When It’s Not Your Patient

Physicians accept exacting responsibility for their patients’ health—they profess to be clinically competent and compassionate, to respect the patient’s autonomy and protect confidentiality; in general, to put the patient’s interests above their own. These professed duties make it critical to distinguish who is a patient from who is not. This month’s authors examine the circumstances under which a physician enters into a patient-physician relationship with someone and how the practice of medicine in the twenty-first century has changed that relationship.

Volume 14, Number 5: 363-436 Full Issue PDF
  • Case and Commentary
    May 2012

    Requests for Care from Family Members

    Erik K. Fromme, MD, MCR
    When family members request treatment, physicians should attempt to see that they get good care, preserve good relationships with them, and put neither themselves nor their relatives at risk.
    Virtual Mentor. 2012;14(5):368-372. doi: 10.1001/virtualmentor.2012.14.5.ccas1-1205.
  • Case and Commentary
    May 2012

    Responsibility for Patients after the Handoff

    Robert Macauley, MD
    What professional responsibility does a physician have for a patient after handing the case off to those in the subsequent shift? Should he or she comment on the next team’s approach to care?
    Virtual Mentor. 2012;14(5):373-377. doi: 10.1001/virtualmentor.2012.14.5.ccas2-1205.
  • Case and Commentary
    May 2012

    A University Physician's Duty to Nonpatient Students

    Cynthia Geppert, MD, MA, PhD, MPH
    A physician in a university student health center may feel a duty to intervene when he finds out from a patient that a student who is not a patient is diverting medication, but doing so would violate patient confidentiality.
    Virtual Mentor. 2012;14(5):378-382. doi: 10.1001/virtualmentor.2012.14.5.ccas3-1205.
  • Medical Education
    May 2012

    A Longitudinal Approach to Handoff Training

    Jeanne M. Farnan, MD, MHPE and Vineet M. Arora, MD, MAPP
    Overview of a program for medical students, residents and fellows, and academic medical center faculty to train them in useful handoff and handoff evaluation techniques.
    Virtual Mentor. 2012;14(5):383-388. doi: 10.1001/virtualmentor.2012.14.5.medu1-1205.
  • Medical Education
    May 2012

    Turfing Revisited

    Catherine V. Caldicott, MD
    When a patient is turfed, the interdisciplinary relationships take on the characteristics of a power play. In medicine, duties to patients are paramount, and some physicians appear to consider themselves in some ways exempt from that duty.
    Virtual Mentor. 2012;14(5):389-395. doi: 10.1001/virtualmentor.2012.14.5.medu2-1205.
  • Health Law
    May 2012

    When Is a Patient-Physician Relationship Established?

    Valarie Blake, JD, MA
    The legal definition of a patient and the corresponding duties of the physician have been debated in state courts for over a century, and many aspects of the question are still unresolved.
    Virtual Mentor. 2012;14(5):403-406. doi: 10.1001/virtualmentor.2012.14.5.hlaw1-1205.
  • State of the Art and Science
    May 2012

    The Patient, the Physician, and Dr. Google

    Bradford W. Hesse, PhD
    Rather than creating an environment of disintermediation, information in the absence of an intermediary, the Internet may be creating an environment of apomediation, information surrounding all parties. This puts the medical team in the position of interpreter or guide.
    Virtual Mentor. 2012;14(5):398-402. doi: 10.1001/journalofethics.2012.14.5.stas1-1205.
  • Policy Forum
    May 2012

    Physician Assistants and Their Role in Primary Care

    James F. Cawley, MPH, PA-C
    The author argues that long-term trends point to a future for physician assistants and nurse practitioners as the principal front-line deliverers of primary care, with physicians focusing on managerial duties and specialty care.
    Virtual Mentor. 2012;14(5):411-414. doi: 10.1001/virtualmentor.2012.14.5.pfor2-1205.
  • Medicine and Society
    May 2012

    Individualism, Solidarity, and U.S. Health Care

    James E. Sabin, MD
    When the tension between solidarity and individualism hardens into entrenched oppositional politics, attempts to widen health care coverage are stymied.
    Virtual Mentor. 2012;14(5):415-418. doi: 10.1001/virtualmentor.2012.14.5.msoc1-1205.
  • Personal Narrative
    May 2012

    A Medical Student-Cadaver Relationship

    Helena Winston, MSc, MPhil
    The medical student's anatomy-lab cadaver is not exactly a patient, but neither is the cadaver merely an object.
    Virtual Mentor. 2012;14(5):419-421. doi: 10.1001/virtualmentor.2012.14.5.mnar1-1205.
  • Viewpoint
    May 2012

    Follow-Up after a Health Fair

    Carolyn T. Bramante, MPH and John Song, MD, MPH, MAT
    Though they seem inocuous, health fairs can pose an unexpected risk to patients if the follow-up prevents patients from seeking routine medical care.
    Virtual Mentor. 2012;14(5):422-425. doi: 10.1001/virtualmentor.2012.14.5.oped1-1205.