In an interesting post on the medscape site (subscription/registration probably required): The Pitfalls of Giving Free Advice to Family and Friends Shelly Reese described some of the challenges of giving medical advice
to friends and family (even if you are a wannabe Dr Phil).
As she puts it the path can sometimes lead to challenging areas of ethics and professional boundaries.
How do you address or deflect such requests? Unfortunately, there are no easy answers. It depends a lot on you, your boundaries, and the situation.
And she links to the AMA Guidelines
The American Medical Association (AMA) Code of Medical Ethics is clear, however: “Physicians generally should not treat themselves or members of their immediate families.” The statement goes on to provide an extensive list of good reasons why, including personal feelings that may unduly influence medical judgment, difficulty discussing sensitive topics during a medical history, and concerns over patient autonomy (Ref: American Medical Association. Code of Medical Ethics Opinion 8.19: Self-treatment or treatment of immediate family members. Issued June 1993.)
Some of the challenges of simple advice include
- Escalation to more complex or persistent advice
- Long distance diagnosis with missing data
- Lack of Doctor/Patient relationship and documentation
- Impaired judgement
- Changing and coloring of relationships
In one section she describes the challenges of dealing with family members and says
“I try not to give too much medical advice, even to my parents. I see my role as an advocate: to help them synthesize information when they have questions. When my mother calls and says, ‘I’m short of breath and I don’t know what to do,’ I walk her through all the things her doctor has talked to her about: Have you taken your blood pressure and pulse? Do you know how many times you’re breathing per minute?”
Good advice on being the patient advocate and healthcare manager for your family members (which many already are)
In the end it boils down to personal judgement and your own boundaries.
Questions are appropriate and to be expected, Caplan says, but doctors have to wrestle with themselves in determining how to respond if they’re to act responsibly and ethically. “When close friends and family ask for medical advice, that’s always a matter for introspection, and at the end of the day, it’s not resolved by codes of ethics but by considered individual judgments.”
It used to be as the trusted source of knowledge where access to information was limited this was a significant responsibility but with the age of
and medical applications like
AskMD, iTriage and HealthTap to mention a few you might find there is fewer and fewer requests. So for those of you that like the opportunity to help others out…enjoy it while you can mHealth and Telemedicine may be changing the landscape and soon!
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