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To Those Who Are Physicians: Do you ever diagnose and treat a family member?
It is generally accepted medical professional dictum that it is unwise to diagnose and then treat a family member. But I suspect that a number of physician do treat and can give a rational explanation for why they do so. I think it would be interesting to find out for what conditions or symptoms such treatment was carried out and what explanation the physician might give to have violated the above dictum. I truly can't remember any time that I treated a family member but it could well be that I am a physician statistical outlier.
By the way, if you feel squeamish to answer, just answer anonymously. ..Maurice.
By the way, if you feel squeamish to answer, just answer anonymously. ..Maurice.
asked Feb 23, 2010 at 10:43PM in Other
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0Votes
answered Feb 24, 2010 at 10:15AMDr Bernstein,
I believe that EVERY physician diagnoses their own family members....we started doing this about the first or second week of medical school. I also believe we treat family members. We may not write a prescription, but we treat. I also believe that it is not a violation of standard of care to treat certain illnesses (pharyngitis, sprained ankle, otitis media, GERD, seasonal rhinitis) as the general population can treat themselves for these illnesses without a physician and with the FDA consent.
Did we never offered a family member medical advice? Never was asked to look at their throat or listen to their chest with one of the 30 stethoscopes in the closet? Would we say to our son "Its just a sprained ankle, but your mom will have to get you into the orthopedic surgeon, because I can't treat you"?
One could argue, that it is impossible to not diagnose and treat family members on some level. The dilemma is where do we draw the line?
Great question, by the way!!! -
1Votesanswered Feb 24, 2010 at 12:08PMGerry, good response! To present an initial diagnostic impression to a family member is an acceptable use of the physician's knowledge and experience. To follow up with treatment is the "no-no". What I think is acceptable and what should not be considered treatment is for the physician to present general advice based on the diagnostic impression: "We should take you (or you should go) to your doctor" vs "It would be OK to go ahead with home remedies". I think that the line is drawn with one or other other of these two responses.and nothing further. If some believe that simply giving this extent of advice is actually engaging in treatment, I would disagree. ..Maurice.
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2Votesanswered Feb 25, 2010 at 07:37AMMy son plays hockey. I am always available to the team for injuries during a game and practice. Are you saying that the AMA would allow me to diagnose and treat his team-mates but not my own son?
I need to read the article. I have no problem with telling a family member, "you need your own private physician and I can't be your doctor." But I don't think the recommendation was intended to be so restrictive as to say NEVER is it appropriate. I would venture to guess that the drafters of the AMA rule have at some point in time and at some level, treated their immediate family in the privacy of their own home.
Treatment begins the moment there is an patient-physician encounter. Healing begins the moment there is an expectation that the physician is involved. That's why we became physicians. We heal the whole person and not just the complaint. One could argue, (and were are not, by the way) that diagnosing and treating on some level, is unavoidable. Now, off to read the AMA opinion paper.
I would love to be a part of your ethics classes.
Gerry -
0Votesanswered Feb 25, 2010 at 07:54AMAddendum:
From the article sited above: "While Opinion 8.19 of the "Code of Medical Ethics" advises that "physicians generally should not treat themselves or members of their immediate families," it also states that "in emergency settings or isolated settings where there is no other qualified physician available, physicians should not hesitate to treat themselves or family members until another physician becomes available." And even though physicians should not be the primary care physician for a family member, sometimes routine care is acceptable for short-term, minor problems. This opinion language leaves room for interpretation, so discernment on the part of the physician is essential in such circumstances."
Thanks for the reference.
Gerry -
1Votesanswered Feb 26, 2010 at 02:13PMThose who are considering the answer to my question may find the visitor responses on my blog thread
http://bioethicsdiscussion.blogspot.com/2010/02/should-doctors-examine-diagnose-and.html#comments
with the same subject worth while reviewing. ..Maurice. -
1Votes
answered Mar 03, 2010 at 07:15AMYeah, that is unfortuantely an occupational hazard (for myself and my family members). I actually discovered my wife's thyroid cancer but quickly handed over her case to colleagues eventhough i'm an endocrinologist and treat 100's of these. I think assisting family and friends with medical complaints is part of the "calling". Knowing when to back out and seek alternative advice is the tricky part and should be done as early as possible...in my opinion..
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The content on or accessible through Medpedia.com is for informational purposes only. Medpedia is not a substitute for professional advice or expert medical services from a qualified health professional.
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http://www.ama-assn.org/amednews/2009/04/13/prca0413.htm