Physician-Patient Relationship
The relationship between a physician and his or her patient can be one of the most critical factors in determining what action the patient takes after an injury. There is a perception, which may or may not be valid, that the relationship between patients and their physicians has, over recent years, deteriorated. This may have to do with compensation issues, insurance coverage or simply the increased workload. Many physicians deem it necessary to shorten patient visits to maintain their practices.
Physicians may have a direct relationship with a patient, deal with them through guardians or, for the pediatric patient, through a parent. ELM programs explore the multiple relationships which a physician may have with the patient or a surrogate and how the physician should approach the establishment, maintenance and dissolution of the physician-patient contract. ELM programs examine how much contact is necessary to constitute the establishment of a physician patient relationship, the role of the consultant and what constitutes a referral. ELM examines the responsibilities of hospital based providers such as radiologists and pathologists to assure appropriate care, even if they never actually see or talk to the patient. ELM programs examine the relationship between supervisory physicians, residents and intermediate care providers and their patients, and how differences in opinion about proposed or actual management of the patient can be resolved.
ELM programs examine the appropriate management and disclosure of errors, both of the involved provider and of other providers. Specific examples guide providers through disclosure of error and the value, and appropriate manner, of saying “I'm sorry.” The physician patient relationship also involves all of the office staff, and hospital nursing personnel, who may be seen as extenders of the physician’s practice. ELM programs address appropriate guidance for these other providers.
At times it is necessary for a physician to unilaterally discontinue the care of a patient. ELM programs provide guidance as to appropriate methods for discontinuing care for the disruptive patient, the noncompliant patient and the patient that the physician determines should be cared for elsewhere. The physician will learn to differentiate discontinuance of care from abandonment of a patient.
Course Recommendations
YEAR ONE:
Accepting Patients I
Informed Consent I
Consultation & Referral I
YEAR TWO:
Communication: Disclosure I
Discontinued Care I
Minor Consent I
YEAR THREE:
Patient Conduct I
Duties to Non-Patients I
Provider Interaction I