Learned my lesson about providing family members with "medical opinion"

[00CR7]

Disclaimer: I always dread being asked my "medical opinion" by family, and I make it a point to say that I have no "medical opinion" to give. I am only an M2. The only opinion I can give is a personal one and I'd much prefer to give no opinion. But anyway...

My MIL calls my partner last night and wants my opinion about an "eye thing." I know pretty much nothing about eyes, and I really don't want to get involved but I overhear that she had a sudden onset of large unilateral floaters and "flashes of light" when she moves her eye. She says she looked it up and is worried about a retinal detachment. She asks what I think.

I make the mistake of telling her that it does sound a bit concerning and that if she thinks it could be a retinal detachment she should go to the ED because it could be a medical emergency. The only thing I do know about retinal detachment is that you can go blind if it goes undetected/untreated. I don't want to say "don't worry, you are totally fine" and she wakes up blind. I would rather be safe than sorry.

My partner and I end up going to the ED with her. We offered the suggestion of going to the nearby academic L1 trauma center, but its farther than the local community hospital, so she decided to go to the local community hospital. The PA sees her and does a bedside US. PA says they don't see an obvious detachment, but they want an ophthalmology opinion (r/o retinal or vitreous detachments, etc). No ophthalmology on call, so they recommend transfer to nearby academic L1 trauma center or sign out AMA. MIL wants to go home to sleep and considers signing out AMA. She asks my opinion and I say she probably shouldn't sign out AMA and she should do what the ER staff recommends.

Long story short, she goes to nearby academic center via her own vehicle, but community ER says they are aware she is coming. At nearby academic center, it apparently takes like 6 hours to be seen and obviously its miserable for her bc everyone hates being a patient in the ED. This morning, she tells us that the retina is not detached (although I know nothing else about what the ophthalmologist said). She is obviously exhausted from the ordeal and has had a bad experience. I am empathetic because clearly that is very frustrating, but also I'm not willing to join in on complaining about the ER staffs because I know how tough it is on their end (worked in the ED at a L1 trauma center for 3 years).

Now, I feel like the "bad guy" because I "made" her go through this expensive and frustrating experience when the problem was not actually an emergency. No one has blamed me (MIL or partner) but obviously, I feel badly. I don't regret recommending her she go to the ED since she was concerned (god forbid it was a surgical emergency and she didn't go and somehow ended up going blind). However, I now never want to give any kind of opinion to family or friends again. Definitely learned my lesson to just keep my mouth shut.

Sorry for the long winded venting. Just wondering if anyone else has had a similar experience or has an opinion about the situation/how to navigate family questions in the future.

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[Tangerine123]

Ugh I hate when that happens with friends and family.

Unless it's an emergency, I just tell them "Idk, i might have read something about that a few years ago, but I'm a Psychiatry resident now. That's not my field. You should make an appointment with a/an XYZ" and then proceed to recommend one.

 

[Rapsidy]

I just tell them I plan to be a psychiatrist so I’m not a real doctor anyways.

 

[RangerBob]

Ugh I hate when that happens with friends and family.

Unless it's an emergency, I just tell them "Idk, i might have read something about that a few years ago, but I'm a Psychiatry resident now. That's not my field. You should make an appointment with a/an XYZ" and then proceed to recommend one.

Basically this.

“If you’re worried about it, call your doctor or go to the ER.”

You made the right call. Don’t mess around with eye stuff. Just like the heart and brain. If someone told me they had the symptoms she told you (and sudden onset as you point out) I’d tell them the exact same thing. I’d rather spend a day in miserable ED than lose my eyesight.

You were right to recommend evaluation by an ophthalmologist as well.

 

[operaman]

OP you 100% did the right thing. I frequently tell patients and family to go to the ER when they tell me about concerning symptoms. And often they don’t have a life threatening emergency. That’s just how it goes. If their biggest complaint after potentially vision threatening symptoms is that wait in the ER, then my response would be “you’re welcome.”

Don’t forget that the licensed professional at the other hospital also wanted an Ophtho eval, so you weren’t being unreasonable.

My mentors taught me that if you’re doing things right, you should have a lot of experiences like this. If every patient you send to the ER or scan or biopsy has a serious finding, then you’re probably missing a lot too.

Eyes and hands pretty much always have me recommending ED when I get family and friends curbsides. There’s just too much subtlety and often innocuous findings can be serious. And for everything else, I usually do the “if you’re really worried about it then you should go get it checked out.”

 

[00CR7]

These responses make me feel much, much better about the situation. Thank you, I really appreciate it!!

 

[ESP_LTD_97]

I just tell them I plan to be a psychiatrist so I’m not a real doctor anyways.

Haha I do the same too man. Whatever pays the bills 🤷‍♂️

 

[cj_cregg]

I have some family/friends who go a little overboard on this at times or even asking if I'll be their PCP. If it's an educational question I'll talk with them (how does this a-tor-vas-tin medicine work? the doctor told me I have atrial fibrillation, what the heck is that? what do you think about this new COVID booster?). When we start getting into specific advice - I'm having X symptom, do you think I should X - I have started going with "oh gosh, I don't answer medical questions like that for family anymore. If I was wrong or if something bad happened I would just feel so guilty. Maybe you should call your doctor." People have seemed to be pretty understanding of that.

 

[mrbreakfast]

Couple thoughts:

1) Depends what field you go into, but you're likely going to have to do this professionally all the time. You will get plenty of patient messages describing all sorts of symptoms which may or may not be an actual emergency. You'll tell some people to the ED, and some will get admitted and some will be told "nothing's wrong with you." You'll never bat 1.000 in anything in medicine.

2) Get used to this happening in your personal life. People you know will call you at any hour and ask your medical opinion, including on things that aren't your specialty, though ironically it can sometimes be easier for things that aren't within your field than are.

3) I see monocular vision changes in the ED all the time - I'm no eye expert, but some of the ED docs will ask for presentations like this to be emergently cleared by neuro before consulting ophtho. If it makes you feel better, I don't think you mismanaged this case.

 

[ACSurgeon]

Disclaimer: I always dread being asked my "medical opinion" by family, and I make it a point to say that I have no "medical opinion" to give. I am only an M2. The only opinion I can give is a personal one and I'd much prefer to give no opinion. But anyway...

My MIL calls my partner last night and wants my opinion about an "eye thing." I know pretty much nothing about eyes, and I really don't want to get involved but I overhear that she had a sudden onset of large unilateral floaters and "flashes of light" when she moves her eye. She says she looked it up and is worried about a retinal detachment. She asks what I think.

I make the mistake of telling her that it does sound a bit concerning and that if she thinks it could be a retinal detachment she should go to the ED because it could be a medical emergency. The only thing I do know about retinal detachment is that you can go blind if it goes undetected/untreated. I don't want to say "don't worry, you are totally fine" and she wakes up blind. I would rather be safe than sorry.

My partner and I end up going to the ED with her. We offered the suggestion of going to the nearby academic L1 trauma center, but its farther than the local community hospital, so she decided to go to the local community hospital. The PA sees her and does a bedside US. PA says they don't see an obvious detachment, but they want an ophthalmology opinion (r/o retinal or vitreous detachments, etc). No ophthalmology on call, so they recommend transfer to nearby academic L1 trauma center or sign out AMA. MIL wants to go home to sleep and considers signing out AMA. She asks my opinion and I say she probably shouldn't sign out AMA and she should do what the ER staff recommends.

Long story short, she goes to nearby academic center via her own vehicle, but community ER says they are aware she is coming. At nearby academic center, it apparently takes like 6 hours to be seen and obviously its miserable for her bc everyone hates being a patient in the ED. This morning, she tells us that the retina is not detached (although I know nothing else about what the ophthalmologist said). She is obviously exhausted from the ordeal and has had a bad experience. I am empathetic because clearly that is very frustrating, but also I'm not willing to join in on complaining about the ER staffs because I know how tough it is on their end (worked in the ED at a L1 trauma center for 3 years).

Now, I feel like the "bad guy" because I "made" her go through this expensive and frustrating experience when the problem was not actually an emergency. No one has blamed me (MIL or partner) but obviously, I feel badly. I don't regret recommending her she go to the ED since she was concerned (god forbid it was a surgical emergency and she didn't go and somehow ended up going blind). However, I now never want to give any kind of opinion to family or friends again. Definitely learned my lesson to just keep my mouth shut.

Sorry for the long winded venting. Just wondering if anyone else has had a similar experience or has an opinion about the situation/how to navigate family questions in the future.

When I saw the title I thought the post was going to be about someone who gave medical advice or took responsibility for someone’s symptom. You can be any random son in law with zero medical knowledge and have a symptom sound scary enough that you say “if it was me I’d go to the ER”.

You’ll never regret telling someone to go see a third party medical professional. You will regret playing doctor with family/friends…

 

[00CR7]

Couple thoughts:

1) Depends what field you go into, but you're likely going to have to do this professionally all the time. You will get plenty of patient messages describing all sorts of symptoms which may or may not be an actual emergency. You'll tell some people to the ED, and some will get admitted and some will be told "nothing's wrong with you." You'll never bat 1.000 in anything in medicine.

2) Get used to this happening in your personal life. People you know will call you at any hour and ask your medical opinion, including on things that aren't your specialty, though ironically it can sometimes be easier for things that aren't within your field than are.

3) I see monocular vision changes in the ED all the time - I'm no eye expert, but some of the ED docs will ask for presentations like this to be emergently cleared by neuro before consulting ophtho. If it makes you feel better, I don't think you mismanaged this case.

When I saw the title I thought the post was going to be about someone who gave medical advice or took responsibility for someone’s symptom. You can be any random son in law with zero medical knowledge and have a symptom sound scary enough that you say “if it was me I’d go to the ER”.

You’ll never regret telling someone to go see a third party medical professional. You will regret playing doctor with family/friends…

I appreciate these sentiments much more now having read everyone's responses. I was being overdramatic before saying that I never want to give advice again. I will surely be asked for similar advice from patients, family, friends, etc ad nauseam for my entire career. At the end of the day, everyone is right. I would much rather tell someone to go see their doctor/go to ER and it end up being nothing than the opposite. I feel a lot better hearing people say that they would've done something similar. Thank you so much for the input!

 

[operaman]

Couple thoughts:

1) Depends what field you go into, but you're likely going to have to do this professionally all the time. You will get plenty of patient messages describing all sorts of symptoms which may or may not be an actual emergency. You'll tell some people to the ED, and some will get admitted and some will be told "nothing's wrong with you." You'll never bat 1.000 in anything in medicine.

2) Get used to this happening in your personal life. People you know will call you at any hour and ask your medical opinion, including on things that aren't your specialty, though ironically it can sometimes be easier for things that aren't within your field than are.

3) I see monocular vision changes in the ED all the time - I'm no eye expert, but some of the ED docs will ask for presentations like this to be emergently cleared by neuro before consulting ophtho. If it makes you feel better, I don't think you mismanaged this case.

Definitely hear ya on the “not your field” thing.

I feel like I’m always getting asked about rashes and skin lesions and Ortho things. The one time a year someone asks an actual ent question I get really excited.

 

[doyouhaveaflag]

You did the right thing, I would say the same thing to my MIL given those symptoms.

Sometimes you have to involve yourself. I was on a vacation with my husband's family when his mom became febrile (she's 90). His sister, a nutritionist, wanted her to just take some high dose vitamin C and rest. I checked on her an hour later and she looked like hell and was tachycardia and tachypneic. I said given her appearance and age and overall protoplasm we should go to an ER. Sister in law said no way she'll get sick there and die, started crying and mass hysteria. I said I either take her now or I call an ambulance. I drive all of us there with the sister in law still in hysterics and saying what a mistake it is. We get to the ED and she's super hypotensive and gets admitted to ICU for septic shock.

This same sister in law routinely calls me for antibiotics when she has a cold, antifungals for her yeast infections, etc. I tell her no antibiotics for her cold and I'm not that kind of doctor and she should see someone qualified if she's concerned.

 

[mrbreakfast]

The one time a year someone asks an actual ent question I get really excited.

For me, it's usually calls at night saying "I hit my head really hard on X and now I'm dizzy, nauseous and have a bad headache" or some other sudden-onset focal neurological deficit which is impossible to assess over the phone and is almost certainly nothing but has a very, very low chance of being extremely serious. I obviously dread those.

Ironically, plenty of people complain to me about migraines, yet when I say "you know, there are a lot of really good medical options for that," I have yet to have anyone actually follow my advice.

If it isn't a question about neurology, 95%+ of the time it's a question about a rash or a postop problem, the two things for which I am the most useless.

 

[Esmolol]

I mean… she said all the right things… like a UWorld vignette. Light flashes, then dark floaters… you picked the correct answer.

 

[tiedyeddog]

Wait until you’re a resident who’s been a doctor for a couple years or a attending. If you’re the only doctor in the family then you WILL be the personal doctor of the family for stuff like this, like it or not.

 

[AlbinoHawk DO]

I would have done the exact same thing. You hear alarm signs and tell her to get checked out. You didn't have experience in the field or the equipment to diagnose this on your own. Next time do the exact same thing