Family Physicians Managing Medical Requests From Family and Friends

It is inevitable that at some point a medical doctor will be asked by a friend or family member for medical requests or advice. While physicians are taught treating friends and family is ethically inappropriate, physicians commonly provide treatment or advice to family members and friends. Due to a wide range of circumstances, some things the physician needs to consider when being asked for medical advise include expected consequences of making mistakes, work-life balance, relationship with the nonpatient, amount of trust in their knowledge and skills, and risk of disturbance in the doctor-patient process.

The study design was a qualitative study using focus groups consisting of junior physicians and senior physicians. The participants were all physicians associated with the Family Medicine Specialty Training Program at Maastricht University. The selection criteria were the junior physicians were 1st year residents, and the senior physicians needed to be family physicians with a minimum of 5 years of work experience in family medicine who supervised a resident in their own practice. We thought using a different approach (individual interviews or standardized, anonymous surveys) might have been more beneficial and led to quantifiable data that could be used in further research, such as second opinions, constructing a survey based on the results of this focus group, and including family members/friends to see what the impact is on patient care. We also thought with these focus groups, the sample was small and not very diverse, as all members of the study are colleagues and practice in the same hospital system. This could lead to a lack of opinions and thoughts, as well as people being unwilling to express unpopular opinions.

While we agree with the finding from the article, that all physicians will be asked for medical advise or requests, we don't believe any particular specialty will receive more or less questions. We thought this would have been an easily quantifiable question to answer by asking a variety of physicians if they receive medical questions from friends and family members. We also thought the general population does not fully understand the differences between medical specialties. Instead, it is known that we are doctors, so many people expect us to be able to answer their questions, regardless of specialty. This could be because they do not understand the differences between the specialties or that since every doctor has to attend medical school, they have more general medical knowledge than others.

The attitudes towards a physician providing medical advise and care to a nonpatient may be dependent on a variety of factors such as location, culture, financial status, patient age, etc. We discussed how in a European healthcare system, the ability of a person to get in to see their doctor may differ from that of an American healthcare system. Thus, asking a physician in a European country a medical question may be more acceptable as opposed to in the United States, where you can generally get in to see a physician quickly. Also, we discussed how certain patient populations, such as children, might lead someone to ask a physician a medical question when they otherwise would not.

While many of the topics we discussed were not mentioned in the article, we thought this article could be used as a starting point for many other research topics into this ethically difficult question of managing medical requests from nonpatients. We thought this article mentioned 5 important factors to consider, but we believe obtaining opinions and outlooks from a larger sample of physicians, from different locations, with diverse specialties would ultimately lead to a more representative opinion of how to mange these medical requests.

Competing interests: None declared