Tena TC, Sánchez GJM

Language: Spanish
References: 27
Page: 553-559
PDF size: 64.69 Kb.

ABSTRACT

More than ever the physician-patient relationship is deteriorated by diverse factors, among these liability complaints stand out, and have propitiated the practice of defensive medicine, an attitude considered in many countries as inappropriate, expensive and unethical. Defensive medicine widens the distance between a physician and his patient. To revert this vice and its noxious effects which corrupt the patient-physician relationship in our country, we propose that physicians put to practice actions which permit the renewal of the essence of humanistic medicine in their daily practice and the restoration of the relationship. These changes in attitude sum up to a proposition of professional practice which we have denominated assertive medicine. This offer is resumed in four points: 1) Maintain a proper verbal and non verbal communication with each patient, 2) Keep continuously up to date skills, knowledge and abilities, 3) Respect the patient’s rights and 4) Defend their own rights as physicians.

REFERENCES

1. Albury WR, Weisz GM. The medical Ethics of Erasmus in the physician-patient relationship. Med Human 2001;27(1):35-41.

2. Robles T. Concierto para cuatro cerebros en psicoterapia. México: Alom, 1990;p:223.

3. Coulehan JL, Platt FW, Eger B, Frankel R, et al. “Let me see if I have this right…” Words that build empathy. Ann Intern Med 2001;135 (3):221-7.

4. ABIM Foundation, ACP–ASIM Foundation, European Federation of Internal Medicine. Medical Professionalism in the New Millennium: A Physician Charter. Ann Intern Med 2002;136(3):243-6.

5. Smith R. Why are doctors so unhappy? There are probably many causes, some of them deep. BMJ 2001;322 (7294):1073-4.

6. Ham K. The medical profession, the public, and the government. BMJ 2002;324(7341):838-42.

7. Palmisano DJ. Health care in crisis: the need for a medical liability reform. Yale J Health Policy Law Ethics 2005;5(1):371-83.

8. Mechanic D. Physician discontent: challenges and opportunities. JAMA 2003;290(7):941-6.

9. Schoenbaum SC, Bovbjerg RR. Malpractice reform must include steps to prevent medical injury. Ann Intern Med 2004;140(1):51-53.

10. Studdert DM, Mello MM, Sage WM, DesRoches CM, et al. Defensive medicine among high-risk specialist physicians in a volatile malpractice environment. JAMA 2005;293(21):2609-17.

11. Kereiakes DJ, Willerson JT. Health care on trial: America’s medical malpractice crisis. Circulation 2004;109(24):2939-41.

12. Brooks RG, Menachemi N, Hughes C, Clawson A. Impact of the medical professional liability insurance crisis on access to care in Florida. Arch Intern Med 2004;164(20):2217-22.

13. Povar GJ, Blumen H, Daniel J, Daub S, et al. Ethics in practice: managed care and the changing health care environment. Ann Intern Med 2004;141(2):131-36.

14. Bates AS, Harris LE, Tierney WM, Wolinsky FD. Dimensions and correlates of physician work satisfaction in a midwestern city. Med Care 1998;36(4):610-17.

15. Cosby KS. A framework for classifying factors that contribute to error in the emergency department. Ann Emerg Med 2003; 42(6):815-23.

16. Weingart SN, Iezzoni LI. Looking for medical injuries where the light is bright. JAMA 2003;290(14):1917-9.

17. Ansbacher R, Richards BC. Professional liability: Not just caps on indemnity. Obstet Gynecol Surv 2005;60(9):559-61.

18. Rivera-Cisneros AE, González NJ, Martínez-López S, Campos-Castolo M, et al. Estudio exploratorio sobre la enseñanza de la comunicación humana asociado a la práctica médica. Cir y Cir 2003;71(3):210-6.

19. Runciman WB, Merry AF, Tito F. Error, blame, and the law in health care, an antipodean perspective. Ann Inter Med 2003;138(12): 974-9.

20. Hevia A, Hobgood Ch, Lewin M. Medical error during residency: tell or not to tell. Ann Emerg Med 2003;42(4):565-70.

21. Sandars J, Esmail A. The frequency and nature of medical error in primary care: Understanding the diversity across studies. Fam Pract 2003;20(3):231-6.

22. Gonçalves-Estella F, Aizpiri-Díaz F, Barbado-Alonso JA, Cañones-Garzón PJ, et al. Síndrome de Burn-out en el médico general. Medicina General 2002;43:278-83.

23. Tena TC, Ruelas BE, Sánchez-González JM, y col. Derechos de los médicos: experiencia mexicana para su determinación y difusión. Rev Med IMSS 2003;40(6):503-8.

24. Tena TC, Ruelas BE, Sánchez-González JM, y col. Derechos de los pacientes en México. Rev Med IMSS 2002;40(6):523-9.

25. Lange NP, Jakubowaki PA. Assertive behavior and clinical problems of women. In: Alberti RE (ed). Assertiveness: Innovations, aplications, issues. California: Impact, 1976;pp:415-7.

26. Alberti RE, Emmons ML. Your perfect right: A guide to assertive behavior. California: Impact, 1978;pp:75-86.

27. Zuger A. Dissatisfaction with medical practice. NEJM 2004; 350(1):69-75.