Alternative TreatmentsAlternative or complementary medicine is a common term for health practices which are generally not available from modern physicians and hospitals. The physician should not abandon the patient who elects to try an alternative treatment. Requests by patients for alternative treatment require balancing the medical standard of care with a patient’s right to choose care on the basis of his or her values and preferences.
Such a request warrants careful attention from the physician. Before advising a patient, the physician should ascertain the reason for the request, for example, whether it stems from dissatisfaction with current care. The physician should be sure that the patient understands his or her condition, standard medical treatment options and expected outcomes.
The physician should encourage the patient requesting alternative treatment to seek literature and information from reliable sources. The patient should be clearly informed if the option under consideration is likely to delay access to effective treatment or is known to be harmful. The physician need not participate in the monitoring or delivery of alternative care to the patient. However, physicians should recognize that some patients may select alternative forms of treatment. This decision alone should not be cause to sever the patient–physician relationship.
Disability CertificationSome patients have chronic, overwhelming or catastrophic illnesses. In these cases, society permits physicians to justify exemption from work and to legitimize other forms of financial support.
In keeping with the role of patient advocate, a physician should assist a patient who is medically disabled in obtaining the appropriate disability status. Disability evaluation forms should be completed factually, honestly and promptly.
Physicians will often find themselves confronted with a patient whose problems may not fit standard definitions of disability but who nevertheless seems deserving of assistance (for example, the patient may have very limited resources or poor housing). Physicians should not distort medical information or misrepresent the patient’s functional status in a misguided attempt to help these patients. The trustworthiness of the physician is jeopardized, as is his or her ability to advocate for patients who truly meet disability or exemption criteria.