Using a family systems approach in a balint-style group: an innovative course for continuing medical education

Primary care physicians provide access and continuity of care to difficult patients and their families. Optimal medical management may be jeopardized by the emotional responses of physicians caring for such patients. These responses may pose moral dilemmas for the physician, who may be reluctant to treat these patients. Even though physicians have the right to dismiss such patients, the ethos of primary care engenders a sense of obligation to provide access to care. Traditional continuing medical education (CME) overemphasizes content and avoids emotional issues common in problematic physician-patient relationships. This CME demonstration project for community based physicians addressed this issue through a longitudinal course which was learner-centered and process-oriented. This article reports the successes and difficulties in organizing this innovative course.