Physician-Patient Relationship

Chapter 16 Physician-Patient Relationship




Clinical Case Problem 1: “I Trust the Doctor, but …”


A 42-year-old man who has been your patient for 4   years comes to the office for a routine office visit. You have been treating chronic migraine headaches for the patient. He mentions that he would like to see a neurologist who he heard speak on the radio. Although you have done a complete evaluation of his headaches, he is concerned that he might have a brain tumor or other disease.



Select the best answer to the following questions




1. Considering the situation, what should you do?


a. explain to the patient that you have investigated the condition completely and that there is no need for a referral

b. tell the patient that if that is the way he feels, he probably should find another family physician

c. empathize with the patient about his symptoms and refer him to a neurologist of your choosing

d. empathize with the patient about his symptoms and refer him to the neurologist he mentions

e. tell the patient that you are deeply offended by his request; he has no right to question your competence

2. What is the primary purpose of consultation or referral to a specialist?


a. to validate the findings of the family physician

b. to ensure that the family physician has not missed anything

c. to provide reassurance to the patient that the family physician is concerned about his or her welfare

d. to improve the quality of health care by making available to patients and referring physicians the knowledge and skills of specialists or consultants at appropriate times

e. to provide protection for the family physician against a malpractice suit

3. Trust in one’s physician is described by patients as


a. an inherent personality trait

b. having no relationship to the institutions with which the physician is associated

c. a learnable skill that can be improved

d. separate from competence issues

e. different from being a “good doctor”


Clinical Case Problem 2: You Can Be a Tool of Change


A 56-year-old female patient had been diagnosed with diabetes mellitus, insulin dependent, several years earlier. She had great difficulty maintaining her weight and medication schedule. She often denied that she needed to remain on the regimen recommended by her physician. Each visit, the physician would spend time discussing the importance of lifestyle and adherence to medication programs.



4. The patient’s relatively long relationship with her physician is likely to


a. enhance her ability and commitment to follow the treatment plan

b. overburden the physician and encourage him to refer her elsewhere

c. have no influence on the treatment process

d. allow her to feel less guilt over her nonadherence to the plan

e. enable her to set her own treatment regimen

5. Trust in one’s physician contributes to


a. discontinuity of care

b. patient dissatisfaction

c. elimination of need for second opinions

d. improved treatment adherence

e. more frequent office visits

6. “Trust” is defined as


a. taking the physician’s word for recommended treatments

b. expectation that the physician will put the patient’s interests first

c. belief that the physician will not allow insurance incentives to influence him or her

d. assumption that all consultants to whom the physician refers have the same perspective of patient care

e. all of the above


Clinical Case Problem 3: “Do You e-mail?”


A couple and their two young children move to the West Coast because of job requirements. One of the first things that they must do is find acceptable primary care for the family. They have come to appreciate the flexibility of having a physician who is willing to use electronic communications. As they search for a physician or group that will support their needs, they outline the following concerns.



7. Access to “e-health” offers them


a. convenience

b. control

c. choice

d. a and b

e. all of the above

8. The e-health options can affect the physician-patient relationship by


a. causing greater distance because there is less face-to-face interaction

b. improved sense of commitment because the physician can send reminders or quick, preprogrammed questions about how a patient is doing

c. creating patient dissatisfaction because physicians answer e-mails at unacceptable times of the day

d. reducing liability risk by keeping a copy of physician-patient interactions

e. b and d

9. Soon after the couple selects a physician who is electronically savvy, one of their children develops a significant asthma attack with very rapid breathing, wheezing, and some blue discoloration around his lips. They immediately e-mail the physician’s office for instructions.


a. this is unacceptable because e-mail should never be used for an emergency

b. the physician’s e-mail has a header instructing that if the query is an emergency, the patient should call 911 and not use the e-mail contact

c. the patient signed a release form in the physician’s office indicating that she understood the e-mail address was for making appointments, following up visits with brief questions and the like, and should not be used for emergent issues

d. the couple take their child to the nearest emergency department and on returning home use the physician’s e-mail to provide his office with an update on the emergency department visit and request for a follow-up office visit

e. all of the above


Clinical Case Problem 4: Communicating for Continuity


A 52-year-old white man presents to your office with prostate cancer. It has been previously treated with surgery, and his primary care physician has been following his PSAs. He has moved across the country for job-related reasons and is seeking a new primary care physician.



10. Communication with cancer patients is particularly problematic because


a. it is always bad news

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on Physician-Patient Relationship

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