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Retired NBME 18 Answers

nbme18/Block 4/Question#9 (reveal difficulty score)
A 16-year-old girl calls the physician on a ...
I can have one of my colleagues call you back to further discuss your concerns. 🔍 / 📺 / 🌳 / 📖
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submitted by ootscoot(34)
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I was split between B & D, but ultimately ended up going with B because emergency contraception needs to be taken within 72 hours of unprotected sex to be effective. Waiting a whole weekend for her regular doctor to get back to her might make her miss the window (& would cause a ton of stress for her over the weekend). This just was my reasoning, not sure if it's actually correct

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utap2001  Also another one principle: never refer. +2
jurrutia  Never refer, always resolve. Recommending to call women's health clinic leaves it to the patient to resolve. Having colleague call back is more actively resolving. +1
jurrutia  Never refer, always resolve. Recommending to call women's health clinic leaves it to the patient to resolve. Having colleague call back is more actively resolving. +2



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submitted by mikoto00(1)
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I dont get it. Why can’t the answer be “I recommend that you call the local women’s health clinic” (Choice C)? (my thoughts were like this : oh this is against the physician’s Morals -> he should be refusing but he must recommend other doctors -> B and C are almost the same , he is recommending a clinic which she can call and any doctor there will answer and help her immediately, job done here -> regarding B it may be right but C is better because it doesnt involve disclosing the information to any doctor else ) where am i wrong ?

B : “I can have one of my colleagues call you back to further discuss your concerns.”

C : “I recommend that you call the local women’s health clinic”

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hardmonster93  By choosing option C you’re sort of abandoning your patient so it is incorrect. Option B reveals that the doctor is willing to help the patient even though it’s against his/her morals. +
drdogood20  Well asking her to call a local clinic isn't necessarily providing a direct alternative. Providing another doctor who can prescribe the medication would be much better and you would be directly transferring care. If you asked her to call the women's health clinic you would not be transferring care to anyone specific and that might be detrimental to the patient's health. I mean it's ethics ... anything could be justifiable really 😛 but you directly transferring care is probably better than leaving the patient to deal with it on her own is probably what they are going for here. +



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