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@NEJM Ask the Authors & Experts: The Doctor's New Dilemma


The Doctor's New Dilemma

Suzanne Koven, M.D.
N Engl J Med 2016; 374:7| February 17, 2016 | DOI: 10.1056/NEJMp1513708


In 1906, George Bernard Shaw’s The Doctor’s Dilemma first appeared on the London stage. The play concerns a physician, Sir Colenso Ridgeon, who’s discovered a cure for tuberculosis. Ridgeon’s dilemma is that he has a limited supply of the medication and a small staff to administer it. He can treat only 10 patients at a time and so must decide whose life is most worth saving.

The dilemma I face most often as a primary care doctor, however, is not one that Shaw anticipated. The commodities I struggle to ration are my own time and emotional energy. Almost every day I see a patient...and I find myself at a crossroads: Do I ask her what’s really bothering her and risk a time-consuming interaction? Or do I accept what she’s saying at face value and risk missing a chance to truly help her? 


Originally Appeared in The New England Journal of Medicine on February 17, 2016.

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