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.
The physician must consider the potential benefits of the new procedure and then determine, through discussion with the patient, what value the patient places on those specific benefits.
The causes of many health behaviors are deeply rooted in our culture, and using a counseling model that assumes individual control and responsibility for these behaviors can cause patients to feel hectored instead of helped.
The Boston Health Care for the Homeless Program (BHCHP) seeks to build trusting relationships with patients before addressing their medical needs and to take account of their surrounding environment in treatment.
AMA J Ethics. 2015;17(5):469-472. doi:
10.1001/journalofethics.2015.17.5.mnar2-1505.