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Old 11-04-2012
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Medicolegal and Ethics Patient-Physician relationship Contradictory - 100 cases and Kaplan

From 100 cases:
1. A 60 year old male physician who is an internist has had a female patient for the last 20 years. Both have lost their spouses several years ago. They are spending time together outside the office. The female patient wants to begin a sexual/romantic relationship with the physician.
What should he tell her?


A. "I can never do that with you, ever."
B. "We can be social, but not sexual."
C. "We need the ethics board's approval first"
D. "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."
E. "Because this is your initiative we can begin dating."

From Kaplan:
2. A 24 yo woman comes to the physician because of pain and stiffness in her lower back. Physical exam shows no abnormalities except muscular stiffness of the lumbosacral region. The physician explains his findings and suggests that her condition may respond to muscle relaxants. The patient says, "Wow! You've got great hands, Doc. Just having you touch me makes feel better." As the patient is getting dressed, she asks the physician if he is married, and then asks if he ever dates patients. The physician is attracted to the patient, and would like to see her socially. Which of the following is the most appropriate next step?


A. Begin to see the patient socially as long as she understands that it must be kept separate from the medical relationship.
B. Explain that as long as she is his patient, no social relationship is possible.
C. Refer the patient to a colleague and begin to see her socially.
D. Tell the patient that he will not pursue any social relationship with her, but that he would like to continue to be her physician.
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10 views in 11 minutes.
Zero responses.
My oh my!
:P
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Old 11-04-2012
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...the topic is contradictory...........

but for the exam we must choose only one---------there shouldnt be any social relationship between physician and pt.

abt. the q's asked

1.A
2. i have doubt regarding options presented here........B would be the choice(but 'as long as pt,social relationship is not possible' implies there can be relationship if she is not pt. ----so it's not the answer i guess)
i would choose D(but also have doubt abt this)

thanks
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D. Tell the patient that he will not pursue any social relationship with her, but that he would like to continue to be her physician.
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Thanks for the response.

As per Dr. Fischer's 100 Cases the answer for Q1 (which is question number 73 in the book) the answer is D - "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."

And as per Kaplan, the answer for Q2 is D. Tell the patient that he will not pursue any social relationship with her, but that he would like to continue to be her physician. I'm attaching the explanation given by Kaplan.

I think I'm going to go with Kaplan.
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Quote:
Originally Posted by abcxyz View Post
Thanks for the response.

As per Dr. Fischer's 100 Cases the answer for Q1 (which is question number 73 in the book) the answer is D - "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."

And as per Kaplan, the answer for Q2 is D. Tell the patient that he will not pursue any social relationship with her, but that he would like to continue to be her physician. I'm attaching the explanation given by Kaplan.

I think I'm going to go with Kaplan.
yes, be with kaplan...

for 2nd one D is the right for sure(as there are no correlational options to this one)

1st one --it must be A------>atleast for exam purpose(coz kaplan videos stresses out it...if you have doubt,listen to it yet again----hope it will get clear).............better go with kaplan
goodluck...thanks
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Old 11-04-2012
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Haven't done ethics yet, but I just love these questions.

I would go with D in both questions, and why? Because it just feels right.

They are already seing one another outside of his office, therefore the answer should be 1D instead of 1A.
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Quote:
Originally Posted by abcxyz View Post
From 100 cases:
1. A 60 year old male physician who is an internist has had a female patient for the last 20 years. Both have lost their spouses several years ago. They are spending time together outside the office. The female patient wants to begin a sexual/romantic relationship with the physician.
What should he tell her?


A. "I can never do that with you, ever."
B. "We can be social, but not sexual."
C. "We need the ethics board's approval first"
D. "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."
E. "Because this is your initiative we can begin dating."

From Kaplan:
2. A 24 yo woman comes to the physician because of pain and stiffness in her lower back. Physical exam shows no abnormalities except muscular stiffness of the lumbosacral region. The physician explains his findings and suggests that her condition may respond to muscle relaxants. The patient says, "Wow! You've got great hands, Doc. Just having you touch me makes feel better." As the patient is getting dressed, she asks the physician if he is married, and then asks if he ever dates patients. The physician is attracted to the patient, and would like to see her socially. Which of the following is the most appropriate next step?


A. Begin to see the patient socially as long as she understands that it must be kept separate from the medical relationship.
B. Explain that as long as she is his patient, no social relationship is possible.
C. Refer the patient to a colleague and begin to see her socially.
D. Tell the patient that he will not pursue any social relationship with her, but that he would like to continue to be her physician.

1. D. "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."

2. B. Explain that as long as she is his patient, no social relationship is possible.
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Quote:
Originally Posted by abcxyz View Post
Thanks for the response.

As per Dr. Fischer's 100 Cases the answer for Q1 (which is question number 73 in the book) the answer is D - "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."

And as per Kaplan, the answer for Q2 is D. Tell the patient that he will not pursue any social relationship with her, but that he would like to continue to be her physician. I'm attaching the explanation given by Kaplan.

I think I'm going to go with Kaplan.
Ya 1 st question seems reasonable but regarding 2nd question- As both doctor and patient is attracted to each other. So In future if doctor continues to see that same patient would affect his discussion.
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yes 2b seems better... that's what I would say to my patient.

But what does Step1 want to hear? Something like:"we can NEVER!!!! have a relationship even when you see another doctor?"
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Quote:
Originally Posted by Curacao View Post
yes 2b seems better... that's what I would say to my patient.

But what does Step1 want to hear? Something like:"we can NEVER!!!! have a relationship even when you see another doctor?"

"But what does Step1 want to hear?"
Kaplan has stressed that Patient-Physician social or sexual relationship is a NO!

If we follow Kaplan (as most do) the answers would be: 1. A 2. D

Scroll up to see my last post and Kaplan's explanation.
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my ans is d for both
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Old 11-05-2012
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[QUOTE=abcxyz;159677]From 100 cases:
1. A 60 year old male physician who is an internist has had a female patient for the last 20 years. Both have lost their spouses several years ago. They are spending time together outside the office. The female patient wants to begin a sexual/romantic relationship with the physician.
What should he tell her?


A. "I can never do that with you, ever." (so most probably this one is corect answr acording to me)

D. "I cannot date you and be your doctor - maybe in the future we can date, after you get another doctor."(if we say like this to that patient she wil obiviously go for getting anothr doctor so i think we cant say like that to any patient)
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