Admittedly, the first place I go when a non-fatal rash appears on my arm, or I feel a strange numbness in my right leg after working out, is the Internet. I look it up on WebMD and proceed to email my cousin’s husband, who is a doctor. Doctor J usually tells me to stop being paranoid and get some sleep, or that if I'm really worried about it I should go to my real primary-care physician in the next few days.
It’s not that I don’t have health insurance; it’s just that going to the doctor's includes waiting rooms and time off work. So, like many who are fortunate enough to know people with some medical knowledge, I often ask for personal health advice when I see friends who have graduated medical school, or even friends who are currently in med school.
The problem is that asking for medical advice isn’t exactly like asking your astrophysicist friend to explain string theory to you. Doctors face ethical dilemmas when they are asked to treat, or further write prescriptions, for their friends or family. Additionally, even though one might prefer a friend or relative to be their doctor—the flip side might be a totally different story: They might not want to be your doctor.
This is the topic of a recent New England Journal of Medicine essay by a group of doctors looking at the challenges M.D.s face when asked to discuss illness, refill a prescription, or even perform surgery for a friend or family member. The essay says that there are complicated ethical issues involved in treating friends and family, as anxiety and emotional investment can result in bad medical judgment. Additionally, a friend or family member is less likely to sue for malpractice, which could meddle with how doctors think about risk.
Yet an informal poll on NEJM’s website has 62 percent saying yes to a hypothetical situation of writing a prescription for an asthma albuterol inhaler for a neighbor, though 88 percent say they would not prescribe an antidepressant for an acquaintance. And although the American Medical Association and American College of Physicians recommends against treating friends and family members, two surveys cited in the essay indicate that 4 percent of children had their parents as their doctor, and 83 percent of doctors had prescribed medication for relatives.
All this suggests that under the pressure or friends and family or of their own accord, physicians will sometimes treat their friends or family members. The authors themselves said an informal survey of their colleagues found that many had treated family members. Their reasons for doing so included that they were qualified, as well as that it was more convenient, less time consuming and complicated for everyone involved. In the end however, the authors conclude that physicians should not help their friends or family members unless it is an emergency.
The question of whether to help your friends and family in a professional capacity isn't relevant only to doctors. Lawyers, for example, face the same challenge. It’s not a coincidence that the American Bar Association has a page dedicated to the pros and cons of fielding legal questions from friends. (The blog Bitter Lawyer has more colorful account.) Bartenders are asked to “help out” at parties. (Read: make all the drinks, don't have fun or get paid.) Editors are asked to proofread cover letters and college essays, and photographers to "help out" with birthdays and weddings.
Fortunately, certain online innovations also mean that there may be other routes to cutting down on the hassles that stand between patients and sound medical advice. HealthTap has more than 60,000 physicians answering questions online for free, and the American Telemedicine Association estimates that as many as half a million patients will see a doctor using a webcam this year.
For a handyman or a bartender, online services like TaskRabbit can help find someone to handle the job, instead of bugging a skilled acquaintance. Rocket Lawyer promises to do the same for many legal services. These services, like using a friend, aren't perfect substitutes for the real thing—but they are a better option than asking your friends.
As for me, I'm ready to have easier access to sound medical advice from a doctor online. And I'm pretty sure Doctor J is ready for me to stop emailing him.
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