The Journal of Bone and Joint Surgery (American). 2008;90:208-210.
doi:10.2106/JBJS.G.01176
© 2008 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the exam for this article:
 CME 1: January, February, March 2008 (publication date April 4, 2008; expir...
Right arrow Letters to the Editor: Submit a response
Right arrow Letters to the Editor: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Capozzi, J. D.
Right arrow Articles by Gantsoudes, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Capozzi, J. D.
Right arrow Articles by Gantsoudes, G.
Related Collections
Right arrow Ethics in Practice
Right arrow Elbow
Right arrow Ethics
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Ethics in Practice

Terminating the Physician-Patient Relationship

James D. Capozzi, MD1, Rosamond Rhodes, PhD2 and George Gantsoudes, MD2

1 Mount Sinai Medical Center, Manhattan Orthopedic and Sports Medicine Group, 1065 Park Avenue, New York, NY 10128. E-mail address: capoz5{at}aol.com
2 Departments of Bioethics Education (R.R.) and Orthopaedics (G.G.), Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

A.G. is a thirty-six-year-old reading teacher who presented to an orthopaedic surgeon with patellofemoral pain. After an appropriate evaluation, the physician suggested a course of physical therapy and anti-inflammatory medication. The patient asked for and received time off from her work, stating that her job required her to climb stairs. At multiple follow-up visits, A.G. was found to be poorly compliant with physical therapy and home-exercise programs. Her only interest appeared to be in securing the doctor's letter of support for an extended medical leave. At each visit, she demanded that the physician write a letter stating that she was unable to work as a reading teacher due to knee pain. At one point, she became belligerent with the medical office staff when the letter was not prepared.

When her physician tried to elicit information about whether there were any unaddressed obstacles to rehabilitation treatment, A.G. did not answer the questions. Instead, she explained that her job required her to climb stairs and that she was unable to return to work because of the continued knee pain. The physician explained that, on the basis of his examination and assessment, he expected that her pain would improve if she complied with the treatment plan.

After multiple visits, the orthopaedic surgeon counseled the patient that he did not see that his attempts to help her were providing any benefit and that perhaps it would be best for her to seek help from another physician. A.G. replied that she did not want to start going to another doctor. She stated emphatically that he was her doctor, that she was paying him, and that she wanted a letter saying that she should be granted an extended medical leave from work because of her inability to climb stairs. After this encounter, the surgeon thought it best to terminate the professional relationship.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


Letters to the Editor:

Read all Letters to the Editor

A Psychologist Responds
Dorothea Z. Lack, Ph.D.
JBJS Online, 7 Jan 2008 [Full text]
Dr. Capozzi et al. respond to Dr. Lack.
James D. Capozzi, M.D., et al.
JBJS Online, 23 Jan 2008 [Full text]