Patients rely on their physicians to keep them well, to diagnose their medical or surgical conditions and to treat them appropriately. In doing so, physicians must earn their trust, convince them when hospitalization is indicated and resist their desire to go home when a discharge would be unsafe or endanger others.
Having practiced Internal Medicine for forty years, primarily as a hospital-based physician, I understand that conflicts between patients and their physicians routinely occur. In many cases, a second opinion or consultation serves to dissolve the crisis. In some cases, a patient may need to undergo evaluation to determine if they are competent to make decisions, especially when an important therapy is declined or when a threat to leave the hospital against medical advice occurs.
Unfortunately, physicians may give in to patient demands in the interest of efficiency or due to legal concerns; no doubt, physicians have played a significant role in the ongoing crisis of narcotic addiction. Now we see that political pressure may also sway their behavior; allowing the President, infected with Covid-19, to leave the hospital for a photo-op and to be discharged ahead of schedule to appease his personal whims are disturbing choices. Perhaps Trump was forced to sign-out on both occasions but, if so, the public should be informed of that fact. Otherwise, putting the health of the President, his staff and other contacts in danger suggests a willingness to enable compulsive behavior with potentially tragic consequences.
