Intended for healthcare professionals


Beyond etiquette based medicine

BMJ 2014; 349 doi: (Published 04 August 2014) Cite this as: BMJ 2014;349:g4809
  1. Brian J Secemsky, resident physician, Department of Internal Medicine, University of California – San Francisco, San Francisco, CA
  1. brian.secemsky{at}

I was introduced to Ms B earlier this year as a new patient in my outpatient continuity panel. Her demographic was not unique to patients seen in the safety net community clinic where I work: undocumented Spanish speaking woman in her early 60s, out of medical care, and with no medical insurance.

What caught my attention upon meeting Ms B was the urgency in her demeanor; she made it very clear that she had a specific issue to discuss. By the end of the …

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