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

A colleague tried the direct approach:

My standard reply during a [social] gathering is a simple: "Please let me relax—I'm off duty," whenever someone comes up with a request for advice.

Another primary care physician tried both evasion and wry humor to avoid treating an acquaintance:

I remember an incident at a party several years ago. A man kept following me around asking about elbow pain when he played golf. After unsuccessfully avoiding him and his questions, I gave him an answer. I told him he would just have to stop playing golf.

An emergency department physician regretted help given out for free:

I cleaned out a nasty wound and prescribed some Augmentin® for my landscaper when a neighborhood dog bit him. He was very gracious and thanked me profusely, saying how much a trip to the ER would have cost him out of pocket. Weeks later he billed me full charge for some mulch and yard work... Does a plumber unclog your pipes for free? Does an electrician do your wiring out of the goodness of his heart?

But many doctors were equivocal. A conflicted surgeon wrote, "One cannot deny outright the request; at the same time, one should somehow wriggle out without hurting them."

A neurologist advised colleagues to simply proceed with care: "I will give very cautious advice, usually very generic, or make recommendations about who I trust to see."

A urologist concurred and went into greater detail:

After 45 years of practicing medicine, here a few tips: know your boundaries and limitation; do no harm; do not assume; always say... "The advice I give you is incomplete and limited."... If they insist, offer your official service by requesting politely: I will be glad to see you in the office if you so wish.

And a neurologist tried to see all sides:

If advice to friends and family causes harm, then it has negative implications. On the other hand, if advice prevents harm, or leads to a more optimal outcome, then it has positive implications. It's like everything else in life; you win some and you lose some.

The final word goes to a surgeon, who summed up one important aspect of this dilemma succinctly, "I suppose one needs to choose your friends wisely. But with family, I guess there is no choice."

The complete versions of these two discussions are available online: Giving medical advice to friends and family and The Pitfalls of Giving Free Advice to Family and Friends

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Brandon Cohen. Family as Patient: Yes, No, or It Depends? - Medscape - Jun 15, 2015.

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