The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Monday, December 11, 2006

Can I be Friends with my Patients?

I am putting this out there. Not only to fellow residents, physicians and medical students, but to the public at large. Is it possible to be friends with your patients?

It has happened a few times in the year I've been working in this community that I've just really hit it off with a patient. They're always my prenatal patients-- they're female, close to my age, and in many cases just damn cool people. I meet with them monthly during their early pregnancy, then every two weeks, then every week... you get to know a person pretty well when you spend that much time with them. Then, at the end of it all, I get to play a key role in one of the most important events in their lives. They like me. I like them. Often, I like their husbands too. And I'll find myself thinking of how much fun it would be for my husband and I to hang out with them. Last week, one of my prenatal patients who is nearing the end of her pregnancy joked that she'd buy me a beer when all this was over if I could get her through the birth without tearing. Meant as a joke, I know. But when you think about it, would it really be wrong? On one hand, I know things about my patients that I don't know about my friends (for example, I've never seen Vitamin K's va-jay-jay, even through she's been my best friend for years... and we like it that way). On the other, it's not like I'm thinking about people's embarrassing medical issues when I bump into them on the street.

My preceptor has some overlap between his friends and his patients. They were all friends first, though, if that makes a difference. Which I don't entirely understand. There is no way in hell I'd go to a friend to have my paps done, no matter how professional he or she was about it. In fact, Dr. Boss has even delivered the babies of his friends and coworkers. Again, too much information. But they have no problem with it.

Sigh. Can't wait to do emergency medicine full-time. This isn't an issue when you don't get to know your patients.

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12 Comments:

Blogger Liana said...

Nope, bad idea. As one preceptor said to me, don't confuse being friendly with patients with being friends.

Of course, this becomes much harder if you're the lone family doc in a rural setting. Have not yet figured out how I'm going to deal with that issue when it raises its ugly head.

10:00 PM

 
Anonymous Anonymous said...

Aha...good question! I was thinking it myself, for recently I went to a new doc for my annual gyn exam, and she was so great! We both have kids about the same ages (elementary school) and are well-educated people. To make it worse, I recently moved to this smallish city with my family and have no friends! Everyone I meet is so provincial and conservative. But that doctor was so nice and we had a great converation about the local schools. I really wanted to talk more, to help get a handle on this area from a like-minded person. However for me the mores are too strong for me to initiate some friendly overture.

Also, once I partially fell in love with the doc who saved my life when I had pneumonia...he was very reserved, but treated me like a fellow human and not a hurdle he had to jump before he could go home. That's all it took! He was the highlight of my day every day I was stuck in the hospital. (I did not cause a problem though. I just worshipped him from afar. After all I was married! But my husband was no comfort. Rather he was extremely annoyed at me for becoming so ill and inconveniencing him.)

2:42 PM

 
Anonymous Anonymous said...

I think for some people it's o.k. As long as it doesn't affect your judgment, if it does, you're probably too close to the person to be treating them for anything non-routine, and if that is the case, you are also close enough to tell them what's happening and refer them for anything that's not routine. Also, for all things medical, reserve time to chat in office. If they call you outside the office for medical reasons, and that makes you uncomfortable, suggest they come in for a visit.

3:58 PM

 
Anonymous ripple said...

I think it would be fine, especially if you're starting emergency full time and won't be their doctor anymore. I could see myself being friends with my new doctor, but won't because I'd rather have her as a good doctor than a friend.

1:31 PM

 
Blogger The Ambivalent MSILF said...

Since things are so small and close-knit here, there's almost no doctor who doesn't treat friends. It's not really an issue. I think it's ok, though I have seen some breaches of confidentiality between groups of friends of which one or more are doctors to others. It's considered totally fine to call doctor-friends with medical questions when you need to. I'm sorta sorry medicine has gotten to the point where this has to be a question. I dislike the idea of "doctor" as someone distant or set apart in some way from everyone else.

3:17 AM

 
Anonymous jojo said...

The official stance is no, you can't. In medical school we had a session on boundaries and I remember one of the examples was a (female) family physician telling a long time patient that she liked her new haircut. Apparently this would be inappropriate. Seems kind of harsh to me and I probably WOULD say something like this to a patient, or rather the mother of a patient. As a pediatrician and mother of young children I often have a lot in common with my patients' mothers and, like you, have thoughts that we could probably be friends if we'd met under different circumstances.

9:21 AM

 
Blogger the granola said...

Making the mention of a new haircut inappropriate IS harsh. I wonder if that isn't one of the problems with patient/doctor relationships. Patients do better with doctors who they feel comfortable with. Sincere compliments and friendly talk are the language equivalent of grooming. During grooming (for primates who engage in it) endorphins are released and the animal becomes noticably more relaxed.

We aren't so different from that. Doctors can do their job better if they can put their patients at ease.

And yet there are appropriate boundaries. As has been mentioned, there are 'you know TMI' issues with patients and lack of objectivity issues with doctors. Other than some pretty obvious lines that should never be crossed, boundaries are unique to individual and community situations.

12:44 AM

 
Blogger Calavera said...

I'm glad I found this entry. I had an issue of my own earlier this year, and I feel more re-assured now.

Though I AM just a student, so it's different for me. But still.

12:08 PM

 
Blogger Bongi said...

i think in principle there is nothing wrong with becoming friends with your patients. having said that i also think it can become problematic.
one thing to consider is whether the patient wants to be friends with his/her doctor. many of them may want to maintain a certain respectful distance. the next thing is the possibility of a somewhat less than normal relationship. one of the comments speaks about falling in love with the doc who saved her life. this scenario could be a bit trickey and is probably best avoided.
i also think it is slightly more difficult for a surgeon, partly because of the type of people who do surgery, but also because of the vulnerability of the patient under anaesthetic with abdomen open. a bit too close maybe.

anyway, complex issue

5:16 AM

 
Anonymous pharmacy said...

Great post! Keep it up the good work and also keep posting.

4:38 PM

 
Blogger lionelmessi10 said...

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3:40 PM

 
Blogger lionelmessi10 said...

sexually transmitted infection (STI) It is caused by infection with the bacterium Neisseria gonorrhoeae It infects warm moist areas of the body Gonorrhea is transmitted by unprotected oral anal or vaginal sex People who have multiple sexual partners and who do not use a condom are at greatest risk of infection The best protection against infection is abstinence monogamy (having only one sexual partner) or condom use Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection These include alcohol abuse or abuse of illegal drugs

3:40 PM

 

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