A sometimes-thorny doctor dilemma: When family, friends ask for medical advice

Medical guidelines say that doctors should generally not treat family members or friends, but that doesn’t stop nonpatients from seeking medical advice.

Indeed, more than 99% of physicians say they’ve received requests from family members asking for medical advice, and a new study suggests doctors need experience to negotiate the complex issues those requests can raise.

When confronted with a medical request from nonpatients, physicians follow a complex process in deciding how to respond, according to the study published in the Annals of Family Medicine.

Researchers from the Netherlands conducted seven focus groups that included 33 junior and 16 senior physicians asking about their experiences and attitudes managing medical requests from family members or friends. In many cases, a physician’s decision depends on who the person is making the request. Doctors said they considered various factors in deciding how to respond, such as the nature and strength of the relationship, the amount of trust in their own knowledge and skills, potential consequences of making mistakes, the importance of work-life balance and the risk of upsetting the person’s relationship with his or her own doctor.

Senior physicians applied more nuanced considerations when deciding whether to respond, while junior doctors had more difficulties dealing with these requests and were less inclined to respond, the study found. Less experienced doctors were more concerned about disturbing the existing relationship the person has with his or her own doctor, the study said.

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Although requests are common, doctors rarely formally discuss the issue. But researchers believe that facilitated group discussions that allow physicians to share experiences may help junior doctors become more confident as they develop their own strategy about providing advice or treatment to family and friends.

In addition to dealing with requests from nonpatients, another study found that when doctors deny special requests from their own patients they often see their satisfaction levels drop. Patients who ask for referrals to specialists, laboratory tests or certain medications and have their request denied tend to be less satisfied with their physicians.