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Old 10-28-2012
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Default Ethics discussion.

Wanted to seek confirmation on two things on Ethics (Yes going through the book by conrad Fishcer, it's not bad!

1) When we as physicians committ an error in patient's management: What I remember from the video and also a question in UW is that every error must be communicated to the patient. It doesn't matter how small or big, but that we must tell the patient. But Dr. Fishcer's book says:
"there is no mandate to inform a patient about minor errors that will
have no impact on her care or treatment. If the blood tests were delayed or a single test
forgotten the patient does not have to be informed of this as long as the information is
obtained in a timely fashion and as long as it will not impact her care. The main determinant of the need to inform the patient is not the magnitude of the mistake, but rather the
impact on her life and health care".

So we don't tell the patient if something hasn't affected them in anyway? If we've missed a test or something, we don't tell them? What do you guys think?

2) Secondly, the Book explains the issue of reprtable STD's very well. It states that we always first encourage patient to discuss with partner. In the event that the patient is unwilling or refuses, only then do we report to the Health Department (who will trace the partner, and inform the partner while keeping the patient's identity hidden). We can also inform the partner ourselves. But I was wondering, isn't it a risk leaving the responsibility on the patient? considering that if the patient doesn't tellthe partner, the partner will already have been infected till we find out from the the patient that he never told the partner despite our discussiom? What are your thoughts?

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Old 10-28-2012
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haha...gr8 thoughts you got..

according to me...for 1) for exam purpose we should follow kaplan(informing even minor errors to pt..) ....but in real life i think conrad is true abt it....

2) leaving the responsibility to the pt...--- i think that depends on severity of STD pt. get..if the pt. diagnose in more severe stage,it is mandatory to inform ,but also discussing and encouraging abt this matter prior is necessary for sure.....

anyways lets wait for more explanations too(coz i'm not too good at ethics).......

thanks for pointing your doubts..
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Old 10-28-2012
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1..we should tell a pxt every mistake we made in their management But minor mistakes that pose no harm should not be told for eg;you forgot to check CBC,you can come in the next day and do it without telling the pxt but you must not backdate it in pxts folder.
CF & dr Daugherty agreed on this. STD,you will 1st encourage your pxt to discuss with partner & You must Confirm the partner has been told.Pxt must come with partner to you for counselling & testing especially if they are married.
For unmarried cases,pxt must not tell his partners but should give their names and address.if pxt refuses to give their names,no law will be held against him.
(it's properly explained in the video)
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Old 10-28-2012
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Default I have 2 questions too guys

1...Romantic relationships with pxts;
In FA,such relationships is NEVER allowed BUT in kaplan Ethics,a Dr can have a romantic relationship with his pxt as long they 1st end the dr/pxt relationship.he says the only exception is that psychiatrists will NEVER engage with a former pxt of his??

2..Impaired automobile driver;FA agrees we can breech confidentiality of such pxt for eg a 60 yr old driver with serious glaucoma,got his drivers licence renewed on Internet and sent to him by mail.that we can report to DMV to seize their licence so as to prevent harm from others.
This sounds true but Kaplan 100question ethics states that we are not protected if we breach such confidentiality.we should only encourage pxt to seek another means of transport but if we report to DMV & pxt decides to sue us,we will loose the case.

Pls any idea guys?I have been looking for the real answer
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Old 10-28-2012
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1- Like said before on the exam they will not give you little things liek you forgot to do a test it will be bigger things like they were given the wrong meds or something. So go with tell them.

2- If it is a reportable disease you have to report to the state board no matter what, however you ask the patient to inform their sexual partners, if they refuse to then you can inform the state board.

1- In the real world Kaplan is right you can actually date a FORMER pt UNLESS you area Psychiatrist. However on the exam if they ask you about this you do not advise the patient to switch doctors just so you can start dating them (or int he real world for that matter, if things go wrong they can sue saying you used your authority and well you don't need that). For exam purposes consider it always a NO-NO

2- This is a good question. Have not heard about a severe glaucoma and drivers license. However if the glaucoma means that they are legally blind then you DO report that to the DMV. Anyone considered legally blind even with corrections must be reported to DMV. So if without my glasses I am legally blind but with them I am not then that does not need to be reported to DMV. Legally blind is vision of 200/20
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