Page 44 - Hard Goals

Heartfelt 35

they thought about them as unique individuals rather than as
anonymous members of a group of people with the same medi-
6
cal issues. Physicians were given different medical scenarios and
asked to choose the most appropriate treatment. There were two
versions of each scenario: one described an individual patient,
the other described a group of patients. Here’s an example:

• The individual perspective: For example, H.B. is a young
woman well known to her family physician and free from any
serious illnesses. She contacts her family physician by phone

because of five days of fever without any localizing symptoms.
A tentative diagnosis of viral infection is made, symptomatic
measures are prescribed, and she is told to stay “in touch.” After
about 36 hours she phones back reporting feeling about the
same: no better, no worse, no new symptoms. The choice must
be made between continuing to follow her a little longer by tele-
phone or else telling her to come in now to be examined. Which
management would you select for H.B.?
• The group perspective: For example, consider young
women who are well known to their family physicians and free
from any serious illnesses. They might contact their respective

family physicians by phone because of five days of fever without
any localizing symptoms. Frequently a tentative diagnosis of
viral infection is made, symptomatic measures are prescribed,
and they are told to stay “in touch.” Suppose that after about
36 hours they phone back reporting feeling about the same: no
better, no worse, no new symptoms. The choice must be made
between continuing to follow them a little longer by telephone
or else telling them to come in now to be examined. Which
management strategy would you recommend?