MMI Question Advice

[medstudent257]

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Hello,

So I've been trying to prepare for my upcoming MMI and came across the following question:

You are a family physician working in a practice with three colleagues. As a practitioner of family medicine, you treat people from “womb-to-tomb.” You are not on call today, but late in the afternoon you receive a call saying that one of your patients that is living in a nursing home is failing. Her family has signed a do-not-resuscitate (DNR) order, but they are now reconsidering and ask that you come immediately to discuss their options. You have already made a commitment to your spouse to come home for a family event. Discuss your course of action.

I'm wondering if an appropriate answer would be to say (generally) that despite my plans being personally important, I would still see the patient, as the situation is rather urgent. I would perhaps message my spouse and tell them I might be a little late . One the one hand, I could just as one of the doctors at my practice to see the patient and have them discuss the options. Despite this being a reasonable decision, I do know this patient and family better than anyone else and thus would be able to provide them with the best help possible. However, if it did become a reoccurring issue, I would provide them with resources (pamphlets, guides, counselors) that would be able to assist them with the decision.

Would this be seen as a wishy washy/inflexible cave to the patient?

 

[HomeSkool]

You'd go see the patient and tell your spouse you'd be late. Since this is your patient and it's an end-of-life discussion, it's inappropriate to punt to one of your partners. You may miss your family event, but that's part of the responsibility you and your spouse both accepted when you became a physician.

As an MMI interviewer, I'd interpret any other answer as a clear statement that you don't really want to come to my medical school.

EDIT: I would agree with @Matthew9Thirtyfive if this weren't an end-of-life discussion for an actively decompensating patient.

 

[Matthew9Thirtyfive]

You'd go see the patient and tell your spouse you'd be late. That's part of the responsibility you both accepted when you became a physician. As an MMI interviewer, I'd interpret any other answer as a clear statement that you don't really want to come to my medical school.

This is not the philosophy that I follow (I’d go see the patient as you said), but I don’t think it would be unreasonable for a physician to want to maintain some sort of boundary where the physician on call handles that sort of thing—eg, the patients are shared. It’s pretty common in OB, and I know some FPs do the same thing.

 

[medstudent257]

This is not the philosophy that I follow (I’d go see the patient as you said), but I don’t th7ink it would be unreasonable for a physician to want to maintain some sort of boundary where the physician on call handles that sort of thing—eg, the patients are shared. It’s pretty common in OB, and I know some FPs do the same thing.

That's what I was thinking

 

[Matthew9Thirtyfive]

EDIT: I would agree with @Matthew9Thirtyfive if this weren't an end-of-life discussion for an actively decompensating patient.

Fair enough. Like I said, I would 100% see the patient.