Reply #155: If the patient said she believes seat belt laws

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are a communist plot so she refuses to wear them, or allow her children to drink fluoridated water for the same reason, should the physician remain silent?

When I lived in the Bible belt it was commonplace for doctors to discuss "God's plan" during a regular visit for tonsillitis or something trivial. To continue a good rapport with the doctor I'd have to bite my tongue.

The patient wanted to discuss politics, she doesn't' have the privilege to control both ends of the conversation. It might have have been unprofessional for the provider to bring it up before the patient, but even at that in a certain context it would have been fine, such as discussion about the unavailability of insurance.