Physician/Patient Statement of Mutual Commitment

by

Richard & Annette Bloch

WE SUGGEST YOU DISCUSS THIS WITH YOUR PHYSICIAN

Cancer is a complex disease with numerous treatment options. Often there is only one opportunity for success. Effective treatment requires effort by both the patient and physician. A clear understanding of what each can expect of the other will help. Thoughts and feelings of the doctor are transmitted neurologically affecting the health of the patient.

Patient Commitment:
1. I will do everything in my power to assist in my healing.

2. I will keep all my appointments on time, listen attentively and follow the agreed-upon treatment to the letter.

3. I will keep you informed of any problems or questions.

4. I will keep you informed of any therapy or medications I take.

5. I will let you know about my concerns or worries that may affect my medical condition.

6. I will consciously choose to believe in our ability to make a difference in the healing process.

Physician Commitment:
1. I will be honest with you in stating facts and optimistic when sharing judgment. (I will not state as a fact anything I do not know to be a fact.)

2. I will work with you to discover the very latest information known in my specialty for your particular disease and to identify medical and community information sources beyond my specialty.

3. I will not speak for any discipline other than my own. If I am uncertain, I will refer you to a qualified physician who might help.

4. I will listen attentively, and give sufficient time to courteously answer all your questions, in order that I might treat the “whole person”.

5. I will respect your right to make an informed decision and abide by it.

6. I will consciously choose to believe in our ability to make a difference in the healing process.