Page last updated at 05:00 GMT, Wednesday, 21 October 2009 06:00 UK

Doctors 'should avoid treating family'

John Holden
VIEWPOINT
Dr John Holden
Medical Defence Union adviser

Doctor listening to patient's chest
People are often tempted to ask a friend who is a doctor for help

Doctors sometimes get asked to treat friends and relatives but it is a situation they should avoid if possible, according to the Medical Defence Union.

Its adviser, Dr John Holden, argues that it is all too easy for the doctors to put their livelihoods at risk.

Most of us are more than happy to use family connections or call upon friends in the know when we need expert help or advice, whether it's 'the car has a puncture' or 'the computer is infected with a virus'.

After all, it makes sense to seek the help of someone we trust and eliminate the time and uncertainty of trying to find someone available, willing and qualified to help.

As the old adage goes 'What are friends for?'

'Significant pitfalls'

As any doctor will tell you, many people also call on such connections when a health problem arises.

Treating friends and family is something doctors should avoid, not least because they could be putting their livelihood on the line

Many doctors will identify with the scenario of being asked to reassure a relative with a worrying mole or prescribe antibiotics to a friend with a temperature, often in the middle of a busy restaurant or at a house party.

The problem is that treating friends and family holds significant pitfalls for the doctors themselves and is generally not in the long-term interests of patients either.

Of course, there are some situations where there is little alternative.

In remote communities with only one practice, a GP's family will usually register with another doctor in the practice but it's still possible that GPs may find themselves treating a patient one day and sitting down to dinner with them the next.

And in an emergency where there is no one else available, doctors have an ethical obligation to provide immediate medical care to anyone who requires it, whoever they may be.

Risk to livelihoods

However, doctors are expected to follow this up with the patient's own GP.

In general though, treating friends and family is something doctors should avoid, not least because they could be putting their livelihood on the line.

It is easy to assume that you know what medication a family member is already taking but how can you be certain without access to their medical records?

The General Medical Council (GMC) repeatedly makes this point in its guidance to doctors.

It states: 'Objectivity is essential in providing good care; independent medical care should be sought whenever you or someone with whom you have a close personal relationship requires prescription medicines' (Good Practice in Prescribing Medicines, 2008).

In particular, doctors should avoid prescribing controlled drugs to themselves or their family.

In rare cases, this has led the GMC to investigate a doctor's fitness to practise, putting their career in jeopardy.

Clouded judgement

So why is treating family and friends such an ethical minefield?

The MDU advice to our medical members is that it is all too easy, when treating someone close to you, for your judgement to be clouded by your relationship with them.

Who would feel entirely comfortable, for example, in asking their elderly mother whether she had had suicidal thoughts?

If you need medical treatment, please don't be tempted to keep it in the family

It is easy to assume that you know what medication a family member is already taking but how can you be certain without access to their medical records?

A teenage girl may not volunteer to her doctor-father that she is taking the contraceptive pill, but if he unknowingly prescribes antibiotics in an emergency which prevent the pill from working, the risks are obvious.

And what if an intimate examination was required?

Imagine how awkward it could be if a father asked his GP daughter about symptoms which would usually require an intimate examination to be carried out to diagnose the patient's condition.

That is why it is almost always in patients' own interests for their own GPs to be responsible for their medical care to ensure clinical objectivity and continuity of care.

The message for those who are friends with or related to someone in the medical profession is simple: if you need medical treatment, please don't be tempted to keep it in the family.




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