When friends ask you to help them with a health issue ...

[OncoCaP]

I'm not even in medical school yet and friends are asking me to diagnose stuff that their neurologists, radiologists, and surgeons can't even figure out. I suppose this only becomes more common as you proceed in medical school (assuming of course that you still communicate with the "outside world.") So what do you do typically do when you encounter this? I realize your response may vary, but what is your most common or most recent response?

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[sirus_virus]

Never happened to me, but if it does, I will use some variation of the phrase "bitch! please".

 

[WisePrincess227]

I am not in medical school either, but people figure from my degree in Biology that I already know what I need to know to diagnose them. I would suggest telling them to get a second or third opinion. I know a couple of years ago I had an eye issue and no doctor could figure out what the problem was...I saw probably 3 eye doctors and still no conclusion.. Explain your situation and let it be "speculation" can only lead to further worry on their part and yours too, if they take you too seriously.

 

[Strongbow]

I make something up with the worst possible outcome, then follow it with an "I don't know, put ice on it"

 

[sirus_virus]

I make something up with the worst possible outcome, then follow it with an "I don't know, put ice on it"

Dont even think about it. Believe it or not, you could get sued if they take your advice seriously. Even as a doctor, I will never give random advice outside of the hospital, or in any situation where I am not fully insured.

 

[Strongbow]

Dont even think about it. Believe it or not, you could get sued if they take your advice seriously. Even as a doctor, I will never give random advice outside of the hospital, or in any situation where I am not fully insured.

Please...my friends are smart enough to recognize a joke and sarcasm. Cool down, it isn't as if I'm telling my diabetic friend to stop using insulin.

 

[meddstudd]

I don't even enter med school until the fall, but I am a nerd and my family knows it, so I've been asked this sort of thing since I was in high school. Unless they ask about something that I've read a lot about, I feel obliged to include a disclaimer (it depends on the situation whether my disclaimer is " "I have no idea but I can google that if you want, and so could you; let me know if you have any questions about what you find" or "I don't know, go to a doctor"). But I still feel obligated to at least explain what I do understand to them. The truth is, most people, even intelligent people, are naive about many medical topics, can't tell a good study from a biased one, can't tell an advertisement from a medical journal, and can't understand (at a safe level) things like the Side Effects, Interactions and Precautions sheet they get from the pharmacist with their prescription, even if the pharmacist has tried to explain some of it to them. Let alone the little inadequate warning labels put on OTC packages. If, in the middle of the night, they need to know whether or not they can take a Vicodin, Tylenol, and a Nyquil at the same time, they need to hear that it would be likely be hard on their liver to consume three acetaminophen-laced products at the same time. Most people have no idea what is in Nyquil, they just take it. If they have a bladder infection, they need to know that that leftover Z-pack in the cabinet is not going to help, nor is the cranberry juice likely to clear it up by itself. If they have nausea on the airplane and can't find any Dramamine, they need to hear that diphenhydramine (or most any of the old-school antihistamines) can serve that role admirably in a pinch. I'm certainly not going to say, "I am not trained in anti-emetic administration, here's a paper bag, try not to wretch on my travel pillow." And "No, Gramma, just because you're taking fish oil doesn't mean you can go off your beta-blockers." I could go on and on, but it comes down to the fact that having a scientific mind and even a few years of scientific curiosity still puts us in a position in which we have something to add to other people's knowledge base when they're sick, and, in my opinion, we have an obligation to do so to the extent that we can, and to be honest about the extent that we can't.

 

[alwaysaangel]

I'm not even in med school yet, but I get this from family and close friends. I will say what I know about something on a very base level and suggest they see a doctor if they're really concerned. I don't do it with strangers or people I don't know well and I never go outside of what I know.

But sometimes people get really frustrated, and they like someone they know to put it in laymen's terms. E.g. my mother got some blood tests done and a nurse who barely spoke english called her and said some random high/low results that my mother didn't understand at all and she couldn't get the doctor to talk to her. So instead of letting her panic for hours I told her what the CBC tested, what white blood cells are and a couple of other things that were abnormal (I'm a MA so I know what the abbreviatons on tests are). She felt better and got a professional explanation a week later (with a different doctor).

Surely other people do this too with people they know really well. What are you supposed to do, say "sorry you might sue me go to a doctor?"

 

[dilated]

There are areas in which one can be comfortable commenting based on what you've learned from various sources, provided you tell them to back it up with their actual doctor (diabetes is not a mystery and I explain to patients all the time what the drugs they're on are, so there's no reason not to do it for people I know), and there are areas where I wouldn't even venture.

I've already stitched up one ******* uninsured friend from a drunken escapade. My crooked stitches will forever remind him of why he should have spent that money on health insurance instead of a new Wii and a fifth of bacardi.

 

[OncoCaP]

There are areas in which one can be comfortable commenting based on what you've learned from various sources, provided you tell them to back it up with their actual doctor (diabetes is not a mystery and I explain to patients all the time what the drugs they're on are, so there's no reason not to do it for people I know), and there are areas where I wouldn't even venture.

I've already stitched up one ******* uninsured friend from a drunken escapade. My crooked stitches will forever remind him of why he should have spent that money on health insurance instead of a new Wii and a fifth of bacardi.

That's probably on the gutsy side (can't see too many friends doing that), but you saved your friend maybe a thousand bucks and six to 8 hours of waiting? Seems like that's pretty much what the ER's at the hospitals here in Austin charge.

I hate to see my friends not get the care that they need, but I'm still trying to figure out how much help / guidance I can realistically give them. When I have an issue, I tend to keep trying to find a physician who can help but not everyone is that persistent.

 

[SwineLake98]

The joke during orientation week was that our reply when someone asked us a medical question is supposed to be "I'm practically a doctor already, and you're fine."

Just the other day, my mom asked me my opinion on something, to which I replied "Um, call your doctor on Monday."

I like having discussions with other medical students about the most awkward/uncomfortable medical questions we've been asked by friends or family...

 

[Flopotomist]

I think you have to work within your level of knowledge. For anything complicated, as an M1, I use my extremely limited understanding to explain why the person needs to see a (real) physician.

However, the knee-jerk "see your doctor" isn't always the best answer. You will find that people will ask you extremely basic questions that you WILL be able to answer just fine. Family members who would normally take a motrin for a sore muscle will call you to confirm that this is a good idea. It would be silly to send them to the doctor.

Fun story - when I was 2 weeks into my M1 year, my mom called me,

Mom: "Flop, the doc said I should take _____ for my (complicated disease), what do you think?"

Me: "Uh, the board certified nephrologist who is working with your cardiologist developed this plan?"

Mom: "Yes"

Me: "Did he explain everything to you and answer all of your questions?"

Mom: "Yes, he was very patient, and answered all my questions, but I wanted to run it by you first."

Me: "I would follow all of his instructions."

Mom: "You are so smart, it is so nice having an almost doctor in the family"


See - you don't even have to know anything!

 

[OncoCaP]

I think you have to work within your level of knowledge. For anything complicated, as an M1, I use my extremely limited understanding to explain why the person needs to see a (real) physician.

However, the knee-jerk "see your doctor" isn't always the best answer. You will find that people will ask you extremely basic questions that you WILL be able to answer just fine. Family members who would normally take a motrin for a sore muscle will call you to confirm that this is a good idea. It would be silly to send them to the doctor.

Fun story - when I was 2 weeks into my M1 year, my mom called me,

Mom: "Flop, the doc said I should take _____ for my (complicated disease), what do you think?"

Me: "Uh, the board certified nephrologist who is working with your cardiologist developed this plan?"

Mom: "Yes"

Me: "Did he explain everything to you and answer all of your questions?"

Mom: "Yes, he was very patient, and answered all my questions, but I wanted to run it by you first."

Me: "I would follow all of his instructions."

Mom: "You are so smart, it is so nice having an almost doctor in the family"


See - you don't even have to know anything!

This makes a lot of sense. I guess sometimes people just want some reassurance from someone that they know and trust. I'm going to be staying with a friend and this person wants me to try and diagnose an illness of a close relative. This person asking me could be a sign of frustration in dealing with the physicians trying to help. My friend is very worried. Several physicians and surgeons have been unable to help bring about improvement. I'll just listen and be encouraging for them keep trying to find someone qualified to help. I'm quite sure that actually providing much insight on this issue is something well beyond my abilities. Maybe I'll bring some of my anatomy and pathology books for my friend to look at so that this person can see what I will be studying, the structures involved, and what kinds of things go wrong. Perhaps that will provide some appreciation into why it can be difficult to figure some of these issues out.

 

[MSHell]

Most people just want confirmation and/or reassurance. Some just need basic things explained to them.

A good way to forever shut most people up regarding their complaints-du-jour is by asking them a detailed history of their symptoms. (This is time consuming once, but no parent likes being asked intimate questions by their children.) I end up saying "hmmmm, that's interesting. I have no idea what's wrong. Maybe you should see your doctor??!!"

 

[monday_best]

Most people just want confirmation and/or reassurance. Some just need basic things explained to them.

A good way to forever shut most people up regarding their complaints-du-jour is by asking them a detailed history of their symptoms. (This is time consuming once, but no parent likes being asked intimate questions by their children.) I end up saying "hmmmm, that's interesting. I have no idea what's wrong. Maybe you should see your doctor??!!"

Ha ha. I do that all the time!

Then I give them the supportive answer.

 

[Mayhem]

I simply introduce myself again and go about my business.

"Hello I'm Mayhem, medical student." *add firm handshake*

That usually gets rid of them.

 

[mshheaddoc]

Never happened to me, but if it does, I will use some variation of the phrase "bitch! please".

This works for me. It will get annoying. But the worst I think is family members. THE WORST. Certain aspects I'd have no problem in helping them understand things but when they call up asking things because their child has a fever or is throwing up, I draw the line. I am not there to examine the rash so maybe it might be smallpox ( ). A fever of 102-3 (or even 104!) in a child isn't all that uncommon if it only lasts a few hours. If the baby hasn't had a bowel movement in a few hrs, don't freak out. Oh and there is no bird flu so I'm sure that you don't have it.

I wouldn't give advice. I have offered to keep up on trends or pass along information if I see it (I've recently had a close friend who was diagnosed with MS) which they are grateful for but I think most of my close friends know I'm not there to play doctor (nor is my hubby). See your physician who knows the history, don't ask a med student for medical advice. If you sprained your ankle sure, I'll tell you about RICE and to go see your doctor, but if you think you have cancer, I can't help. Sorry.

I think having someone in medicine can help family/friends understand their condition. Especially in a frightening situation. But overall, I can't give you an opinion if I concur with the doctors finding of a yeast infection.

 

[pennybridge]

my whole plan for picking up med school girls was "hey you're practically a doctor, can you take a look at something real quick? Let's go in my bedroom, the lighting is better in there"

...then I hit the fog machine...

 

[SanDiegoSOD]

If I know the science behind the problem, I'll explain it, with before and after admonitions to visit their physician.

 

[smq123]

This works for me. It will get annoying. But the worst I think is family members. THE WORST. Certain aspects I'd have no problem in helping them understand things but when they call up asking things because their child has a fever or is throwing up, I draw the line.

Marginally related tangent: I heard a story about a family med doctor who went out to dinner with his wife and 2 young children (< 8 years). At the restaurant, one of his patients came over and said, "Dr. A! I'm so glad to run into you here, because I have something to ask you. Listen, I've been having this really weird vaginal discharge...." She then proceeded to go into detail about her last yeast infection in front of the doctor's wife and little kids. That's worse.

Family members and very close friends asking for advice, while annoying, are understandable. They are comfortable with you, so they feel like they can speak freely. (Plus, no co-pay.) It's really irritating, though, when they ask you for your advice...and then ignore whatever advice you gave them. My parents always ask me what I think they should do about X, I tell them to go to a real doctor, and then they just sit and home and refuse to go. So why ask me in the first place?

I don't like trying to diagnose friends when they ask me a question. For me, personally, I have a hard time being really honest and direct. One of my friends got really sick with an STD. He had been too afraid to ask his doctor, but he asked me - did I think that he got HIV along with the STD? It was really hard to look him in the face and tell him yes, especially because I know that he's had family members die from AIDS. It's easy to be honest with strangers, but I think that it's easy to lie (to yourself, especially) when dealing with friends.

Plus, if you really think that your friend IS sick, and he asks you for advice, and you tell him to see a doctor, but then he doesn't go - it's really heart-wrenching and difficult to watch that happen.

 

[InNotOf]

I have a friend who's a bit of a worrywart when it comes to her teenage daughter's health - and she asks me to diagnose stuff she thinks the doctors missed. Abdominal pain from repeated UTIs/bladder infections - "InNotOf, I think she might have ovarian cancer - what do you think?" Thoughts on a (treated) tick - "Could she have lyme disease?" Arrgh...I'm only a freshman - what do I know?

 

[mjl1717]

I think you have to work within your level of knowledge. For anything complicated, as an M1, I use my extremely limited understanding to explain why the person needs to see a (real) physician.

However, the knee-jerk "see your doctor" isn't always the best answer. You will find that people will ask you extremely basic questions that you WILL be able to answer just fine. Family members who would normally take a motrin for a sore muscle will call you to confirm that this is a good idea. It would be silly to send them to the doctor.

Fun story - when I was 2 weeks into my M1 year, my mom called me,

Mom: "Flop, the doc said I should take _____ for my (complicated disease), what do you think?"

Me: "Uh, the board certified nephrologist who is working with your cardiologist developed this plan?"

Mom: "Yes"

Me: "Did he explain everything to you and answer all of your questions?"

Mom: "Yes, he was very patient, and answered all my questions, but I wanted to run it by you first."

Me: "I would follow all of his instructions."

Mom: "You are so smart, it is so nice having an almost doctor in the family"


See - you don't even have to know anything!

I agree,this is true, sometimes you can be of help without taking risk or being liable.
For example telling basic fact about Diabetes, HTN, Cholesterol or just giving reassurance, etc. That is part of this medical arena. Dont always have to be a girl..

#2- most importantly thse pseudo patients are getting free, super conveniant, strong professional advice, without co-payment( there is no other person in the world who will give such profound "I got a free oil change type advice" actually sometimes I think its a little unfair, because sometimes I think my advice is better then many hurried, insurance riddled, medicaid wrestling (if they take medicaid) poorly communicating M.Ds. who barely dialogue with their patients...

 

[Tired Pigeon]

Based on personal experience, I think the following situations were appropriate in my capacity as a medical student:

1. Accompanying a family member (upon that person's request) to a doctor to help the family member understand what is being said with regard to diagnosis, treatment, prognosis, etc.

2. Answering any type of BS question that I knew the answer to long before going to medical school (actual examples: "My doc prescribed these antibiotics for 10 days, but I've only taken them for 2 days & I feel better. Do I need to keep taking them?", "Am I not supposed to take Tylenol if I'm gonna be drinking?", and "Do you think if I started exercising I might lose some weight?").

3. Listening to a family member's health concern and saying, "Well, if you're concerned, you should make an appointment with your doctor."

4. Helping a family member organize their thoughts/questions prior to a doctor's appointment so they can get the most out of the interaction.

5. Explaining why the internet is not always a reliable source for medical information and advice.

 

[TMP-SMX]

How do you sue a medical student with no money and negative debt?

 

[indo]

I recommend isotonic enemas to all my friends no matter what? "does this look broken?" "I recommend a coffee enema."

 

[mjl1717]

How do you sue a medical student with no money and negative debt?

Funny!

 

[shantster]

My grandma likes to ask me questions about things constantly, and I'm not starting med school until the fall. My mom is a nurse and she won't listen to her, but if I tell her the exact same thing that my mom told me she had said to my grandma, she'll listen to me.

 

[mjl1717]

My grandma likes to ask me questions about things constantly, and I'm not starting med school until the fall. My mom is a nurse and she won't listen to her, but if I tell her the exact same thing that my mom told me she had said to my grandma, she'll listen to me.

Goes with the territory...

 

[Law2Doc]

A good way to forever shut most people up regarding their complaints-du-jour is by asking them a detailed history of their symptoms.

If you tell them you need to do a digital rectal exam before you can have any opinion and start putting on the glove that probably will end the inquiry faster than any history. Particularly if you are in a public place (cocktail party, etc).

 

[mshheaddoc]

Family members and very close friends asking for advice, while annoying, are understandable. They are comfortable with you, so they feel like they can speak freely. (Plus, no co-pay.) It's really irritating, though, when they ask you for your advice...and then ignore whatever advice you gave them. My parents always ask me what I think they should do about X, I tell them to go to a real doctor, and then they just sit and home and refuse to go. So why ask me in the first place?

Yeah that's another issue. I just get annoyed with a particular relative that will call every few weeks with a question which set the tone of my post. The line was drawn in which my husband told her that she needs to see her primary care doc and not keep calling him asking for advice. So its even more frustrating when if advice is give, its not followed. Then again, sometimes I can't blame how relatives question things when some of the midlevel providers at the clinic are dishing out meds and you are thinking to yourself, why are they giving this out? That's for another thread though

 

[DDSBound]

I just have been accepted to dental school and I get the same exact thing. People even ask me about their ankles, blood pressure, triglyceride levels etc. I'd imagine it is only going to get worse from here on in.

 

[Rugby MD]

I don't know, a little medical advice can go a long way
my sister was complaining about an itchy mole, she showed it to me and I told her to go to the dermatologist, then I reminded her every day for a week to make an appointment. She just got a dysplastic halo nevi with unusual features excised yesterday.
while the advice go see a doctor is always important, sometimes more important is: did you make the appointment yet, did ya, how bout now? You really need to call the doc.

 

[SoCuteMD]

I usually say, "I'm just a second year. They've taught me how to kill you, but not how to bring you back. See a doctor."

If a family member or close friend asks me "Can I drink on this medication" or something, I will probably bust out my ePocrates and look it up and then tell them, "Well, according to ____."

 

[mjl1717]

I don't know, a little medical advice can go a long way
my sister was complaining about an itchy mole, she showed it to me and I told her to go to the dermatologist, then I reminded her every day for a week to make an appointment. She just got a dysplastic halo nevi with unusual features excised yesterday.
while the advice go see a doctor is always important, sometimes more important is: did you make the appointment yet, did ya, how bout now? You really need to call the doc.

covering the whole gambit and adding some levity this is true also..