Role Of A Physician

Question 1

Fallibilism

Answer 1

Need to accept that we may be wrong
Making fateful decisions on sometimes uncertain, incomplete evidence

Need to be self reflective: could I be wrong? What else could it be?

Interpretation of patient presentation, or treatment may be wrong

Need:
Self-awareness
Openness to criticism

Question 2

Differential diagnosis

Answer 2

Trial and error process; recommending tests and consultations that would help favour one diagnosis over another

Question 3

Two basic commitments when approaching ethics

Answer 3

Respect for humans/ human dignity

Fidelity to reason and critical appraisal

Question 4

Trust in medicine

Answer 4

Informational transparency

Patient involvement

Question 5

What to consider when making a clinical decision

Answer 5

1. Research, evidence-based medicine)

Question 6

Cultural sensitive

Answer 6

Use professional translater when possible (family members may change words or in worst case, hide abuse ie spousal abuse)

Question 7

When can you breach confidentiality

Answer 7

If patient is in imminent or serious danger

Question 8

Primary care provider

Answer 8

Concerned with long term care (long term trust)

Question 9

Why is important to conduct a patient based interview

Answer 9

Learn patients’ preferences, needs, views, interests

Based on autonomy, respect for persons

Patient feels respected, heard, valued, empowered

Question 10

Difficult parts of being a physician

Answer 10

• Endless paperwork
• Stress, emotional impact of caring for people who can’t be cured
• Losing patients
• long hours, burnout

Turn it into a positive:

• taking care of mental health
• debriefing with colleagues (Princess Margaret debrief anecdote)