June 9th, 2017
How Giving Friends and Family Medical Advice Made Me Sick
The other night, my sister called me asking if she should take my niece to the emergency department. She had been complaining of abdominal pain with on-and-off vomiting and diarrhea for a couple days. According to my sister, she had gotten to the point where the pain was unbearable. I quickly ran through my niece’s symptoms, asked a few questions, and developed a differential of what I thought it might be. I was quite certain she had an appendicitis, but thought perhaps I was overreacting given that this was my niece, not my average patient. Come to find out, she not only had an appendicitis, but her appendix had ruptured and she was quite ill.
Since I graduated from nursing school, it is not uncommon for my family or friends to call seeking medical advice. Initially, I didn’t think anything of it. I was flattered that my (large) family trusted me with their queries. However, as my practice began to focus more and more on pediatric cardiac surgery and less on pediatric primary care, I began to recognize how much I did not know regarding noncardiac body systems.
This left me not only constantly questioning the advice I had given, but also worrying about the legalities related to the situation. Granted, I was not actually prescribing for or treating my family, but they were querying me frequently over fevers, rashes, ear pain, stomachaches and the like. With each query, I would second-guess myself and perseverate over advice given. What if I had dismissed that rash as contact dermatitis and it was actually infectious, an allergic sensitivity, or something more bizarre? I couldn’t help but think that if the advice I’d given over the phone was wrong, I would land in court defending myself. This was an irrational fear, as I didn’t actually think that my family or friends would sue me. Nonetheless, it caused me a great deal of stress.
Another unpleasant side effect of trying to help was the pushback I received. The level of questioning I got in response to my advice was almost insulting at times. In my head, I told these callers, “If you trusted me enough to call me with your ailment, why aren’t you trusting my opinion?” “If Dr. Google says otherwise and you already researched this, don’t ask me.” “If you generally want my opinion, I am happy to give it, but please, I can’t stress it enough, do not rebut me with the latest entry on Wikipedia.” Of course, I never I actually said any of this.
Things came to a head when I was surrounded by a lot of severe illness in my family. Naturally one to externalize my stress, I began to notice various physical symptoms and poor sleep setting in. I knew I didn’t need to see my primary care provider, but I wanted to address my stress level. So, taking advantage of my employer benefits, I consulted with a naturopath, who recognized my infirmities as anxiety over giving my family and friends the wrong medical advice. I love my family, and I certainly love helping. However, the thought of providing misleading advice was almost crippling. I found myself thinking and rethinking the most simple of complaints.
After seeing my naturopath, I decided to cut the cord on providing medical advice to non-patients. My clinician gave me strict instructions to not respond to texts after 7 PM. As those hooked on communication devices (all of us, it seems?) can imagine, this was like having an itch I couldn’t scratch. The compulsion to check my phone haunted me. Nevertheless, I stuck to it, and I also made a plan to set firm boundaries with those calling with medical questions. I started telling people things like, “My specialty is pediatric cardiology and cardiac surgery. I am sorry your finger is swollen, but you’ll have to see your provider if it is bothering you” and “I can help change a dressing, but no, I will not buddy tape your toe and diagnose it as broken. For that, you need to see a provider.”
Slowly but surely, the healthcare queries stopped. I do still get calls; the case of my niece is a perfect example. I would be upset had my sister not called in that situation. Overall though, the number of queries has lessened and, most importantly, I can sleep at night again.