The participatory decision-making model for patient-physician relationships is the best approach for addressing the individual family-related and social influences that stress that relationship.
Pairing medical students with chronically ill community volunteers for 2 years helps those students gain appreciation for the experience of illness, develop self-reflection and perspective-taking, and learn to communicate with people who may be quite unlike them.
The current Medicare operation—reimbursing medical goods and services to a growing number of people without basing the reimbursement benefit on the actual cost of the services—is unsustainable, but there are some possible remedies.
Chris Feudtner, MD, PhD, MPH, David Munson, MD, and Wynne Morrison, MD
The way that we choose how to frame the conversation with parents about halting or continuing such therapy for their children who will not recover has special importance in medicine and in society.
Physicians should demonstrate compassion when the parent of an ill child asks the physician for his or her personal opinion regarding the parents' choice to continue experimental treatment when the prognosis is not good.
Pediatricians should be aware of the cultural issues surrounding body image when they counsel certain patients and their parents about the importance of weight loss and the related health concerns.
Physicians who treat children with Down's syndrome should ensure that their parents fully understand the children's capabilities and long-term prognosis and counsel them on the appropriate actions to take regarding their children's care.