Transference phenomena in medical practice: being whom the patient needs

Article Abstract:

Transference is the mental process whereby a person transfers patterns of feeling and behavior that had previously been experienced with important figures such as parents or siblings to another person. This process often affects the physician-patient relationship, and can determine how patients behave during an encounter with a physician. Transference can also affect whether the patient will adhere to the physician's orders regarding their treatment. The physician also brings certain biases and emotional needs to the physician-patient relationship that will eventually shape the outcome of their relationship. The physician-patient relationship is a skewed one, because the patient needs the physician more than the physician needs the patient; the patient reveals more about him- or herself than the physician does; and the physician may explore certain anatomical parts of the patient that are usually kept private. During transference, the patient may, through word choices or dress, be openly seductive to the physician and it is important that physicians learn to identify and deal with this possibility. Additionally, patients may also give the physician gifts as a nonsexual means of seduction. When done as means of manipulating the physician, the practice should be discouraged without rejecting the patient. When a patient's relationship needs are not attended to in the office, the patient may develop physical symptoms that have no discernable causes. It is suggested that physicians tailor their approaches to the relationship needs of different patients while maintaining a certain distance from their patients so as not to overstep appropriate boundaries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Case studies, Telecommunications systems, Physician and patient, Physician-patient relations, Patients, Transference (Psychology)

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Maintaining the confidentiality of medical records shared over the Internet and the World Wide Web

Article Abstract:

The Boston Electronic Medical Record Collaborative has designed a protocol that must be met by any security technology to be used in the transfer of patient records over the Internet or World Wide Web. The potential benefits of being able to instantly transmit a patient's medical records as needed to a hospital emergency department are considerable, if patient confidentiality is protected. The protocol sets requirements for access, patient consent, authentication and other aspects of confidentiality balanced against the need for instant information.

Usage, Safety and security measures, Internet, Medical records, Hospitals, Hospital emergency services, World Wide Web

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The Charter on Medical Professionalism and the limits of medical power

Article Abstract:

The Charter on Medical Professionalism created by the American College of Physicians Foundation, the American Board of Internal Medicine Foundation, and the European Federation of Internal Medicine implies that doctors alone can create an ethical health care system. Doctors must partner with other groups, including patients or their advocates and representatives from health care institutions. Public health officials must also be involved in this effort.

Editorial, Medical ethics

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