Family as Patient: Yes, No, or It Depends?

Brandon Cohen


June 15, 2015

The awkward issue of caring for friends and family received a thorough examination in discussions among physicians on Medscape message boards. A primary care physician began one conversation by noting that the American Medical Association had recommended that physicians avoid treating close friends or family members.[1] With that in mind, the primary care physician posed the question, "How often do you give medical advice or provide medical care to your friends and family?"

A significant segment of respondents vehemently opposed the idea of such limitations being placed on doctors. Quite a few had anecdotes supporting their position.

One primary care physician wrote:

If we keep all the knowledge to ourselves, aren't we doing a disservice to society? We were celebrating [with family] the other day and all the little kids were wrestling with their uncle. My three-year-old came to me crying that uncle had hurt her bones in her arm... I made her come to me, and without a word I relocated her elbow. She screamed, and everyone was shocked until I told them what I had done... How could I have not treated her?

An internist shared this sensibility:

I got a call about stroke in evolution from a friend and directed them to the emergency room: This constitutes advice. I saw a friend having shaking chills, and auscultation showed pneumonia, so I prescribed antibiotics. This was at a Christmas party. Would a better choice have been ignoring them or referring to the emergency room?

An oncologist was similarly skeptical of the hands-off-family policy:

There are many family members who are still alive thanks to older doctors who fortunately had enough common sense and influence in their care to effect an outcome that would have been otherwise disastrous. The bureaucracy doesn't have a clue [about] day-to-day medical practice in the trenches.

But there were other physicians who came down firmly against treating, or even advising, family and friends. One ophthalmologist described how to deal with this recurring problem:

My dad doesn't understand why I refer him to his physician every time he complains of a problem. I am the doctor who doesn't want to help family. I am getting used to it anyway and fighting it out, trying to make them understand my dilemma in the matter.

Many others had developed specific strategies for dealing with the inevitable requests for help. A pulmonary specialist had a pat routine:

When approached at a party, I tell them to go into the corner and take off all their clothes. I will be there in a minute. This, of course, while I am smiling and explaining the hazards of offering advice without an exam.


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