for it. I am anticipating the outcome and response of the reviewing agency and provide a document that complies with the check boxes and doesn't hurt the public, either through causing conflict with buildings over lines, or by charging a client an extra $39,500 for something they didn't want or need.

Its worth noting that part of any such service is the discussion about how it may not be accepted by the agency and forewarn the client that the full $40,000 might be needed.


Mikey Mueller, PLS 9076
Sonoma County

[No_Target]

At the risk of being derided ruthlessly... I agree (to an extent) with Mikey. I worry that surveyors are becoming a tool for NIMBYs rather than a tool for progress. The idea that surveys are a luxury item does not sit well with me. I understand we need to charge what we are worth, but we also need to give people the ability to build correctly and within reason without spending 50% (or more) of their project's budget on a survey.

While property boundary determination is necessary on smaller and more urban parcels, in the rural places I operate (for now), I have encountered many situations where I do not understand why the most expensive option (Full boundary determinations) is necessary for my client. Take an unrecorded 40 acre parcel building a garage in the very middle of the property. I look it over and make non-field boundary determinations and flag anything that might require a record of survey, but do I need to survey this entire parcel to the same accuracy that I would a 50x100 foot urban lot? The county recorder checks each map the same way, and the person at the planning desk won't waive a thing. They follow a checklist regardless of common sense.

I am licensed to protect the public and not just millionaires who can afford to spend money on me resolving a boundary line they are nowhere near.

To pre-address the Benson arguments... I started surveying in the Bay Area and fight hard to do a good job. There are certainly some bad practitioners there. However, if you think Benson was the only syndicate of land graft I think you might want to start looking into how LA got its water. Now in my hometown, much more rural, I find much of the same practices occurred up here. The whole state is covered in your bullseyes.

Kyle Brook
PLS 9686
PPS (Professional Pot-Stirrer)

[hellsangle]

. . . hate to beat a dead horse . . .

but sounds like the architect's note applies to the barn/garage scenario in the middle of 40 acres . . . you don't need no stinkin' surveyor

Crazy Phil again

[DWoolley]

While local agency culture and reviewer discretion can influence how plans are processed, licensed professionals are obligated to comply with the rule of law, not the rule of convenience. Local culture is largely the problem in many jurisdictions. Regulations exist to protect the public, ensure fairness, and establish consistent expectations—not to be selectively followed based on what might be overlooked. Following the law also creates professional parity and cost uniformity that fosters legal compliance.

Professionals are not merely service providers—they are fiduciaries of the public trust. The standard must be full compliance with the law, not calculated risk-taking based on informal local practices. It's true that not everyone can afford a land survey—just as I can no longer afford to buy a home in California. But that fact alone doesn't entitle me to one, nor does it prevent someone from giving me a house or selling it to me below market value out of generosity. Similarly, a land surveyor is not obligated to take on every project or to charge for their work if they choose not to. However, once a survey is performed, the legal and ethical obligation to follow all applicable laws, codes, and standards remains unchanged.

Importantly, the waiver process exists precisely to allow for legally sanctioned exceptions. It is the only appropriate method to deviate from a requirement. Circumventing the process by submitting partial or misleading documentation is less than ideal professionally. Again, review Title 16, California Code of Regulations § 476(c) (Rules of Professional Conduct for Land Surveyors) as it pertains to following laws, codes, rules etc.

Avoiding clear requirements by presenting documents that strategically downplay or omit relevant information runs contrary to this ethical standard and erodes trust in the profession. Land surveyors should not count the technical ignorance of a planner, permit processor, civil engineer or architect to guide their judgment.

Widespread noncompliance also triggers regulatory backlash. When practitioners cut corners and damage the public, agencies respond with tighter procedures, reduced flexibility, and increased scrutiny for everyone—including those who follow the rules. In the long run, this undermines the market, efficiency and professionalism across the board. I have had several land surveyors, of the SoCal variety, state "I will follow the law when everyone else follows the law". Migrated Benson blood, muscle memory.

DWoolley

[Kyle, based on the business challenges you've described in the forum, is the core issue a technical or legal inability to compete— is it that others are disregarding the rules you’re choosing to follow?

Put another way: if everyone in your area were held to the same legal standards, wouldn’t you be thriving? It seems the real problem isn’t the law itself, but rather the willingness of the local professionals to ignore it—something you’re not willing to do, and rightly so.]

[Mike Mueller]

While local agency culture and reviewer discretion can influence how plans are processed, licensed professionals are obligated to comply with the rule of law, not the rule of convenience.

Please show me the law that covers a siteplan for a lot line adjustment submittal in Sonoma County. Building code references are for construction documents btw. I am quite familiar with the County's posted requirements and comply with them.

Local culture is largely the problem in many jurisdictions.

Culture is often described as the rules we follow that we don't consider rules. So what is your culture Dave? What are the "rules" that you think are right and proper that are just a product of where you live? Is it thousands of dollars for a RoS review? Is it that every RoS requires a boundary resolution note? Is it that a Basis of Bearings has to be between two found monuments shown on a recorded map? Is that every house should require a parking space per bedroom?

Regulations exist to protect the public, ensure fairness, and establish consistent expectations—not to be selectively followed based on what might be overlooked.

I would agree in principle, not in fact. I would also point out that regulations are directly related to population density. Try living in Alpine County (pop 1204) and tell me why you need the same set of regulations that OC has.

How do regulations about shower head efficiency make me safe? What is unfair about different flow rates when I have a well and someone is on city water?
How do the efficiency standards for engines make me safe in light of the Jevon's Paradox? (https://en.wikipedia.org/wiki/Jevons_pa ... nservation.)
How does the crazy costs related to cutting a tree down help me when I live in a fire prone area? Is the "benefit" that I can predict that I can't legally cut a dead tree down without paying $1000's? Is it the fairness that all my neighbors are also prevented from making our forest healthier and safer?

When it comes to regulations about surveying, most of them seem pretty decent, however they are actually quite minimal and mostly cover business related things, RoS, CR, and the SMA. The words "site plan" and "siteplan" do not occur in the PLSA, or the BR, or any part of the 2022 CLSA provided copy of the PLSA, BR, and PRC sections( last copy I had downloaded). It is the interaction of our surveys with the planning, permitting, development worlds that siteplans are dealing with. Which means they are being prepared for a specific purpose that is not really about surveying.

When I am helping a client with a LLA do I need to map EVERYTHING on their property to the last hundreth? Nope. I WILL map the things close to the adjusted boundary quite well to ensure compliance with zoning codes and such that have a nexus with the project scope. Is that breaking the law? If so, which one? If I omit showing a 5x5 chicken coop (accessory building under certain code sections) that is 800 feet from either the pre or post LLA boundary line, and someone here thinks that is wrong, please explain what is the nexus between that omission and the requirements of the LLA process?

Trying to sit in an ivory tower and proclaim that every siteplan needs to have a perfectly resolved boundary is the same as all the environmentalists saying that we need to stop burning all fossil fuels today. Sounds nice, but really isn't grounded in reality. As discussed in other threads, I am of the belief that as a professional we are protecting the public more when we accept that we can't always give them perfection, but will give them something better than the alternative.

For those that want to start bringing up whataboutisms (https://en.wikipedia.org/wiki/Whataboutism) related to other professions, please consider how lawyers often stop helping when you stop paying, but can still help someone with a $1000 consult to give someone a better idea if they should fold early. Or how doctors have patients that will continue to smoke and eat bacon after their 2nd heart attack. Should the doctor stop caring for that patient? Or should they work with the world as it is and try to improve the situation, albeit incrementally?

Mikey Mueller, PLS 9076
Sonoma County