The U. S. health care system encourages patients to take more responsibility for their own treatment decisions and expects their doctors to cooperate in that effort. But the guidelines for exercising that responsibility remain very murky indeed.
Fibromyalgia, with no positive tests, is a “foreigner” in the medical landscape. Medicine looks for signs of pathology, changes in the structure or function of organs. The mantra of physicians facing patients with fibromyalgia: “Your tests are normal.”
Katrina A. Bramstedt, PhD and Francis L. Delmonico, MD
Transplant centers cannot regulate how people establish relationships, but when a donor-recipient pair comes together through Internet solicitation, the center must assess the donor’s motivations carefully.
You are not just the rural patient’s doctor, you are the doctor for the football team, a friend, and perhaps a relative; you speak on health at local schools and are expected to attend fundraisers.
Transparency about teaching hospitals’ educational mission respects patient autonomy and aligns patients’ interests with those of trainees and the public.
If a patient’s feelings become sources of resistance to treatment, clinicians need to know how to address these feelings’ influence on the therapeutic capacity of patient-clinician relationships.