The federal requirement for providing emergency medical care to those who cannot pay has been unsuccessful in eliminating refusal of care and the practice of “patient dumping.”
This case illustrates how emergency physicians find themselves with an empty toolbox and must compromise to meet their responsibilities to patients and themselves.
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.