My girlfriend and I were having a discussion tonight about if your spouse can be your primary care physician ( either M.D., R.N., etc...)? Is this against the Hippocratic oath or any laws.

What about as specialized care if they were a specialist?

4/14/2010 9:53:22 PM

just don't run for president and have MS

4/14/2010 10:02:37 PM

Definitely not allowed. I don't know what law or code that applies, but I had this discussion with my wife a while back. That extends to not just the spouse, but any immediate family members.

I'll ask my wife if I think about it, but i think there are one or two docs on here who might know off the top of their head.

4/14/2010 10:03:38 PM

Won't that affect the hard choices they have to make because they're emotionally involved with the patient?

4/14/2010 10:39:15 PM

Oh, excellent point

4/14/2010 10:40:48 PM

There is a conflict of interest.

4/14/2010 11:01:06 PM

I could definitely see the "conflict of interest" aspect and it makes a lot of sense.

What though if you lived in a small town? There could be a very good chance that your spouse may be the only doctor in town, such as some rural areas out west...

4/14/2010 11:11:12 PM

I'm my husbands optometrist...don't know if that counts though

4/14/2010 11:46:22 PM

It is pretty much impossible to not be at least a front line diagnostician to your spouse. It is almost involuntary.

Here is the AMA opinion:

http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion819.shtml

4/15/2010 3:05:43 PM

I don't see the big deal, conflict of interest? what the hell does that mean, doctors who aren't related to their patients aren't supposed to care?

4/15/2010 5:28:07 PM

^

Quote :

"Won't that affect the hard choices they have to make because they're emotionally involved with the patient?"

caring is one thing..being emotionally involved with the patient is another level of caring.

[Edited on April 15, 2010 at 5:29 PM. Reason : .]

4/15/2010 5:29:09 PM

i think there is some type of law or regulatory code prohibiting medical professionals from performing *free* services for their family but i don't see why it wouldn't be ok if they bill you at a reasonable and fair rate

4/15/2010 6:07:26 PM

Pretty sure you can't write prescriptions for your family members - at least not for any good drugs.

4/16/2010 6:23:47 PM

My dad is a family physician, and my wife is a physician's assistant working in a family practice, my brother-in-law is a nurse practitioner (basically all 3 are primary medical care providers)

I think so long as you're talking about something normal it makes every sense to have your family members who are care providers involved. Whether they should be your PRIMARY medical provider, probably not, but things like colds, infections, stitches, etc. there's really no reason they can't assist in that. We've had a couple people come out to visit and my wife has written prescription anti-nausea and altitude sickness medicine before.

Now if you had a serious medical condition, I think you should go to your PCP, not your family member. If they were a good medical care provider, they would want you to see someone else as well to get a second opinion.

And note the AMA said "generally" in their opinion. It is not a code or law, but there's good reason behind why they don't recommend it. Again, my belief is it depends entirely on the situation and illness.

After reading it again, the AMA does a good job summing it up:

Quote :

"In addition, while physicians should not serve as a primary or regular care provider for immediate family members, there are situations in which routine care is acceptable for short-term, minor problems"

[Edited on April 16, 2010 at 7:45 PM. Reason : .]

4/16/2010 7:42:08 PM

This isn't allowed because it could really screw up a "death panel"

[Edited on April 16, 2010 at 7:58 PM. Reason : But seriously I don't see anything wrong with it for most things]

4/16/2010 7:57:34 PM

All the doctors at the pediatrics practice I work for take their kids to doctors other than themselves for all visits.

4/16/2010 10:48:03 PM

well for doctor's visits of course. i doubt they bring them in if they're just fighting a cold, but for regularly scheduled appts. it makes sense.

4/17/2010 12:41:00 AM

The docs I know personally (only two) regularly treat and prescribe little stuff to friends and family, mainly so people don't waste their time and their doctors' time by going in when they don't need to. It comes in handy on family trips and stuff.

I think for official stuff like check-ups or big stuff, you got to another physician, but as a professional courtesy, you can get free or discounted care. In other words, your spouse can't treat you, but her colleague can, and it will often be discounted. Obviously, your spouse will be expected to do the same for her colleague.

In fact, professional courtesy is supposed to help remove the temptation that doctors may have to treat their own family.

4/17/2010 1:27:53 AM

Quote :

"Pretty sure you can't write prescriptions for your family members - at least not for any good drugs."

Yes, this is a federal law. If caught, a physician is likely to lose his or her DEA license, which means they are unable to write prescriptions.

4/17/2010 7:37:54 AM

my ex's dad used to write ones for her all the time.. although it was for minor shit like antibiotics usually. and he'd usually have the other doc that worked for him look at family for anything beyond the flu or something like that.

4/17/2010 8:14:58 AM

Prospero sums it up nicely.

No law or code but should seek routine care from another provider. We barely touch on this (like 5 minutes) in ethics. Actually, I think we went over this more in a Wilderness Medicine course.

However, if my wife or close family member needs sutures for a small laceration I'd suture it, abx for suspected bacterial infection, etc. But for primary care concerns, no way.

A neighbor comes to you and their kid has an issue, I would tell them to see their provider, because that's the kind of thing that will bite you in the ass. Unless, of course, it was a life-threatening emergency and we were far from care.

4/17/2010 11:07:32 AM

Quote :

"I think for official stuff like check-ups or big stuff, you got to another physician, but as a professional courtesy, you can get free or discounted care. In other words, your spouse can't treat you, but her colleague can, and it will often be discounted. Obviously, your spouse will be expected to do the same for her colleague. In fact, professional courtesy is supposed to help remove the temptation that doctors may have to treat their own family."

The issue of professional courtesy is yet another area in which government and insurance companies have trampled upon physician autonomy. For example, waiving a co-payment while billing insurance for the visit is technically a no-no under private insurance and government insurance contracts. While this would be difficult to prove, a physician could also get in trouble for giving professional courtesy to another physician who is in a position to refer patients. It is no longer as simple as old-fashioned professional courtesy.

4/17/2010 11:28:08 PM

^Yeah, I was reading about that.

Craziness!

4/18/2010 9:40:25 PM