Treating Family Members: The Pros and The Cons

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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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Colin Kaide, M.D. -

I have no problem treating friends and family members for simple, self-limited problems and have been doing so for the last 20 years of practice. I do however send people to the ED or facilitate referral to a specialist when the problem is complicated or I feel my judgement may be compromised by my relationship with the individual in question. I am occasionally asked about the inpatient treatment of friends or family members. I am very careful to not interfere in their care by the attending physician taking care of them. I have taken the time on many occasions to discuss their case with their attending doctor ( with their fully documented permission) and I have found that I can help in explaining to the patient about how and why the doc is doing what he or she is doing. It can go a long way toward reassuring the patient that their care is being handled well. On the flip side, I have caught a couple of big mistakes in care by respectfully questioning the diagnostic and treatment plans on a both a family member and the mother of a personal friend. In the first case, the hospitalist was going to send home a relative and I convinced her to do some cardiac imaging...95% LAD lesion that was causing the fatigue and vague SOB. The other was a missed full-blown serotonin syndrome!
I agree that it can become a slippery slope and you have to be vigilant when taking care of friends and family members to be sure you don't cross the line into bad territory. And NEVER prescribe a controlled substance to someone who is not under your care in a formal, documented, doctor-patient relationship! Just my thoughts.

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