Physician-Patient Relationships

General Rules About Physician-Patient Relationships 

Rule 1 Patient is number one always place the interests of the patient 

Rule 3 Tell the patient everything, even if he or she does not ask. 

Rule 4 Work on developing a rapport on an ongoing basis. Always seek 

Rule 8 Admit to the patient when you make a mistake. 

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Eugene Dowdle. You have not mentioned the effects of Medical Aid schemes on physician-physician and physician-patient relationships. One of the keystones of the Oslerian ethic was the sense of collegiality that bound the medical profession and provided, indirectly, a form of peer review that was of benefit to both patients and to medical practitioners. Medical Aid schemes, by their monetarising effects, have done much to damage those professional bonds. 

Aikin, Kathryn ]. 2003. The Impact of Direct-to-Consumer Prescription Drug Advertising on the Physician-Patient Relationship. PowerPoint presentation. Available at www.fda.gov/ cder/ddmac/aikin/sldOO 1. htm. 

There are some important differences in the physician-patient relationship when the patient is a child or unemancipated adolescent. First, the child psychiatric patient often is brought to the clinician because someone else (e.g., parent, teacher) is concerned or annoyed by the child s behavior. Thus, the patient may be a passive, if not reluctant, participant in treatment. Second, there is a greater possibility with children than with adults that a beneficial medication may have deleterious effects on growth and development. Therefore, clinicians need to consider the following questions carefully before initiating treatment ... 

As outlined above, some professional organizations are more specific than others. However, the general theme appears to be that while minor gifts, entertainment, and drug samples should not be solicited they may be acceptable if they directly promote better patient care or indirectly promote education or research and, in either case, do not affect the integrity of the physician-patient relationship. 

In summary, self-perceived negative effects on mood, motivation, and life satisfaction as a result of chronic sleep loss are almost universally reported in medical trainees. The consequences of these psychological factors on the physician-patient relationship and on interactions with other professionals in the hospital setting have been largely unexplored. The potential for significant health-related consequences in residents, particularly morbidity and mortality related to drowsy-driving accidents, is supported by a number of studies. 

The scope, prevalence, and significance of the problem of inadequate sleep and fatigue in residents must be more specifically and rigorously defined, particularly in regard to the impact on performance in actual clinical settings, on the physician-patient relationship, on the health and safety of residents, and on the quality of their medical education. 

Levine, R. J. (1991). AIDS and the physician-patient relationship. In F. G. Reamer (Ed.), AIDS and ethics (pp. 188-214). New York Columbia University Press. 

A. General Rules About Physician-Patient Relationships... 

Disease Patient Medical Situation Physician-Patient Relationship (If Any)... 

The refusal of the patient to participate in a study must never interfere with the physician-patient relationship. 

History of therapeutic radiation exposure Hormonal therapy (estrogen, progesterone) Isotretinoin therapy within the last 6 months Median-depth or deep resurfacing procedure within the last 3-12 months No visible adnexal structures Poor general health and nutrition status Poor physician-patient relationship Previous ionizing radiation exposure Predisposition to keloids Psychological instability Recent facehft surgery Recent use of isotretinoin (Accutane )... 

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