AMA Journal of Ethics^®

Kelly Leonard, executive director of insights and applied improvisation at Second City Works, relates how improvisation can help clinicians build relationships with patients and improve their outcomes.

Success depends on strong support, rehabilitation, adherence, and social integration.

Caring for the elderly imposes financial burdens and strains families. System changes are necessary to mitigate these problems.

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.

A carefully constructed consent and treatment plan is outlined for a neglected and abused child hospitalized with a severe behavioral disorder.

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 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 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.