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"I Promise I'll Give You The Same Care I'd Give My Mother"

Discussion in 'Emergency Medicine' started by Birdstrike, Aug 12, 2015.

  1. Birdstrike

    7+ Year Member

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    Here's an observation I've made, about another sacred cow, that I find peculiar and amusing And I'm not picking on any one person with this, because I've used this phrase myself. Often people use the analogy "Treat him just how you'd treat your own Mother" or "Sir, I'm doing exactly for you what I'd do for my own family member."

    We use that analogy and on the surface assume it's analogous and equal to the ultimate and highest level of care. Yet as a profession, we consider it unethical, and poor practice to treat close family members. At the same time our societies openly acknowledge that as professionals we are predisposed to giving family members worse care than normal and do so with clouded judgment and harmful bias we can't put aside. Yet we promise this as "our best" when it's clearly not. Patients love it and it sounds good when we say it, but we're really promising something the AMA strongly cautions against and says is more likely than not to be substandard care clouded by bias, emotion and conflict of interest.

    Shouldn't we be saying, "Sir, I'm promise I'll treat you like you're anybody but my closest family member"? Lol. I don't doubt that if he was a doctor, Dr. George Costanza would say exactly that. And if so, he just might me right.











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    AMA position on how treating family members equals substandard care-

    http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion819.page?
     
    #1 Birdstrike, Aug 12, 2015
    Last edited: Aug 12, 2015
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  3. msgsk

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    If you read the AMA position, the only real harm is if you try to treat beyond your expertise. And I don't think I would ever try to do that unless there were some serious (like stuck in the middle of the desert) extenuating circumstances. Otherwise all the harm in treating family members is in either not taking complete histories or not doing potentially sensitive physical exams. When you tell a patient you're going to treat them like family you still do those things - it's the decision making you're referring to.
     
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  4. Apollyon

    Apollyon Screw the GST
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    It's a minor difference, but, to me, it is quite profound (like the guy with whom I worked about what he said when he played poker - is it "I win almost every time" or "I almost win every time"?). I don't say, "this is what I would do for my family". I say that I use the "family standard", and what would I have done FOR my family (by a third party).

    And, as I re-read, I see that the guy above said the same thing in his last sentence.
     
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  5. dchristismi

    dchristismi Gin and Tonic
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    I prefer to use that when I'm referring... as in "I'd trust Dr X with my mother." Or in all actuality, "I trusted Dr Y to operate on my father-in-law."
     
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  6. Doctor Bob

    Doctor Bob EM/CC
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    As part of the discussion of "would you do X to your family member", what we don't talk about it how much we like our family member.
    The assumption in that question from patients is that we would want the best for our family member... but what if that isn't the case?
     
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  7. Birdstrike

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    Lol

    "I recommend exactly what I would for Uncle Jim Bob..." little do they know what you would actually recommend for Jim Bob. Lol
     
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