Family Physicians Managing Medical Requests From Family and Friends

Abstract

PURPOSE Although guidelines generally state that physicians should not treat their family members or friends (nonpatients), physicians regularly receive medical requests from nonpatients. We aimed to explore junior and senior family physicians' experiences with and attitudes toward managing medical requests from nonpatients. METHODSWe conducted a qualitative study with 7 focus groups with junior and senior physicians. We performed a thematic analysis during an iterative cycle of data collection and analysis.RESULTS When confronted with a medical request from a nonpatient, physicians first oriented themselves to the situation: who is this person, what is he or she asking of me, and where are we? Physicians next considered the following interrelated factors: (1) nature/strength of the relationship with the nonpatient, (2) amount of trust in his/her own knowledge and skills, (3) expected consequences of making mistakes, (4) importance of work-life balance, and (5) risk of disturbing the physician-patient process. Senior physicians applied more nuanced considerations when deciding whether to respond, whereas junior physicians experienced more difficulties dealing with these requests, were less inclined to respond, and were more concerned about disturbing the existing relationship that a person had with his/her own physician.CONCLUSIONS This study provides insight into the complexity that physicians face when managing medical questions and requests from nonpatients. Facilitated group discussions during which experiences are shared can help junior physicians become more confident in dealing with these complex issues as they formulate their own personal strategy regarding provision of medical advice or treatment to family and friends. 2018;16:45-51. https://doi Ann Fam Med

Self-treatment and treatment of close relatives: Prevalence, perceptions and attitudes among primary health care physicians.

“…Physician's perceptions about self-treatment and treatment of close relatives; including perception of related risks with this practice (10 items) [4][5][6] and attitude in treating specific family members (10 items).…”

“…Similar to self-treatment, treatment of close relatives is subject to international recommendations and opinions, and is generally not advisable. Physicians are instead advised to encourage their relatives to formal care and "not undermine the confidence that their relatives have in their own GP by disparaging the advice and treatment that they are given" [6].…”

“…Therefore, several institutions, such as the British Medical Association (BMA), the American Medical Association (AMA) and the American College of Physicians (ACP) have stated on this issue, advising doctors not to get involved in selftreatment or treating family members [4][5][6]. These institutions presented a list of risks associated with self-treatment and treatment of close relatives, such as compromised professional objectivity by excess of emotions; which impedes all times of the care procedure.…”

“…Another argument was the risk of overtreatment in relation with the physician being anxious to seeing his family member get well quickly. Furthermore, treatment of close relatives may have social consequences which include family quarrels and disunity that may occur if the outcome of treatment is negative [4][5][6].…”

In This Issue: Community Health, Clinical Care, and Clinician Calling

“…In a qualitative study, Giroldi and colleagues provide insights into the nuanced factors considered by junior and senior physicians in dealing with these requests. 17 A research brief by Aslan et al provides the dirt on a little-known hyperpigmented skin lesion called terra-firma-forme-dermatosis. 18 Board certification may be a marker for better training, higher quality, and greater system connectedness.…”