0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
On Being a Doctor |

Daily Dilemmas

Julie R. Rosenbaum, MD
[+] Article and Author Information

From Yale University, New Haven, CT 06520.


Requests for Single Reprints: Julie R. Rosenbaum, MD, Yale University, Primary Care Internal Medicine Residency, Waterbury Hospital Health Center, PO Box 208030, New Haven, CT 06250; e-mail, julie.rosenbaum@yale.edu.


Ann Intern Med. 2011;155(12):855-856. doi:10.7326/0003-4819-155-12-201112200-00011
Text Size: A A A

As a primary care physician, sometimes it is the smallest request that can create the most trying challenge.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Author Misses the Boat
Posted on January 18, 2012
David O., Staats, MD
Conflict of Interest: None Declared

To the Editor: This piece misses the boat in several regards.

1. An older, highly-functioning person, who suddently misses an important deadline, should be a red flag to the clinician that this change in behavior could be the sign of illness, ranging from presntation of a silent stroke or acute myocardial infarction, to delirium from fecal impaction or occult infection, or heralding the onset of memory changes.

2. In such a person, living on a fixed income, an increase in costs of $400 per month has a staggering effect on the person's quality of life. Deciding among medications is unfortunately a common and vexing conundrum for many older persons in this country. Not seeing the medical effects of this impoverishment demonstrates a lack of understanding of the tripartite assessment of the medical, psychological, and social support domains which is the fundamental basis of clinical geriatric medicine.

3. To feel anger, to feel frustration is good. It may lead to good quality assurance studies or better organization of clinics to minimize the clerical functions of physicians. To become angry at patients, to cast them as the enemy, who stands between the physician and her family duties, is burnout knocking at the door. It leads to bad clinical judgment and bad care.

Let us remember the words from the Oath of Maimonides: "May I never see in the patient anything but a fellow creature in pain."

David O. Staats, MD Nichols Hills, OK

Conflict of Interest:

None declared

Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)