Quite regularly, I am asked to comment on the care of folks who are not my patients. Often, these are friends or their relatives who are suffering gastrointestinal (GI) distress. “Would you be able to give her a call”? On other occasions, a member of my own family wants me to connect with someone who has a GI issue.
This is tricky terrain and I navigate it very cautiously. Obviously, I am not the individual’s doctor
and would never assume this role. The individual
shares with me only his version of the facts which may not represent the
totality of the medical situation. I don’t have the data and have not performed
my own examination.. It would be highly
irresponsible and unethical for a physician from afar, who has no professional
attachment to the individual, to dispense medical advice or to sow doubts about
the quality of the medical care rendered.
Indeed, a physician who crosses a line here can cause confusion and
doubt which can have deleterious health effects.
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In some instances, I simply decline to
connect with the individual. In selected
instances, I will reach out to folks who have unanswered questions. I make it clear that these conversations are
informal and I will not be giving medical advice or challenging their own
physicians’ care. As we conclude, I
always direct these individuals to return to their care teams. Despite all of these qualifiers, I maintain
– and these folks and their families agree – that my conversations with them have
value.
They can ask me every question on their minds as there is no
ticking clock in the background. They
often don’t fully understand the rationale for recommended tests or medications
which I can explain to them. They may
need clarification why a certain consultant was brought in on the case. I can
also suggest questions that they might pose to their medical
professionals.
I serve as a listener and an explainer. These cases remind
me how often patients – including mine – might not have the full understanding
of their medical situation that we doctors think they have. I can’t count, for example, how often I have
asked a patient why he is on a certain medicine to be told he has no idea.
Sometimes, all we want is a chance to tell our story and to
be heard.
We learned the art of the "cut off" on med school on the 70s, as in, how to cut people off. This is not as unfeeling as it sounds; some people simple cannot organize their thoughts on a manner that produces a coherent narrative, some are anxious, and others simply have verbal diarrhea. The Art lies in deciding which is which. For friends & relatives seeking a free curbside consult you can always suggest they call the office for an appointment.
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