Curbside Consultation

This department addresses legal, psychological, and ethical issues physicians may encounter in their day-to-day practice. Each article contains a brief case scenario, followed by a commentary section written by a consultant who responds to the particular issue addressed in the scenario.

Jan 1, 2001 Issue
A Patient Seeking Disability
The frustration of the physician who wrote this case scenario is real, and many physicians experience this frustration in their practices. Physicians receive forms from various disability-granting agencies requesting information regarding the initiation or perpetuation of disability claims.

Dec 1, 2000 Issue
A Daughter Estranged from Her Dying Father
This case scenario clearly represents the challenges, complexities and paradoxes often faced by physicians working with dying patients and their families. Views and reactions regarding the end of life encompass a breadth of emotional, spiritual, personal and cultural factors that may take us far from standard medical practice.

Nov 1, 2000 Issue
A Doctor Who Is Blamed for a Patients' Condition
Our colleague faces the situation of having evaluated a patient with diffuse myalgias, fever and nausea. After finding evidence of liver damage and an abnormal CT scan, the patient refused an appropriately recommended MRI, resulting in a delay of the diagnosis of cholangiocarcinoma. The physician is blamed by the patient who, along with most family members, refuses to see him.

Oct 1, 2000 Issue
A Consultant Takes Over
What is the role of a consultant in the referral process?

Sep 1, 2000 Issue
The Seductive Patient
It is likely that all physicians, regardless of training, would recognize that this case scenario deals with a seductive patient.

Aug 15, 2000 Issue
A Dying Patient, Like Me?
When should a physician disclose personal information to a patient, and what do we do when a particular case touches on our own suffering? At a deeper level, how do we deal with our own mortality in caring for the seriously ill and dying?

Jul 1, 2000 Issue
A Daughter Who Won't Let Her Mother Go
The family physician submitting this case is to be commended for wrestling with a very difficult problem. The patient's family physician has taken an appropriate first step in the management of this situation by setting boundaries through a verbal contract about limits in providing care for the mother.

May 1, 2000 Issue
What Your Patients Don't Tell You
Why is such critical information about patients and their lives so frequently left unsaid? There are a myriad of possible explanations.

Apr 1, 2000 Issue
A Potentially Violent Patient?
There is probably no situation more difficult for the physician than working effectively with a potentially violent patient.

Mar 1, 2000 Issue
Bending the Rules to Get a Medication
The scenario described above will become increasingly familiar to most practicing physicians over the next few years. Currently, we are witness to at least 40 million “medically indigent” patients without insurance and the number continues to increase.

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