Dialogue Volume 12 Issue 4 2016 | Page 56

practice partner
( iii ) the rent is normal for the area in which the premises are located , and
( iv ) the amount of the rent is not related to the referral of patients to the landlord ;
As the regulation makes clear , if a physician elects to rent premises from a pharmacy , she / he must pay market rate that is normal for that area , and the rent cannot be related to referral of patients to the pharmacy . Patients must be able to freely choose the pharmacy at which they wish to have their prescriptions filled . Physicians should not coerce or unduly influence patients into using a specific pharmacy . As with any business contract or venture , the College strongly advises members to seek out an independent legal opinion to ensure that their proposal conforms to all relevant regulations and policies . If you have questions about this or any other practice related issue , please contact the Physician Advisory Service at 1-800-268-7096 extension 606 . MD
Family Histories
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other during this tough time . This patient ’ s own well-being was being compromised . “ Family comes into play . It can ’ t be excluded ,” says Dr . Ash . As the journal Family Practice Management once stated : “ Maneuvering among phantom family members in the room is an intricate dance . The first step is to become aware of their unseen presence .” When doctors confront family dynamics related to a patient ’ s health , that presence isn ’ t always unseen . For example , there are frequent opportunities in medicine to directly interact with family members – when they come to appointments together with your patient , or when they appear in hospital rooms . That can be positive . Families can ask questions and share information . They can be advocates and convey their wishes . They provide emotional and practical support . All of that can be important in ensuring the best health care and decisions . Yet when all these views emerge , the doctor ’ s ultimate responsibility remains to his or her patient . In talking to family members , doctors might perceive abnormal or negative family dynamics ( another reason to ensure private time with the patient ) or simply conflicting beliefs . End-of-life periods are a prime example , where family values can be expressed in different ways . Like in switching from treatment to palliative care . Or in cases where family members ask the doctor to tell or don ’ t tell the patient about the severity of the condition . “ That can be a very challenging situation for physicians ,” says Dr . Brown . “ Often it ’ s a matter of understanding the family ’ s values and expectations , and trying to see the impact it has on the patient . Within that , you try to find common ground .” In this dynamic , however , one person matters most . “ I don ’ t talk about person-centred care or family-centred care ,” says Dr . Brown . “ My preference is to talk about patient-centred care , recognizing that the family is part of that care on some level . The patient comes first – that ’ s the priority .” MD
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Dialogue Issue 4 , 2016