How to Be a Friend Who Is a Physician Without Being a Physician Friend.

As physicians, we are often asked for advice when loved ones become ill. Sometimes, the request advice is explicit; often, it is more supportive in nature and this may blur the boundary between being a friend and being a physician. Through various excerpts from social medial exchange, this narrative discusses the experience with a friend who was diagnosed with head and neck cancer during my Palliative Medicine Fellowship.

Ethics committees in small, rural hospitals in East Tennessee.

BACKGROUND: Little research has been conducted to observe the impact that rural settings have on the structure and function of hospital ethics committees. Additionally, studies need to focus on ethics committees, as it is often the body which protects the values of the community as globalization increases. The purpose of this study is to provide an overview of ethics committees in rural hospitals in East Tennessee. METHODS: From a list of fifteen hospitals in East Tennessee, eleven hospitals in communities of 15,000 people or less were contacted, ten of which had functioning ethics committees. Phone calls were made to identify members of the ethics committee and interviews were set up with nine of the hospitals. A structured interview format was used to address the range of topics. Hospital size ranged from 6 to 230 beds. RESULTS: The most unique trait afforded to small hospital ethics committees was their ability to communicate effectively and efficiently due to their small size. The culture of the area subtly impacted the type of issues the committees faced as did the hospital network affiliation. CONCLUSIONS: While connection to a network provides abundant resources, small hospital size reduces the inefficiency created by the bureaucracy of larger hospitals and enhances communication. Ethics committees in rural hospitals are variably effective and contain a level of organization comparable to that of larger hospitals.