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.
Survey of faculty physicians at the University of Pennsylvania led to a list of proposals for health care reforms beyond those included in the Affordable Care Act.
AMA J Ethics. 2015;17(7):680-688. doi:
10.1001/journalofethics.2015.17.7.sect2-1507.
An adolescent patient with poor social support who has already lost one transplanted kidney due to complications of nonadherence may not automatically be inappropriate to list for a second transplant if he can prove his ability to adhere to the demands of a dialysis regimen.