Why doctors shouldn’t treat their family and friends

martineehrenclou.com

Some good commentary on the American College of Physicians on the risks of patients being treated by family and friends, while noting a few benefits. The actual ethical guideline is:

Physicians should usually not enter into the dual relationship of physician–family member or physician-friend for a variety of reasons. The patient may be at risk of receiving inferior care from the physician. Problems may include effects on clinical objectivity, inadequate history-taking or physical examination, overtesting, inappropriate prescribing, incomplete counseling on sensitive issues, or failure to keep appropriate medical records. The needs of the patient may not fall within the physician’s area of expertise . The physician’s emotional proximity may result in difficulties for the patient and/or the physician. On the other hand, the patient may experience substantial benefit from having a physician-friend or physician–family member provide medical care, as may the physician. Access to the physician, the physician’s attention to detail, and physician diligence to excellence in care might be superior.

Very much on the one hand, on the other. Groopman in How Doctors Think also discusses this issue, calling this the affective fallacy as doctors may overlook certain signs or issues to spare someone close to them additional pain or aggravation (I forget what he calls the contrary, where doctors may miss things with patients who are ‘difficult’). He of course provides some good questions or discussion points to help both doctors and patients in both situations.

For cancer and other patients with ongoing chronic conditions, we do develop stronger longer-term relationships with our doctors, and need to be aware of the above issues.

Why doctors shouldn’t treat their family and friends.

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