Dr G, 52, was a family practitioner who worked in a practice with several other primary care physicians. He had worked in the practice for the past 15 years and some of his patients had been with him for years. Some were even the grown children of previous patients.

Such was the case with Mr M, 28. Mr M’s parents were both patients of Dr G, and when Mr M outgrew his pediatrician and started college, he began seeing the physician as well. Aside from being treated for depression and mood swings while in college, Mr M was quite healthy and generally only came in for minor complaints, such as a sore throat or possible flu. The young man, now a computer programmer living on his own, didn’t generally come in for checkups, so Dr G was surprised when he saw Mr M in the waiting room.

It turned out the young man was planning a backpacking trip with a group of friends. The trip would be going through several countries, including a few that had a very high incidence of malaria. Mr M had come in to get any necessary vaccinations and to ask about preventive treatments for malaria.

Dr G went over the patient’s immunization record, made sure he had everything necessary, and after confirming that Mr M’s destinations had a high risk of malaria transmission the physician wrote preventive prescriptions for atovaquone and proguanil hydrochloride tablets and mefloquine hydrochloride tablets. The physician also instructed Mr M to take precautions against mosquitoes, including wearing long sleeves and long pants, and using insect repellent. He explained to the patient that he would need to take the medications before, during, and after his trip in order to be fully protected. He wished the young man well, and ushered him out of the exam room, telling Mr M that he expected to see pictures when he returned from his trip.