What Do You Do When Your Loved One Is Ill? The Line between Physician and Family Member

2 December 2008 | Volume 149 Issue 11 | Pages 825-829

Conventional wisdom and professional ethics generally dictate that physicians should avoid doctoring family members because of potential conflicts of interest. Nevertheless, cross-sectional surveys find that the practice is commonplace.

Physicians have unique opportunities to influence their family member's care because they possess knowledge and status within the health care system; however, when physicians participate in the care of family members, they must not lose objectivity and confuse their personal and professional roles.

Because health care systems are complicated, medical information is difficult to understand, and medical errors are common, it can be a great relief for families to have someone "on the inside" who is accessible and trustworthy. Yet, the benefits of becoming involved in a loved one's care are accompanied by risks, especially when a physician takes action that a nonphysician would be incapable of performing. Except for convenience, most if not all of the benefits of getting involved can be realized by physician–family members acting as a family member or an advocate rather than as a physician.

Rules about what is or what is not appropriate for physician–family members are important but insufficient to guide physicians in every circumstance. Physician–family members can ask themselves, "What could I do in this situation if I did not have a medical degree?" and consider avoiding acts that require a medical license.

Author and Article Information

Acknowledgment: The authors thank their family members and the 2 anonymous reviewers whose comments were so helpful in improving this manuscript.

Grant Support: Dr. Fromme is supported by a Career Development Award from the National Cancer Institute (K07CA109511-01A1).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Erik K. Fromme, MD, Oregon Health & Science University, L586, Division of Hematology and Medical Oncology, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239; e-mail, frommee{at}ohsu.edu.

Current Author Addresses: Dr. Fromme: Oregon Health & Science University, L586, Division of Hematology and Medical Oncology, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239.

Dr. Farber: University of California, San Diego, 8939 Villa La Jolla Drive, Suite 110, La Jolla, CA 92037.

Dr. Babbott: University of Kansas Division of General and Geriatric Medicine, 5026 Wescoe Pavilion, Mail Stop 1020, 3901 Rainbow Boulevard, Kansas City, KS 66160.

Dr. Pickett: Oregon Health & Science University, L-475, Division of General Internal Medicine, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239.

Dr. Beasley: University of Missouri-Kansas City, Saint Luke's Hospital, Department of Medical Education, 4401 Wornall Road, Kansas City, MO 64111.

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