Jack M. Berger, MS, MD, PhD and Nalini Vadivelu, MD
Guidelines for the use of controlled substances for the treatment of pain now consider inappropriate treatment, including undertreatment of pain, a departure from an acceptable standard of practice.
Addicts quickly learn the diagnoses that cannot be definitively confirmed or ruled out by examinations or test results but that elicit prescriptions for opioid pain management.
Harm occurs when race is used as a proxy for characteristics stereotypically ascribed to members of a group, much as the obligatory mention of age is used to indicate the typical patient’s expected health status and vitality.
Physicians working in close-knit communities, whether small towns or urban neighborhoods, have to manage relationships with people who may be simultaneously patients and neighbors, friends, and business associates.
Many patients in settings where residents operate can only afford to seek care in a public hospital. The hospital, faculty, and resident surgeon must find ways to minimize the risk to those patients.
The physician must consider the potential benefits of the new procedure and then determine, through discussion with the patient, what value the patient places on those specific benefits.