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.

May 1, 2007 Issue
How Do EHRs Affect the Physician-Patient Relationship?
In the United States, 28 percent of primary care physicians use EHRs, and another 31 percent plan to implement the system within the next year.

Apr 1, 2007 Issue
Physicians as Role Models
The basic questions asked in the scenario are whether physicians should always “practice what they preach,” and whether a physician's personal life should be accessible and relevant to patients. Professional role models are important.

Mar 1, 2007 Issue
Are Obese Physicians Effective at Providing Healthy Lifestyle Counseling?
More than 40 percent of American adults are classified as obese by the Centers for Disease Control and Prevention, and obesity is associated with many comorbidities (e.g., hypertension, type 2 diabetes, asthma, depression, orthopedic problems, sleep apnea).2 Physicians are not immune to obesity.

Feb 1, 2007 Issue
Emergency Response: Physician Training and Obligations
There is no question that physician training in emergency response is available and effective, and that physicians, if properly prepared, are extremely valuable in mitigating mortality and morbidity during an emergency.

Jan 1, 2007 Issue
Pregnant Physicians and Infectious Disease Risk
This scenario represents a familiar situation: a conscientious physician torn between pressing responsibilities to her patient and colleagues and her responsibility to her baby.

Dec 1, 2006 Issue
STDs in Patients with Multiple Partners: Confidentiality
This scenario raises complex ethical questions. The physician-patient relationship is characterized by a network of obligations and expectations that becomes more complex when patients with close ties are treated by the same physician.

Nov 1, 2006 Issue
Treatment of Patients with Literacy Issues
Low literacy is more prevalent than previously thought. In 2003, almost 25 percent of Americans (45 million persons) who spoke English as their first language had the lowest level of literacy skills (i.e., level 1 out of 5) in reading, writing, and functioning in the English language. Persons with low literacy have difficulty performing common tasks such as filling out a deposit slip, locating the time and place of a meeting, identifying specific information in a news article, and reading prescription drug labels.

Oct 1, 2006 Issue
Facilitating Shared Decision Making with Patients
American society values autonomy and the belief that competent adults have the right to make virtually any decision pertaining to their health care. As health care professionals, we have a responsibility to try to make sure that our patients are mentally capable, well-informed, and free of coercion.

Sep 1, 2006 Issue
Obesity: Psychological and Behavioral Considerations
Assuming that medical causes of weight gain (e.g., hypothyroidism, hypercortisolism) have been ruled out, the physician should consider social, psychological, and environmental factors that may explain the patient’s weight gain and his apparent indifference.

Aug 1, 2006 Issue
Usefulness of Online Medical Information
Patients are not trained to diagnose illnesses across a wide spectrum of diseases and are not familiar with presentations that physicians are trained to detect. However, patients are highly motivated to determine their diagnoses, are more intimately familiar with their own symptoms, and may have more time to investigate potential diagnoses than physicians.

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