PC Professional Ethics & Communication 3 — Questions and Answers
Question 1: A podiatrist learns that a patient's new diagnosis of diabetes may affect their driving ability. The patient refuses to inform the DMV. What should the podiatrist consider?
- Immediately notify the DMV without further discussion
- Explore state-specific mandatory reporting laws and discuss the issue thoroughly with the patient (Correct answer)
- Discharge the patient from the practice
- Document nothing to avoid liability
Correct answer: Explore state-specific mandatory reporting laws and discuss the issue thoroughly with the patient
State laws vary on mandatory reporting; the podiatrist must know applicable law and counsel the patient on safety and legal obligations.
Question 2: Which communication technique is most effective when breaking bad news to a patient about a serious foot complication?
- Deliver all information quickly to minimize the patient's anxiety time
- Use the SPIKES protocol: setting, perception, invitation, knowledge, empathy, summarize (Correct answer)
- Have a nurse deliver the news to preserve the physician-patient relationship
- Send a detailed letter so the patient can process the information privately
Correct answer: Use the SPIKES protocol: setting, perception, invitation, knowledge, empathy, summarize
The SPIKES protocol is the evidence-based standard for delivering serious medical news in a structured, compassionate manner.
Question 3: A podiatrist is asked to treat a patient who is also a close personal friend. The best approach is to:
- Treat the friend as any other patient with full documentation
- Provide informal treatment without creating a medical record to protect the friendship
- Refer the friend to a colleague to avoid dual-role conflicts (Correct answer)
- Provide treatment only for minor issues and refer for serious conditions
Correct answer: Refer the friend to a colleague to avoid dual-role conflicts
Treating close personal relationships creates dual-role conflicts that can compromise objectivity; referral to a colleague is generally preferred.
Question 4: Under the Americans with Disabilities Act (ADA), a podiatric practice must:
- Provide accessible facilities and make reasonable accommodations for disabled patients (Correct answer)
- Refer all disabled patients to specialized practices
- Charge additional fees to cover accommodation costs
- Only accommodate disabilities visible at the time of scheduling
Correct answer: Provide accessible facilities and make reasonable accommodations for disabled patients
The ADA requires healthcare practices to provide physical accessibility and reasonable accommodations to patients with disabilities.
Question 5: A patient signs an advance directive refusing amputation even to save their life. They later present unconscious with gangrenous foot requiring emergent amputation. The podiatrist should:
- Perform the amputation because saving life overrides documents
- Honor the advance directive after confirming its validity and consulting legal/ethics resources (Correct answer)
- Proceed if the family verbally consents
- Ignore the directive because the patient cannot currently reaffirm it
Correct answer: Honor the advance directive after confirming its validity and consulting legal/ethics resources
A valid advance directive represents the patient's autonomous decision and must be honored even in emergencies, after confirming its legal validity.
Question 6: Which practice best demonstrates cultural competence in podiatric care?
- Assuming all patients from the same country share identical beliefs
- Asking open-ended questions about cultural or religious factors that may affect treatment decisions (Correct answer)
- Treating all patients identically regardless of background to avoid bias
- Limiting cultural discussions to first-time appointments only
Correct answer: Asking open-ended questions about cultural or religious factors that may affect treatment decisions
Asking open-ended questions allows patients to share relevant cultural or religious factors that may influence care preferences and compliance.
Question 7: If a podiatrist suspects that an elderly patient is being financially abused by a caregiver, the required action in most U.S. states is to:
- Discuss concerns only with the patient and take no external action
- Report the suspicion to Adult Protective Services (Correct answer)
- Contact the caregiver directly to resolve the situation
- Document the concern and monitor for three visits before reporting
Correct answer: Report the suspicion to Adult Protective Services
Most states mandate healthcare providers to report suspected elder abuse, including financial exploitation, to Adult Protective Services.
PC Professional Ethics & Communication 3
A podiatrist learns that a patient's new diagnosis of diabetes may affect their driving ability.
The patient refuses to inform the DMV.
What should the podiatrist consider?