Is there a doctor in the house, airport, hiking group?
THERE’S not a doctor on this planet who hasn’t given out free medical advice to family, friends and even total strangers. It’s happened to me twice just as I’d arrived in a foreign country.
The first time, after a passport control officer asked me what my job was and I’d responded, “I’m a physician,” he launched into a query about his arthritic hip.
The second time, a uniformed young man suspended his passport stamp in midair, asking: “Oh, you’re a doctor? If a pregnancy test is negative, how long do you have to wait to be absolutely sure there’s no baby?”
Usually, doctors are happy to help out in such situations. But that’s not always the whole story. Here’s what’s actually going on in the doctor’s mind when people ask for informal advice.
Mary Kiehl, an internist at Washington University in St Louis, says that giving casual consultations is part of her social obligation. In a way, she says, it’s payback for the privilege of being a doctor.
Truthfully, there are times doctors don’t want to be on duty. The reasons can vary.
I remember in medical school when one of our professors, a well-known dermatologist, described the challenges of being a skin doctor at a cocktail party.
Everyone always seemed to have a blister, bump or bruise they’d want him to look at. One man turned around and pulled down the back of his pants to reveal a rash at the top of his gluteal cleft.
“What do you think, doc?” he asked. The dermatologist knew right away what the problem was. “That’s herpes,” he said, embarrassed – but maybe not as much as the man who’d asked.
Ranit Mishori, a colleague of mine at Georgetown University School of Medicine, describes a group hiking trip she recently took in the Alps. On learning she was a doctor, one of her fellow hikers launched into the details of his medical saga for the better part of an hour. He had weakness that turned out to be a viral infection, but it hadn’t been diagnosed until he’d been to three specialists, each of whom performed a slew of sophisticated tests.
And that was it – one hour of Mishori’s holiday spent in medical consultation for no discernible reason.
But there are certain informal patients who can make my physician colleagues really uncomfortable:
Someone who is angry about an interaction with a doctor or a poor outcome and wants us to confirm they received poor care.
Related to this, people who tell us things that reveal other doctors’ errors.
People who want a firm second opinion off the cuff.
People who pick an indelicate time or place for the conversation.
People who are involved in a lawsuit and want to draw us into their dispute.
Friends and relatives who send texts with pictures of weird lesions from indecipherable body parts.
Most doctors agree that if all a person wants to do is fascinate us with the sordid details of their seemingly interesting story, they should keep it to themselves. In such situations, we have little concrete help to offer.
On the other hand, if patients want some direction on what to do about a symptom or illness, most of us welcome their inquiries. Especially if someone wants:
Advice on whether they need to check in with their doctor or whether they can just ride out their symptoms.
Clarification about something their doctor told them or about a medicine they are taking.
Ideas for home remedies for minor problems.
A little TLC for self or family.
Within reason, we’ll even take a peek at a rash or inside an ear, as long as the requesting individual is prepared to get what they asked for: our honest opinion. – The Washington Post