Palliative Care and Physician Impairment

Question 1

What is palliative care?

Answer 1

Relief of physical, psychological, spiritual and social suffering
Can be initiated at any point in illness
Are not forgoing treatment just want to relieve the pain
Expected prognosis greater than 6 MONTHS

Question 2

In regards to stress, there is direct and indirect ways to relieve stress. what is another term for indirect way to relieve stress?

Answer 2

Palliate the stress

example: you go run 10 miles due to a stressful day at work

Question 3

What is hospice?

Answer 3

When cure is not possible
provide palliative care for terminally ill patients
expected survival of less than 6 MONTHS
Forgo disease directed therapies

Question 4

What does SPIKES mean in regards to giving patients bad news? (not really that important)

Answer 4

S: setting up the interview
P: perception of the patient 
I: invitation 
K: knowledge 
E: emotions/empathy
S: Strategy/Summary

Question 5

When it comes to giving a prognosis, always ask the patient what?

Answer 5

what they want to know

Question 6

Less than what percent of cardiac arrest victim survive to hospital discharge?

Answer 6

5%

Question 7

Surrogates need to think in terms of what ??

Answer 7

the patient would want (not what they want for the patient)

Question 8

Moderate and severe pain requires combination of what?

Answer 8

scheduled pain medicine and prn dosing

Question 9

For patients with chronic stress what about direct and palliative options, do you reverse the effects?

Answer 9

no, you still have chronic stress

Question 10

What is grief?

Answer 10

emotional response to a loss

Question 11

What is anticipatory grief?

Answer 11

family adjusts to idea of life without loved one

Question 12

What is complicated grief?

Answer 12

purposelessness, disbelief, emotional detachment

Question 13

What is impairment in terms of doctors?

Answer 13

Inability of a licensee to practice medicine with reasonable skill and safety

Question 14

What is the most common abused substance?

Answer 14

Alcohol abuse equal to general population

opiate addiction and other prescription drugs are over represented in MDs

Question 15

MDs have elevated rate of suicide compared to general population. Unlike general population where more men than women complete suicide, among MDs, what is it?

Answer 15

roughly equal

Question 16

What is sexual harassment?

Answer 16

Unwanted and repeated verbal or physical advances, derogatory statements or sexually explicit remarks, sexually discriminating comments

Question 17

Does physical illness limit MD from practicing?

Answer 17

of course not

unless you have something like parkinson or MS

Question 18

What are some examples of misconduct?

Answer 18

Misprescribing controlled substances

Sexual boundary violations

Question 19

What is a disruptive physician

Answer 19

personal conduct whether verbal or physical, that negatively affects or that potentially may negatively affect patient care