Families

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persia

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I was noticing with my family - which right now is my parents - that now that I am almost a doc, they are asking me to diagnose all sorts of things in them. I am really happy that my parents are so excited that I am going to be 'Dr. Persia," but I also notice that my family make terrible patients. I mean, it is almost impossible for me to try and treat them. I have told them this about 1000 times but I realize it is really true.

My mom was sick the last few days and over the phone I was trying to figure it out. No way! I asked her: what kind of pain? sharp? burning? constant, intermittent, etc. Is it muscular or internal? She had 'pain in her abdomen.' She told me, it was not sharp and it felt like it was muscular. Maybe she pulled a muscle, she said. "It's nothing," she said but then admitted she was throwing up. Today she is in the hospital for acute cholecystitis. 😱

I am going to make a GREAT doc, I missed an incredibly important diagnosis. But I just can't seem to diagnose my own family, and they seem to be better patients with other providers. Other people have these struggles? I tell them, go to your FP/ER and have them check you out (especially since I am 1500 miles away). Actually, they do have excellent docs looking out for them which is a big relief.

I lose all perspective and impartiality when it comes to family/friends, and I don't even want to try and figure things out for them. 🙁 What do other people do when family members want you to help them?
 
You missed a diagnosis OVER THE PHONE, with a history from a POOR HISTORIAN and NO PHYSICAL EXAMINATION.

You're not Hippocrates or Dr. House. None of us are. Don't be so hard on yourself. There are a wide variety of things, many of them non-surgical, which can cause abdominal pain and N/V. Even if you had said it could have been her GB, I'm sure your mother would not have believed you (if she's anything like most of our parents...ie, want advice, but then are unsure when we give it if we know what we're talking about). Your mother was diagnosed by another physician who probably took a comprehensive history, examined her abdomen, looked at some labs and ordered a RUQ US. Guess he was a better physician than you, huh? 😉

Many families are bad patients. Mine are the Kings of such. I could curl your hair with some of the requests and diagnoses my family wanted me to make over the phone/without an EKG/ etc. For some reason, without a medical degree and nary a science class outside of basic undergrad requirements amongst them, they seem to know more about it than I. Get used to it. Your mother, like many of your future patients, will want you to tell them what they already believe. Sometimes you can. Many times you cannot.

Start practicing this mantra, "Gee Mom, that sounds awful. You should probably see your PCP/go to the ER to have that evaluated." After awhile they get tired of asking you medical advice.
 
It's that way. A relative of mine told me that I ask too many questions...Another told my mom I wasn't a good doctor yet because I was not getting the same bp readig he gets from his doctor's office. And my favorite is how they never listen when you tell them to quit smoking and take their maintenance meds, but always bangs up on your phone when their chests hurt. It's tough, but I have to admit, taking care of my family, or at least knowing what to do, is a big reason I stayed in medicine.
 
Agree with Winged Scapula's honest response.

People think that by "helping" their friends and family, they're doing them a favor. In most cases, this is not true. By diagnosing and prescribing without giving them the benefit of a regular, normal, full H&P, you're actually doing them a disservice by providing sub-standard care.
 
Thanks Dr. Winged Scapula, that was really good advice. I am also glad to know that I am not the only one with a family like this. 🙂

I totally agree that they don't listen and don't seem to think I know all that much. Well, it depends what they are asking about. Somehow, they want me to miraculously cure an arthritic knee over the phone, but they don't want to go back to the ortho guy to have it really checked out. And they are not very good at telling me all the facts.

I will keep telling them: go and see Dr. Family Medicine Person, or who ever. Glad to know that this is such a common problem, I am the only one in my family in medicine and even our family friends are not in medicine. Thanks everyone for the feedback.
 
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