Physicians who choose rural practice are called upon to deliver care that they have limited experience with, most notably in emergency situations when they are the most skilled people around.
Although patients’ medical gender transition can be facilitated by counseling, as a matter of medical ethics, informed consent must be obtained for treatment.
AMA J Ethics. 2016;18(11):1079-1085. doi:
10.1001/journalofethics.2016.18.11.ecas2-1611.
Timothy Cavanaugh, MD, Ruben Hopwood, MDiv, PhD, and Cei Lambert, MFA
The informed consent model for gender-affirming medical treatment emphasizes patient autonomy in choosing care without involving mental health professionals.
AMA J Ethics. 2016;18(11):1147-1155. doi:
10.1001/journalofethics.2016.18.11.sect1-1611.
Particularly in a small community, patients may want to avoid the social stigma of seeking mental health care by receiving it from their primary care physician—who may know them well enough to have some insights an unfamiliar specialist would not.
Trainees’ expectations and cultural awareness should be managed, and their activities supervised, to create a global health elective that benefits both visiting students and the host country.