AMA Journal of Ethics®

Illuminating the art of medicine

Journal of Ethics Header

AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. January 2005, Volume 7, Number 1.

Module 1

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Case 1.2: Fundamentals of the Patient-Physician Relationship—Mr. Jones Keeps Calling

Case Presentation

Dr. Stevens opts to accept Mr. Jones as his patient, meeting him for the first time in the emergency room. During the first appointment after his hospitalization, Mr. Jones expresses shock about the emergency and is concerned that his medical condition is deteriorating. He tells Dr. Stevens that he hopes he will never need to give himself insulin shots. Dr. Stevens talks with Mr. Jones about his concerns, reiterating the need for him to watch his diet, exercise, and, now, take his oral medication correctly and regularly.

Mr. Jones leaves the office feeling like he has less to worry about. However, every time he mentions going to the emergency room, people tell him about their diabetes and relate horror stories about relatives or acquaintances who have had limbs amputated or gone blind. Mr. Jones again becomes concerned and anxious about his condition. He calls Dr. Stevens' office several times during the next month asking to talk with the nurse or, preferably, Dr. Stevens.

As Dr. Stevens' practice grows he has less time to consult with patients over the telephone, especially with the same patient asking the same questions over and over. In addition, Dr. Stevens gets the sense that Mr. Jones is not doing all that he should to monitor and manage his illness. Mr. Jones's anxiety keeps rising, and Dr. Stevens becomes frustrated.

What should Dr. Stevens do about Mr. Jones? (select an option)

A.   Tell Mr. Jones to schedule an appointment within the next two weeks and ask him to make a written list of his questions.
B. Tell Mr. Jones to "Come and see me when you're sticking to your diet and doing what I told you to do."
C. Tell the office assistant to explain to Mr. Jones that they will discuss his concerns during their next scheduled meeting time in three months.
D. Tell Mr. Jones that it would be helpful for him to see a diabetes educator at the hospital who could talk with him about appropriate diet and exercise.
The people and events in this case are fictional. Resemblance to real events or to names of people, living or dead, is entirely coincidental. The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.