Glenn W. Currier, MD, MPH

What are the 3 signs, or horsemen, of physicians struggling?

When I was young, we had a neighbor named Frank. A proud father of 5 and a trusted employee at the local mill, Frank lived an apparently peaceful and happy life together with his wife, Kay. Frank had a secret, however.

The concept of Primum non nocere ("First, do no harm") is a cornerstone of medical education. This Latin phrase reminds physicians that medical treatments can potentially have both good and bad effects. Sometimes, the ultimate net benefit of an intervention is clear to both the physician and the patient, and treatment proceeds unimpeded by doubt. When the net benefit of a treatment is less certain, in most branches of medicine patient choice and self-determination play a major role in determining which "gray zone" treatments are appropriate. For the most part, this is also true in psychiatry.