Doctor-Patient Confrontations Question?

Question:

My questions: What can a doctor do, if anything, when he or she suspects that a patient is not being honest about substance abuse (or anything relevant to their health)? Should Dr. X have told her that she smelled of cigarettes? Did he have a responsibility to confront her, to engage her more on the issue of smoking/quitting? Can a doctor make a so-called "deal" like he made - i.e., "I'll treat you if you hold up your end of the bargain?" What if such an arrangement were successful in motivating a patient to take care of himself or herself? Where does the physician's responsibility to the patient end?

Answers:
Although as a physician, Dr.X has a legal responsibility to his patient, sometimes a physician needs to go the extra mile for his patient. From what I've learned, if what Dr.X is doing is genuinely in the best interests of the patient, then he should be prepared to stick by any decisions he should make if and when he is confronted by the Board, which he may be if his methods are considered unethical. But a physician who genuinely cares about his patients and wants to go the extra mile will do so, and face the consequences. If there are any. It may be that nothing comes of it, or it may be that the patient wasn't what he thought they would be.
What I'm trying to say is that Dr.X should do what he feels is best for his patient, and accept any potential repercussions. That makes a good,, trustworthy doctor. And I believe this should apply in any case, not just any particular case. =)

I don't believe that a doctor can refuse to treat a patient because they are smoking and have promised that they will no longer do so, even though in doing so, they are killing themselves. I believe that the doctor has no right to refuse them treatment.

There is a thing called doctor-patient confidentiality, so your doctor cannot tell anyone of whether you do cigarettes/drugs or not, unless you are a minor, then he has the right to tell your parents. If he makes the "bargain", take him up on it, your life will be so much better. But, he will stop treatment if you do not hold up your end of the deal, even though he has sworn to treat all ailments..just a thought.

Legally a doctor is required to offer a patient help if he suspects them of using cigarettes, alcohol or drugs.

However, past that, they have no obligation.

I was at the dentist the other day, who asked if I wanted "help" with stopping smoking. I shrugged and said, sure if you've got the patch, I'm willing to try it.

He ran out all happy to get the prescription from the head dentist. Came back to tell me he couldn't do it, that I should go to my doctor. (Thanks for wasting my time! He apologized and told me he's required by law to ask, didn't expect a yes.)

So, doctors should probably mind there own business if a patient doesn't ask for help. Especially since with rules, regulations, laws, and fear of lawsuit and FDA sanction, they can't offer help or aren't willing to risk it when given the opportunity.

If you can find a Doc that cares enough to do this then I'd love to have that Dr as my Dr.,most Drs. are so busy they take care of what the patient complains about and not much more. It's the patients responsbility to tell the Dr about their own drug use etc., the patient should be honest to the Dr. to get the best health care and advise as possible. If its life threatening I would hope the Dr. would take blood tests to find out what chemcials are in the persons' system. I believe if a Dr put that much energy into my care as your asking, I would do my part and be motivated. I have one good Dr. like that she's a back/pain specialist and she saved my life by checking a lump three other doctors said was nothing to worry about, so yeah I have one good Dr. and she's amazing and I'm honest with her, why wouldn't I be I'm going for a reason and that's to get better. Good luck with your doc. Sorry I started ebabbling

Doctor-Patient Confrontations Question?

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