Telling a patient she has herpes, Sample meds in the wrong hands, Our obligation to judge who shouldn't be driving, Are noncompete clauses unethical?
Family physician Elisa Payne's dilemma over informing a woman in a presumably stable marriage that she has genital herpes shows how social issues surrounding a disease can be as problematic as the physical effects of the disease itself ["To tell or not to tell," May 10].
It also shows how much Payne may have underestimated the workings of the human immune system. A recent study showed that about 80 percent of participants with lab evidence of herpes exposure had never reported any symptoms. Clearly, most people's immune systems can hold the virus in check. Under stress, however, the virus could rear its head, much like chicken pox erupts as shingles years later.
Perhaps the outbreak Dr. Payne observed was only the manifestation of an old infection that escaped detection initially because no one had any reason to be looking. Now due to some stressor, the first outbreak is observed. Presenting this possibility may ease a troublesome concern for the patient and, at the same time, allow the physician to keep her patient fully informed about the nature of her disease.
Bob DiDonato, MD
N. Fort Meyers, FL
I think your experts downplayed the danger of office staffers taking home sample medications ["Practice Management Q&A: When employees walk off with office supplies," May 10].
Staff members who help themselves to sample medications are doing more than "borrowing" or even stealing; they are practicing medicine without a license. Using sample medication for themselves or family members without permission is both illegal and perilous, not to mention ethically questionable as the samples are intended for patient use.
Even a sample antibiotic taken home because "I know she has another ear infection" may have grave or even fatal consequences.
Kristin K. Elliott, MD
Shame on FP Bernd Wollschlaeger, who can't bring himself to ground an elderly patient who is no longer capable of driving safely if he has no real alternative for transportation ["How to talk an elderly patient off the road," May 24].
It's not easy to be the "bad guy," but we have an obligation to the patient and to society. I hope none of my family or friends becomes the victim of an impaired elderly driver because a doctor didn't have the fortitude to act.
Denise M. Elser, MD
Oak Lawn, IL
In his letter to the editors ["An employer's take on the noncompete clause," May 24], B. Paul Quinn defends the employer's prerogative to restrict the right of a terminated doctor to practice nearby. It might interest Dr. Quinn, who is from Texas, that lawyers from that state are actually prohibited from entering into noncompete agreements. The State Bar of Texas holds that noncompetes unduly limit both professional autonomy of lawyers and the freedom of clients to choose an attorney.
It's time for the medical profession to show similar concern for our young doctors and the public who needs access to them, andhard as it may be to admitrise to the ethical standards of lawyers.
Russell W. Faria, DO
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Letters to the Editors. Medical Economics 2002;16:8.