Dr. Joseph Sirven: We Are Family

Published: Wednesday, March 7, 2018 - 9:36am
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Dr. Joseph Sirven
Dr. Joseph Sirven

Doctors are taught that we shouldn’t practice medicine on family members — but who is family? KJZZ medical commentator Dr. Joseph Sirven considers the question.

At my screening colonoscopy appointment I assumed anonymity. All of a sudden, an individual enters the room and says, “Dr. Sirven, do you remember me? I’m one of your former residents.”

I politely smiled and without missing a beat, I turned to the anesthesiologist in the room and said, “I’m ready to go to sleep now …”   

One of the complications about working as a health professional is seeing your colleague as a patient or visa versa. But given that health care is a huge industry in Arizona, with more than 260,000 health care workers, the circumstance I describe is increasingly common for all of us.

There are numerous policies forbidding physicians or other healthcare workers from treating their family defined by medical licensing boards as a direct relative or love interest. Yet, the modern definition of family has changed and the boundary between friend and family isn’t always clear.

Surveys both in the United States and abroad consistently show that 80 to 100 percent of doctors and nurses admit to having treated their families and friends. Yet, both the Canadian and American Medical Association say that the only time that a physician should be treating a family member is when there is an emergency or the circumstance is so minor that there is no ethical breach.  

All health groups insist that one must practice medicine with objectivity maintaining appropriate professional boundaries but what constitutes family is not spelled out.  Aren’t colleagues that we spend more than 40 hours a week working alongside considered family? This is a big deal, especially in the setting of the opioid epidemic or end of life decisions.   

Going back to my situation, I’m proud of where I receive my care, and I’m treated with absolute professionalism even in a delicate clinical encounter such as a colonoscopy. If you ask your friend the doctor, nurse, dentist, or technician for care, it may best to get advice on who you should see rather than getting care from them. It may be in your own best interest.  

Paraphrasing a line from comedian George Burns: “Sometimes, happiness is having a large loving, caring, close knit family — in another city.”  

Dr. Joseph Sirven is a neurologist at the Mayo Clinic.

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