A 35-Year-Old Woman Established Primary Care at a Clinic 3

question 1597

Multiple Choice

A 35-year-old woman established primary care at a clinic 3 months ago.  Last month, she arrived unannounced, urgently requesting to see the same physician.  Due to a cancellation, she was seen later that day for the complaint of a rash on her chest.  The male physician completed a thorough but unremarkable physical examination in the presence of a female nurse practitioner.  Two weeks later, the patient comes to the same physician's office at closing time and without an appointment.  She complains of "needing to talk to the doctor immediately about a private matter."  She informs the receptionist that it is "absolutely critical" for her to be seen and examined for similar skin complaints that seem to "come and go" and "itch frequently."  The patient is calm but insists that an appointment with the female nurse practitioner is not acceptable and instead requests to see the physician privately, without the presence of another staff member.  Which of the following would be the most appropriate initial response by the physician?

• A)Ask the patient to have a seat in the office and proceed with the unscheduled appointment.
• B)Have the receptionist contact security to remove the patient from the premises.
• C)Have the receptionist instruct the patient to schedule an appointment during normal office hours.
• D)Instruct the receptionist to inform the patient that she must leave and not return to the clinic.
• E)Transfer the patient's care to a partner who is on call for the evening and available by phone.

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Definitions:

Psychodynamic Theorists

Scholars and clinicians who emphasize the systemic study of the psychological forces that underlie human behavior, feelings, and emotions and how they might relate to early experience.

Obsessive-Compulsive

Referring to Obsessive-Compulsive Disorder (OCD), a mental disorder where individuals have recurring, unwanted thoughts (obsessions) and behaviors (compulsions) that they feel the urge to repeat over and over.

Anal Stage

In psychoanalytic theory, the second 18 months of life, during which the child’s focus of pleasure shifts to the anus.

Dependent Personality Disorder

A psychiatric condition marked by an excessive emotional or psychological reliance on another person.