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Short White Coat blogger Jennifer Srygley
Thursday, August 2, 2007
Short White Coat: Physician, heal thy family
Short White Coat is a blog written by fourth-year Harvard medical student Jennifer Srygley. Her posts appear here as part of White Coat Notes. E-mail Jennifer at firstname.lastname@example.org.
The phone calls started coming in even before Iíd finished one semester of medical school. As the only person in my immediate or distant family to pursue a career in medicine, I often get calls from relatives with questions about particular drugs or treatments or ailments.
They donít mean to bother me; if I were a chef, perhaps they would call to consult me about particular blends of spices. But with these phone calls, the stakes are much higher. The consequence for giving bad advice about paprika is a ruined meal, but the consequence for giving poor advice about blood pressure medication could be a heart attack.
My policy is to listen to my relativesí questions and then to help them formulate questions that they can ask their treating physician about their care. In dire situations (an incident of multiple insect stings comes to mind), I urge them to visit an emergency room. But I cannot see and observe my family members over the phone and even if I could see them, I couldnít render objective advice about their condition. For those reasons, I never give medical advice to loved ones over the phone.
I donít think my family members are unique in having many unanswered questions about their health. That they are more willing to ask an untrained medical student personal questions about their health than to call their doctor is a symptom of the larger communication breakdown in healthcare.
Many patients, my family members included, find their doctors too unapproachable or too busy to bother with small questions. But how one should adjust his insulin dosing when sick, or whether two medications can be taken together, are not small questions to the patient who needs to ask them. One of my favorite mentors in medical school always taught me to ask the patient "Is there anything else on your mind?" at least twice before leaving the exam room. Even on my busiest clinic days, I try to ask the "anything else" question and to be prepared for the full diversity of answers that follow.