One Resident's Recommendations for Responding to Unjust Patient Bias.

All clinicians have the right to work in environments free of discrimination. Trends such as shared decision making and tying reimbursement to patient satisfaction metrics prompt us to ask how we should respond to patient preferences that express unjust bias or prejudice. This article presents one orthopedic surgery resident physician's experience of bias incidents, suggests strategies for addressing patient discrimination, and offers patient care recommendations.

Health Risks of Practicing Correctional Medicine.

Correctional staff suffer high rates of posttraumatic stress disorder compared to military veterans, and the suicide rate among correctional officers is twice as high as that of both police officers and the general population and higher than that of all other professions combined. Correctional facilities' physician employees are at risk of not only burnout but also other adverse mental health effects related to working in a correctional facility. Prison reform efforts should address the needs of both inmates and clinical staff.

Toward better care for lesbian, gay, bisexual and transgender patients.

Studies have shown that the health status of lesbian, gay, bisexual and transgender (LGBT) people generally is worse than that of the population as a whole. This is in part because these individuals have not been well-served by the health care establishment. This article describes ways physicians can begin to better care for this population and provides tips for making practices more welcoming to LGBT patients.

Using medical interpreters.

Research has demonstrated that appropriate use of interpreters in clinical encounters improves outcomes and decreases adverse events. This article reviews both the medical reasons for working with trained medical interpreters and the related laws, and offers practical tips for working effectively with interpreters.

ECT in patients with psychopathology related to acute neurologic illness.

Psychiatrists are occasionally called upon to assist in the management of patients with severe psychopathologic syndromes resulting from acute neurologic illness. In the absence of other options for treating the underlying neurological disorder or with persistence of the psychopathology after resolution of the neurologic illness, electroconvulsive therapy (ECT) may be considered. The authors treated four such patients, two of whom experienced no benefit and two of whom experienced dramatic benefit. The authors provide recommendations for the approach to acutely ill neurologic patients with regard to the use of ECT.

Anticipating potential linezolid-SSRI interactions in the general hospital setting: an MAOI in disguise.

Linezolid, a novel antimicrobial with activity against gram-positive bacteria including pathogens resistant to traditional antimicrobials, also inhibits monoamine oxidase. This latter property can cause potentially lethal adverse interactions with antidepressant medications. Long known to psychiatrists, monoamine oxidase inhibitors (MAOIs) and complications of their use may be unfamiliar to medical and surgical practitioners who may thus unwittingly precipitate a hypertensive crisis or serotonin syndrome. We review the pharmacology of MAOis and describe 3 clinical situations In which linezolid-selective serotonin inhibitor (SSRI) interactions, actual or potential, figured prominently.