Patient's Family Cooked a meal for you? - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 1 Forum

USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 03-26-2012
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 303
Threads: 57
Thanked 106 Times in 67 Posts
Reputation: 116
Send a message via Skype™ to usmlemydream
Medicolegal and Ethics Patient's Family Cooked a meal for you?

you have a patient in your clinic who is elderly with multiple problems. her family is grateful to you for your care and they bring you a meal , they cooked at home a cake and a scarf

what would you do?

A. accept the gift but report it
B. accept the gift
C. offer payment for food
D. refuse the gift
E. it is ethical to accept the gift if you share the food with rest of the staff
f. accept the food but not the scarf
Reply With Quote Quick reply to this message



  #2  
Old 03-26-2012
Hope2Pass's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,684
Threads: 213
Thanked 1,600 Times in 660 Posts
Reputation: 1610
Default

B) Accept the gift

I think you can accept gifts as long as its not causing the patient any sort of financial problem.
Reply With Quote Quick reply to this message
The above post was thanked by:
usmlemydream (03-26-2012)
  #3  
Old 03-26-2012
USMLE Forums Guru
 
Steps History: Step 1 Only
Posts: 452
Threads: 11
Thanked 354 Times in 197 Posts
Reputation: 364
Default

F.....no gifts beyond small tokens...i guess the scarf goes beyond small token
Reply With Quote Quick reply to this message
 
  #4  
Old 04-14-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 49
Threads: 0
Thanked 23 Times in 12 Posts
Reputation: 33
Default

Quote:
Originally Posted by Hope2Pass View Post
B) Accept the gift

I think you can accept gifts as long as its not causing the patient any sort of financial problem.
I agree that B is the correct answer.

But do not agree that we should accept gift until it does not cause financial problem to the patient. I have two reasons:

1. This is a question of ethics as a clinician. If a rich patient, such as Michael Jackson offers clinician a family tour package as a gift, (which is not a causing any financial problem to him), do you think the clinician should accept it ? This question points to the contemporary issue of celebrities who manage to get desired prescriptions of pain killers, steroids etc from their fav physicians. So practice ideals and ethical principles clearly suggest that one should not accept any major/minor gifts from patients, regardless of how rich/poor your patient is. Even when accepting minor gifts such as one mentioned in this question, it should not mean any form of exchange with the patient.

2. Another aspect is patient-doctor relationship. Trust is an important element in this relationship. When patient as a goodwill gesture offers a small article as a gift, rejection could hurt patient. So clinician can accept such small gifts, without any need of disclosure.
Reply With Quote Quick reply to this message
  #5  
Old 04-14-2012
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 127
Threads: 3
Thanked 113 Times in 62 Posts
Reputation: 123
Default

I think the AMA says that you're allowed to accept gifts that are worth less than $10 or $20, I can't remember which one.

But I do remember seeing an old UW question where you have a longtime patient who was a jeweler and he gives you a nice watch... they said that it was acceptable because the gift was within reason for that particular patient (since he's a jeweler). But I think that the person who wrote that question is one of those people who came from a long line of rich people and has no idea of the value of money.
Reply With Quote Quick reply to this message
  #6  
Old 04-14-2012
Valkoff's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 92
Threads: 2
Thanked 13 Times in 13 Posts
Reputation: 23
Default

Why can't it be sharing the gifts with the staff? That seems logical to me- it serves as an acknowledgement that they also played a role in patient care.

Oh Bioethics! Thou art most cruel.
Reply With Quote Quick reply to this message
  #7  
Old 04-14-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 62
Threads: 24
Thanked 7 Times in 7 Posts
Reputation: 17
Default

From the questions I have done from Kaplan, you can't accept anything more than 10 dollars.

I would say F

since the cake was probably less than 10 dollars, and the scarf probably costs more.
__________________
YEA BUDDAY!!!
Reply With Quote Quick reply to this message
  #8  
Old 04-14-2012
Valkoff's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 92
Threads: 2
Thanked 13 Times in 13 Posts
Reputation: 23
Default

Quote:
Originally Posted by No_BS View Post
From the questions I have done from Kaplan, you can't accept anything more than 10 dollars.

I would say F

since the cake was probably less than 10 dollars, and the scarf probably costs more.
I doubt that the monetary value is of any major significance. If the question stated the patient bought you an "extremely cheap scarf", would that make a difference to the principle behind it? Is it a cumulative cost of ten dollars, or is it per item (i.e- if the items cost $9 each, can you accept all of them, or do you have to choose)?

Cursed bioethics!
Reply With Quote Quick reply to this message
  #9  
Old 04-15-2012
USMLE Forums Master
 
Steps History: 1 + CS
Posts: 675
Threads: 84
Thanked 428 Times in 207 Posts
Reputation: 438
Default

I remember a question from UW regarding the gifts issue, it said:

if valuable, then NO
if not valuable, then preferably no
Reply With Quote Quick reply to this message
  #10  
Old 04-15-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 147
Threads: 18
Thanked 49 Times in 30 Posts
Reputation: 59
Default

i would say accept the gift.B
however i must say ethics is a nightmare for us fmg's,sometimes practically its different.
let me give an example,i work in africa in cameroon in a rural area i generally dont accepts gifts,based on my principles,because when you do so,the patient will later want a favour in return like skipping the line of consultation,writing drugs for a relative at home,calling you un-necessarily and expect you to prescripe on the phone.
however refusing in some situations can really hurt the patient.an elderly patient of mine came from a very long distance and remote area and brought me a large bunch of plantains,i couldn't refused because of the pains he took to bring the gift,and the pain of transporting it back if i had refused.
Reply With Quote Quick reply to this message
  #11  
Old 04-15-2012
USMLE Forums Addict
 
Steps History: Not yet
Posts: 108
Threads: 15
Thanked 23 Times in 14 Posts
Reputation: 33
Default

f.accept the food but not the scarf
Reply With Quote Quick reply to this message
The above post was thanked by:
  #12  
Old 04-15-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 25
Threads: 3
Thanked 8 Times in 7 Posts
Reputation: 18
Default

I don't get why people are wondering what they 'read somewhere'. It sounds much better if we could all just think for ourselves. Obviously rejecting the gift would hurt the patient's feelings. And if I had such a patient, I would have accepted. Whether or not UW or AMA says so, I do not think that limits can be placed by saying that 10$ worth gift is acceptable but 10$ 1c gift is not! I believe the intention of the patient is more important!
Reply With Quote Quick reply to this message
  #13  
Old 04-15-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 62
Threads: 24
Thanked 7 Times in 7 Posts
Reputation: 17
Default

Quote:
Originally Posted by reaper View Post
I don't get why people are wondering what they 'read somewhere'. It sounds much better if we could all just think for ourselves. Obviously rejecting the gift would hurt the patient's feelings. And if I had such a patient, I would have accepted. Whether or not UW or AMA says so, I do not think that limits can be placed by saying that 10$ worth gift is acceptable but 10$ 1c gift is not! I believe the intention of the patient is more important!
Well you can think that... and get the question wrong on the test. Go ahead..

ID 7767 UWORLD

lets end the discussion here.
__________________
YEA BUDDAY!!!
Reply With Quote Quick reply to this message
  #14  
Old 04-16-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 12
Threads: 9
Thanked 0 Times in 0 Posts
Reputation: 10
Default

From Conrad Fischer's Ethics Book:

Small gifts from patients of modest value are acceptable on part of the patient. This is provided that there is no expectation of a different form of therapy or a higher level of care based on the gift. You can accept a cake at christmas, a balloon on your birthday, or other tokens of esteem, but not if the patient expects an extra, or different prescription, for something in exchange of your gift.

The answer is B
Reply With Quote Quick reply to this message
  #15  
Old 04-16-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 25
Threads: 3
Thanked 8 Times in 7 Posts
Reputation: 18
Default

Quote:
Originally Posted by No_BS View Post
Well you can think that... and get the question wrong on the test. Go ahead..

ID 7767 UWORLD

lets end the discussion here.
You do realise that there is a world outside of USMLE too?! If someone is going to lie on the exam and say that he would not accept the gift and in reality he thinks that he will accept it, then I'm sorry but I don't think that person deserves to be a doctor. Bioethics is more about understanding than rote learning a couple of books.

If some day UW says that you're allowed to kill patients then I'm sorry but I wouldn't kill my patients just so I could pass Step 1.

And yes, I'd rather get the question wrong than go against my ethics. Seriously sometimes I don't get how some people even got into med school.
Reply With Quote Quick reply to this message
The above post was thanked by:
587964 (05-03-2012), Valkoff (04-16-2012)



  #16  
Old 04-16-2012
Kabutar111's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 414
Threads: 30
Thanked 87 Times in 70 Posts
Reputation: 97
Send a message via Skype™ to Kabutar111
Show Teeth hhhhhhhh



toooooo serious , too tense
__________________
There is no shortcut to SUCCESS ,and there is no excuse for FALIURE - by Kabutar111
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
The above post was thanked by:
d_wiqed (04-16-2012)
  #17  
Old 04-16-2012
USMLE Forums Scout
 
Steps History: Not yet
Posts: 12
Threads: 9
Thanked 0 Times in 0 Posts
Reputation: 10
Default

Quote:
Originally Posted by reaper View Post
You do realise that there is a world outside of USMLE too?! If someone is going to lie on the exam and say that he would not accept the gift and in reality he thinks that he will accept it, then I'm sorry but I don't think that person deserves to be a doctor. Bioethics is more about understanding than rote learning a couple of books.

If some day UW says that you're allowed to kill patients then I'm sorry but I wouldn't kill my patients just so I could pass Step 1.

And yes, I'd rather get the question wrong than go against my ethics. Seriously sometimes I don't get how some people even got into med school.
....But you are allowed to accept gifts from patients, both ethically and legally.
Reply With Quote Quick reply to this message
  #18  
Old 04-16-2012
Hope2Pass's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,684
Threads: 213
Thanked 1,600 Times in 660 Posts
Reputation: 1610
Default

Quote:
Originally Posted by reaper View Post
You do realise that there is a world outside of USMLE too?! If someone is going to lie on the exam and say that he would not accept the gift and in reality he thinks that he will accept it, then I'm sorry but I don't think that person deserves to be a doctor. Bioethics is more about understanding than rote learning a couple of books.

If some day UW says that you're allowed to kill patients then I'm sorry but I wouldn't kill my patients just so I could pass Step 1.

And yes, I'd rather get the question wrong than go against my ethics. Seriously sometimes I don't get how some people even got into med school.
Hey from what I understand -

In Step 1, your answers have to be based on what an IDEAL doctor would do or should do. (ethically and legally) In real life or clinical practice, ethics are not always practiced. You have to know the ethics (according to the USMLE) behind a scenario and then its up to you to practice it or not (as long as its legal). BUT for the exam, you have to go by whats theoretical and not how you want to run your practice.
Reply With Quote Quick reply to this message
  #19  
Old 04-16-2012
DocSikorski's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,353
Threads: 94
Thanked 877 Times in 507 Posts
Reputation: 890
Default

scarf and cake! B)

thats extensively explained in many ethics books.
Everything cheap and small is fine. Stuff under 100$ is alright.

Unless its Burberry - take the scarf too.
__________________
Ambition is a dream with a V8 engine. EP
Reply With Quote Quick reply to this message
  #20  
Old 04-16-2012
USMLE Forums Master
 
Steps History: Not yet
Posts: 590
Threads: 8
Thanked 239 Times in 192 Posts
Reputation: 249
Default

I go for B.....
Reply With Quote Quick reply to this message
  #21  
Old 04-16-2012
Kabutar111's Avatar
USMLE Forums Guru
 
Steps History: Not yet
Posts: 414
Threads: 30
Thanked 87 Times in 70 Posts
Reputation: 97
Send a message via Skype™ to Kabutar111
Default

My answer depend on the color of scarf
__________________
There is no shortcut to SUCCESS ,and there is no excuse for FALIURE - by Kabutar111
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message
  #22  
Old 04-16-2012
USMLE Forums Veteran
 
Steps History: Not yet
Posts: 288
Threads: 28
Thanked 91 Times in 73 Posts
Reputation: 101
Default

lol @kabutar111.....my ans would be B.they didn't say it was an expensive scarf or some custom made scarf...so i am expecting it to be an affordable one and the CAKE,didn't Dr.Daugherty say you shldn't accept a free meal as it would look like meal for service??!
__________________
When you know what you want,and you want it badly enough,you'll find a way to get it!!
Reply With Quote Quick reply to this message
  #23  
Old 04-17-2012
Valkoff's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 92
Threads: 2
Thanked 13 Times in 13 Posts
Reputation: 23
Default

Quote:
Originally Posted by docusmle9 View Post
lol @kabutar111.....my ans would be B.they didn't say it was an expensive scarf or some custom made scarf...so i am expecting it to be an affordable one and the CAKE,didn't Dr.Daugherty say you shldn't accept a free meal as it would look like meal for service??!
Doesn't that logic apply to all gifts? I'd rather it appear that I was providing a service for a meal, than that I was providing a service for a cheap scarf.
Reply With Quote Quick reply to this message
  #24  
Old 04-17-2012
Valkoff's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 92
Threads: 2
Thanked 13 Times in 13 Posts
Reputation: 23
Default

Quote:
Originally Posted by No_BS View Post
Well you can think that... and get the question wrong on the test. Go ahead..

ID 7767 UWORLD

lets end the discussion here.

You are right, but the fundamental problem being discussed is NOT what the answer is, but why that is the answer. The purpose is to come up with a principle that can be extrapolated to other questions of this type.

Being an exam for non- Americans as well as Americans, I don't think that they will have a question that tests a candidate's knowledge of the price of things.

As far as I know, cakes can be more expensive than $10.

I know that your user name is No BS, but you have to allow others a certain amount of it!
Reply With Quote Quick reply to this message
  #25  
Old 04-17-2012
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 303
Threads: 57
Thanked 106 Times in 67 Posts
Reputation: 116
Send a message via Skype™ to usmlemydream
Default ANSWER is accept the gift

its a question from conrad fischer 100 cases
sorry for posting the answer late
had totally forgotten to post the answer
hope2pass just reminded me...thanks buddy
__________________
the sky is not my limit....I am
Reply With Quote Quick reply to this message
The above post was thanked by:
docusmle9 (04-18-2012), Hope2Pass (04-17-2012), Teresa (05-03-2012), Valkoff (04-18-2012)



  #26  
Old 04-18-2012
Valkoff's Avatar
USMLE Forums Scout
 
Steps History: Not yet
Posts: 92
Threads: 2
Thanked 13 Times in 13 Posts
Reputation: 23
Default

Quote:
Originally Posted by usmlemydream View Post
its a question from conrad fischer 100 cases
sorry for posting the answer late
had totally forgotten to post the answer
hope2pass just reminded me...thanks buddy
I guess the most intuitive answer is usually the right one. Did they give an explanation for the answer?
Reply With Quote Quick reply to this message
  #27  
Old 04-18-2012
USMLE Forums Guru
 
Steps History: 1 + CS
Posts: 303
Threads: 57
Thanked 106 Times in 67 Posts
Reputation: 116
Send a message via Skype™ to usmlemydream
Default here is the explanation from Conrad fischer

small gifts from patients of limited value are acceptable.food,plant and small articles of clothing such as scarf are all acceptable.
refusing such signs of gratitude would be hurtful to doctor patient relationship if they are a sign of good relationship with u.
gifts can never be tied to a specific expectation of care such as a particular prescription or successful completion of paperwork such as disability forms.
there is no reporting or disclosure requirement for small gifts of nominal value
__________________
the sky is not my limit....I am
Reply With Quote Quick reply to this message
The above post was thanked by:
Valkoff (04-18-2012)
  #28  
Old 05-02-2012
USMLE Forums Newbie
 
Steps History: ---
Posts: 3
Threads: 0
Thanked 0 Times in 0 Posts
Reputation: 10
Default

C. offer payment for food

As a professional, accepting any gifts is not necessary! You can always accept job tho not with any form of gifts!
Reply With Quote Quick reply to this message
  #29  
Old 05-03-2012
Teresa's Avatar
USMLE Forums Scout
 
Steps History: 1 + CK
Posts: 33
Threads: 0
Thanked 6 Times in 4 Posts
Reputation: 16
Default

Quote:
Originally Posted by Valkoff View Post
I doubt that the monetary value is of any major significance. If the question stated the patient bought you an "extremely cheap scarf", would that make a difference to the principle behind it? Is it a cumulative cost of ten dollars, or is it per item (i.e- if the items cost $9 each, can you accept all of them, or do you have to choose)?

Cursed bioethics!
Accept the gift

"you have a patient in your clinic who is elderly with multiple problems. her family is grateful to you for your care and they bring you a meal , they cooked at home a cake and a scarf

The scarf might not even be new , so the value is irrelevant
What you do with your gift later really doesn't matter.

__________________
Don't take life too seriously. Nobody makes it alive
To view links or images in signatures your post count must be 10 or greater. You currently have 0 posts.
Reply With Quote Quick reply to this message



Reply

Tags
MedicoLegal-Ethics, Step-1-Questions

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
Urine PH after McDonlad's Meal! bunny USMLE Step 1 Forum 14 04-15-2012 09:50 AM
Patient's Response Hope2Pass USMLE Step 1 Forum 6 08-17-2011 08:14 PM
Facial weakness after meal 1TA2B USMLE Step 2 CK Forum 10 04-17-2011 12:08 PM
Patient's Confentiality! Addunga88 USMLE Step 2 CK Forum 2 07-24-2010 04:00 AM
Unusual Patient's Beliefs sharvaree19 USMLE Step 2 CS Forum 3 05-16-2010 06:45 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)