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Clinical Crossroads
November 22/29, 2000

A 44-Year-Old Woman With Difficulty Walking

Author Affiliations

Author Affiliation: Dr Iezzoni is Professor of Medicine, Harvard Medical School, Co-Director of Research, Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, the Charles A. Dana Research Institute, and the Harvard-Thorndike Laboratory, Boston, Mass.


Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.

JAMA. 2000;284(20):2632-2639. doi:10.1001/jama.284.20.2632

DR DELBANCO: Mrs D is a 44-year-old woman with amyotrophic lateral sclerosis (ALS) who is having increasing difficulty ambulating. Married, with children and a grandchild, she lives outside Boston. Mrs D has commercial, managed care health insurance and is currently applying for Social Security Disability Insurance. She received primary care in a community-based practice, but for the past year, her principal physician has been Dr V, a neurologist at Beth Israel Deaconess Medical Center.