Doctoring8-28 Flashcards
What is the protocol for delivering bad news?
SPIKES
Set the stage, Perception, Invitation, Knowledge, Empathy, Summary and strategy
Which health insurance reimbursement plan is most strongly associated with physicians providing more preventive care and health counseling services?
Capitation
Physicans get a fixed amount per enrollee. The cost of too many enrollee’s needing tests and treatment may become greater than the physicains payments. Thus, the physician is incentivized to catch illnesses early and keep patients healthy so they need fewer tests and procedures as they age.
When is it appropriate to ask the parent to leave so that you may speak to an adolescent patient alone?
Whenever the parents presence impedes your ability to get honest answers from the patient (i.e. drugs, alcohol, tobacco, sexual activity).
Under what conditions might a physician challenge a parent’s authority and obtain a court injunction to provide care for a pediatric patient?
If the child is at significant risk for harm and the treatment is life-saving. Only a competent adult can be discharged against medical advice.
Your patient is disoriented. Her friend says she is the medical proxy and does not wish to receive life sustaining medical care. Her husband says she would want every intervention available. Who should make the medical decisions concerning this patient?
The friend
A health care proxy is legally designated to make medical decisions in the event that the patient loses decision-making capacity. This proxy overrules all other possible surrogate decision makers.
