When Friends and Family Ambush You for Free Medical Advice

Neil Chesanow

Disclosures

July 26, 2017

In This Article

Drawing the Line -- in a Nice Way

Doctors use various strategies for responding to requests for medical advice in a caring way without stepping out of bounds.

"The minute people find out I'm a doctor, they tend to ask, 'What kind of doctor?' And then they tailor their questions accordingly," says a family doctor in Los Angeles, California, who requested that her name not be used because she is on staff at a medical school with restrictions on faculty members giving media interviews. "As a family physician, I tend to get two kinds of questions. There's the second-opinion–type questions: 'I went to the doctor, and he said X. What do you think of what he said?'"

"That's tricky, because you want to protect your colleagues. But sometimes, something sounds really egregious. So you have to be very careful in saying, 'I suggest you get a second opinion, but not from me—I'm not your second opinion.'"

The family doctor continued, "And then there's, 'Oh, would you look at this rash?' And before you can say yes or no, you're looking at the rash, and the person is asking, 'What do I do about it?' That's quite common. I get that at least once or twice a week. It's mostly from people I know, but very occasionally from strangers as well."

"I don't have a stock reply, but I do have a stock mantra in my head, which is, 'I am not this person's physician.' So no matter how much I care about them or how alarmed I am, I have to wear this face that is completely neutral, that says, 'Let me see how I can help you,' but not, 'I am going to give you medical advice.'"

"It's not a concern about malpractice risk," this doctor adds, "because it's not a professional interaction. The concern is more about giving inadequate or poor or incorrect advice based on inadequate information, because there's no professional relationship."

"I often end up directing people to online resources for more information," she says. "Most of the time, I have a general recommendation for how they can better communicate with their physicians to get the most out of healthcare encounter. Sometimes I suggest getting a second opinion if it's clear that they've gone to the wrong type of physician or it's not a good fit. I'm more comfortable giving advice about communication techniques as opposed to specific medical advice."

Charles Vega, MD, clinical professor of family medicine at the University of California, Irvine, also has limits on what he will say in curbside consults with patients.

"The thing I really try to avoid is denigrating another doctor's care," he says. "I may hear a patient is on some crazy treatment. But I don't know that person's medical history. I'm not up on his or her clinical situation. So I don't want to judge another practitioner. Some of my own patients are doing things that aren't necessarily part of routine practice, but we got there through some convoluted ways over a period of 2 or 3 years, so it's really important to understand the clinical context before you dispense advice. If you do that, and keep a patient-centered focus, even if it's just giving a moment of empathy, maybe it's all that's needed. Doctors can get into trouble when they're more prescriptive and make bold and broad recommendations that directly affect patients."

When Dr Fryhofer is approached by a friend or family member who seeks advice that is more appropriately directed to their personal physician, she tries to respond in a nice way so that the person doesn't feel put off. "Gosh, I don't know your full history, but it really does sound like you probably need to talk to your doctor about that and get him or her to refer you to someone in your plan," she might respond.

"You care about what happens to people," Dr Fryhofer explains. "And you don't want to be callous. But at the same time, you don't know their full history. And you really cannot make the kind of assessment that they need. If it's a family member or friend, it's really not appropriate for you to ask for their full history. You're not their doctor. And if you do give someone medical advice that's specific to them, and you don't know their full history, then you could be doing them a disservice."

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