Spandorfer J, Pohl C, Nasca T, Rattner SL, eds. Professionalism in Medicine : A Case-Based Guide for Medical Students. Cambridge: Cambridge University Press; 2010.
Video: Commitment to Improving the Quality of Care
A fourth year student is doing an office-based primary care clerkship. In this very busy practice, the student typically sees every third patient and presents the information to the physician and they then see the patient together. Today they are 45 minutes late. The student and physician see an elderly man who has atrial fibrillation and has had difficulty staying at a therapeutic anticoagulant level while on warfarin. The physician evaluates the patient and adjusts the warfarin. After the physician leaves, the student elicits the additional history that the patient consumes about six beers daily.