AFP DEPARTMENT COLLECTION

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.

Feb 1, 2004 Issue
A One-Stop Health Care Request
This scenario is likely to be common in clinics such as the one described here. This physician's frustration with the patient, his family members, and the system as a whole is evident. Providing care to a transient visitor with a chronic disease is a difficult proposition. While many physicians want to make decisions guided by the best evidence, this scenario is one of many in medicine where physicians must rely on clinical intuition. We suggest that maintaining a patient-centered approach with culturally appropriate care and evidence-based disease management might provide a reasonable health care visit for the patient and serve to limit frustration on the part of the physician.


Jan 1, 2004 Issue
Should Doctors Call in Sick?
Many practical factors mitigate against a physician taking a sick day. For physicians in private practice, the economic considerations are great because office overhead and staff payroll costs continue during their absence. Even salaried physicians are subject to the powerful physician work ethic that says we are here to serve and care for patients. In other words, “You need to be here.”


Nov 1, 2003 Issue
Rethinking the Gynecologic Examination
These questions often arise but without any obvious answer because the practice of medicine is an art as well as a science. The history of the annual physical examination for healthy women illuminates the “science” of medicine.


Oct 1, 2003 Issue
The Complete Physical
The concept of the “complete” physical examination can be viewed from several perspectives.


Sep 1, 2003 Issue
Responding to an In-flight Emergency
Although usually it's just the in-flight movie and food we get to fret about, unfortunately, in-flight emergencies are a frequent occurrence.


Aug 1, 2003 Issue
A Shoe-in for Malpractice
The questions being asked in this case scenario can be consolidated into one, “Should I continue as this patient's physician?” An attorney's typical answer to such a query is often a cautious “It depends.” In this case, a more definite answer is appropriate: “No.”


Jul 1, 2003 Issue
Disability Revisited
For Social Security disability claims, it is not requested of the physician to provide a disability determination.


Jun 1, 2003 Issue
Emergency Response
Family physicians who encounter an unexpected medical emergency face a myriad of ethical, legal, and competency issues.


May 1, 2003 Issue
Do I Have to Resuscitate This Patient Against Her Wishes?
In this case scenario, the family physician successfully performed a task that often is forgotten during physician-patient visits—the physician frequently discussed with this patient her wishes for end-of-life care. The conversations specifically included her thoughts about respirators, CPR, and other potential life-prolonging treatments.


Apr 1, 2003 Issue
Should I Give Money to My Patients?
As a rule, physicians should avoid giving money directly to patients. Like most decisions in medical practice, the determination to give a patient money must be weighed carefully, and each case must be evaluated individually.


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