After a stressful week of examinations, you are finally home for the holidays and couldn’t be happier to have a day off from your studies. You are sitting down around the dinner table surrounded by friends and family when suddenly your uncle approaches you and ask you for your medical opinion of his rash. As a medical student, you are happy to discuss the pathophysiology of the rash, but then your uncle continues with his questioning and asks for the best treatment options, followed by questions about a dizzy spell that he had a week ago and so forth. Has this happened to you before? If so, how did you react? Did you answer all of their questions? Did you answer all of their questions correctly? Did you inform them when you were unsure of the answer? Were you worried that you may have been wrong and given inappropriate advice?
As you work towards becoming a doctor, your family and friends will be looking to you for medical advice. It may be a simple clarification or a reassuring affirmation, or they may ask you to interpret laboratory results, act as a second opinion, and even ask you to cross professional boundaries. However your experience may have been thus far, the American Medical Association (AMA) Code of Medical Ethics is clear: “Physicians generally should not treat themselves or members of their immediate families.” Although you may be trying to help in the short term, once you put both feet in the water, it’s hard to get yourself out. Rather than participating as the “family doctor,” consider taking on the role of an advocate. As an advocate, you can help them attain their medical needs while keeping yourself from crossing that fine line of physician and family member who happens to be a physician.
If you so choose to answer your uncle’s medical question, Eastwood recommends the following: (1) Be clear about the expectations of the requester and yourself, including whether you are being asked for simple factual information, your medical judgment and opinion, or more substantial involvement in the situation. (2) Treat your interactions with relatives or friends with the same professional expertise and judgment as you would any patient. (3) Be aware that a physical examination and especially charging a fee strengthen the establishment of a legal relationship with the requester as your patient. (4) Respect the requester’s autonomy and confidentiality and conform to HIPAA requirements where applicable. (5) Be aware of the potential conflict between your roles as a relative or friend and as a physician.
To facilitate barriers between professional roles and personal roles, some physicians develop “safe zones” in which they feel relatively free from the responsibilities of medical practice. These are areas where they prohibit family members or friends from seeking medical advice. Others have disclaimers that they state prior to going forward with their professional role. Examples include,
“I am happy to help but please understand that [I have not examined you], [I am not a cardiologist], [I am not your doctor].”
“I am not your doctor, but in situations like this I believe X is recommended.”
“I am sorry, but I don’t think I can do this because . . . ”
“Under these circumstances, you should not rely on me for medical advice.”
“I would feel better if you asked your doctor about this.”
“I am your friend (or cousin, etc.) who happens to be a physician, but I think you can appreciate that that is different from being your physician.”
Whatever you choose to adhere by in your future career, consider the implications that your advice may have and actively communicate with your loved ones in order to maintain a safe and healthy relationship.
- Reese S. The Pitfalls of Giving Free Advice to Family and Friends. Medscape. https://www.medscape.com/viewarticle/822610_3. Published April 10, 2014. Accessed January 7, 2018.
- Eastwood GL. When Relatives and Friends Ask Physicians for Medical Advice: Ethical, Legal, and Practical Considerations. Journal of General Internal Medicine. 2009;24(12):1333-1335.
Nancy Lopez was born and raised in Los Angeles, California. She graduated from the University of California, Irvine, with a degree in biological sciences with a minor in medical anthropology. She received a Master's in global medicine from the University of Southern California. She has a special interest in rural and public health. In her free time, she enjoys dancing, hiking, snowboarding when the sunny Arizona weather is permitting, and spending time traveling.