Global Health Systems 1st Edition by Margie Lovett Scott ,Faith Prather

Exercise 38

Smith, a 52-year-old, African American male lives down the street from a prominent health center. He enters complaining of a chronic, dry cough for 3 months. He offers to the doctor, "I think it's all these medicines you have me on. How do you expect a person to get better taking all this junk anyway?" His BP is 170/98, pulse 64, and he has gained 10 pounds since his last visit 6 months ago when he was placed on an ACE inhibitor and told to stop smoking cigarettes. The doctor responds to Mr. Smith's statement with, "You are obviously not taking your medications. You need to stop smoking and lose 20 pounds." He quickly examines Mr. Smith and gives him a followup appointment stating, "On the next visit you must convince me that you are serious about following the plan I prescribed for you. Otherwise, you are just not going to get better."
How would you characterize the doctor's approach to Mr. Smith (e.g., straightforward, helpful, punitive)?