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.
When deciding whether to offer deep brain stimulation earlier than usual for Parkinson disease, it is important to consider not only the patient’s autonomy but also the validity of the evidence and concepts of harm that are being used to form practice policies.