Daphne C. Ferrer, MD and Peter M. Yellowlees, MBBS, MD
Telepsychiatry extends access to psychiatric treatment to those who might not otherwise get it, but licensure problems and the risk of boundary violations between patients and physicians need to be worked out.
Rachel O. Reid, MD, MS and Ateev Mehrotra, MD, MPH
An effective policy regarding retail clinics in a primary care practice should address patients' need for timely and convenient acute care and build capacity for enhanced access to acute care within the primary care clinic itself.
Physicians need to manage expectations and clearly explain the prognosis of ICU patients to their families, particularly when the outcome is a negative one.
Physicians should be aware of the level of emotional distress and suffering that a patient is experiencing as a result of his or her illness and incorporate that into the patient's treatment plan.
Physicians should demonstrate compassion when the parent of an ill child asks the physician for his or her personal opinion regarding the parents' choice to continue experimental treatment when the prognosis is not good.
Physicians who treat children with Down's syndrome should ensure that their parents fully understand the children's capabilities and long-term prognosis and counsel them on the appropriate actions to take regarding their children's care.
Physicians should go beyond basic medical diagnosis and treatment to offer support to families about the gamut of social and emotional issues that are involved with caring for a severely disabled child.