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.

Jul 1, 2010 Issue
Improving Sensitivity to Patients from Other Cultures
In this scenario, the physician is facing several challenges: making a patient from another culture feel at ease; managing a female patient's discomfort with a male physician; and recognizing the patient's chief concern. Physicians often treat patients from cultures different from their own.

May 1, 2010 Issue
Practical Considerations for Determining Patient Capacity and Consent
The core issue is whether the patient possesses decisional capacity and can provide informed consent.

Mar 1, 2010 Issue
Discussing Treatment Options with Patients
Sometimes it may seem easier to inject a subacromial bursa or aspirate a knee joint than to engage in shared decision making with your patients about the use of aspirin for coronary artery disease prevention or a PSA test for prostate cancer screening. The path that led to the disparate valuations of these services has become progressively less clear.

Jan 15, 2010 Issue
Recognizing Mental Illness in Culture-bound Syndromes
Somatic symptoms often replace emotional complaints in foreign-born students from cultures where mental illness is stigmatized.

Nov 1, 2009 Issue
Dealing with the Impaired Physician
In 1973, the American Medical Association defined the impaired physician as one who is unable to fulfill professional and personal responsibilities because of a psychiatric illness, alcoholism, or drug dependency. Physicians face the challenge of being able to identify impairment in their colleagues and, most importantly, in themselves.

Sep 1, 2009 Issue
Breaking Bad News Over the Phone
As a general rule, it is preferable to give test results to your patients in person.

Jul 1, 2009 Issue
When a Patient's Chronic Pain Gets Worse
This case encapsulates many of the significant challenges in providing care for patients with chronic noncancer pain.

May 1, 2009 Issue
Nonmalignant Chronic Pain: Taking the Time to Treat
Nonmalignant chronic pain is a common, yet challenging, health problem.1 Numerous factors over the past decade have put primary care physicians in a central role in the management of this pain.

Sep 1, 2008 Issue
Communicating Effectively with Transgender Patients
Transgender persons are those who consider their gender to be different from their biological sex. Hence, a male-to-female person is a biologic male who identifies as a female, and a female-to-male person is a biologic female who identifies as male.

Aug 1, 2008 Issue
Ethical Considerations of Patients with Pacemakers
Modern medicine has increasingly become infused with technology intended to extend a person's quantity and quality of life. More than 1 million persons in the United States have implantable pacemakers and the majority of this population is older than 65 years.

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