🗒 Treating friends, family and yourself

The practice of treating friends and family is not recommended and there have been cases where it has led to disciplinary actions by the regulators including conditions placed on practitioners' registration.

Healthcare practitioners in Australia are expected to practice in accordance with the appropriate Australian Health Practitioner Regulation Agency (AHPRA) Code of Conduct. The relevant codes provide a clear position on treating friends, family and oneself. If you are a healthcare professional, becoming knowledgeable on the relevant codes of conduct will help you act appropriately if you find yourself in one of these situations.

APHRA’s position on treating friends, family members and yourself

Whenever possible, avoid providing medical care to anyone with whom you have a close personal relationship. In most cases, providing care to close friends, those you work with and family members is inappropriate because of the lack of objectivity, possible discontinuity of care, and risks involved for yourself and the patient (Medical Board of Australia).

Issues that may arise when treating friends and family members

Decreased quality for standard of care

The standard of care provided to family and friends can be compromised, the close relationship can cloud your professional objectivity and affect professional judgement. It can become difficult for you to obtain a complete history and to perform a full and proper examination.

Improper prescription practices

When a prescription is provided informally, it may be done without the appropriate assessment. The regular ongoing monitoring for adverse side effects or interactions that you provide as part of your usual practice may be neglected.

Incorrect documentation

Can lead to an informal approach towards your record keeping. Without adequate clinical records there is no documentation of the diagnosis or the patient’s progress.

Incorrect procedural practices

Family and friends can sometimes exert pressure for treatment that you may find difficult to resist. This could be a case of you being asked for diagnosis and treatment that is outside your area of expertise.

What to do when unavoidable circumstances arise

In some cases, providing care to those close to you is unavoidable. When you are in this position and you choose to treat or provide care to someone that you have a close relationship with you should follow good practices. A good practice includes recognising the potential conflicts, risks and complexities of providing care (Medical Board of Australia).

Good medical practices for friends and family as a healthcare practitioner

• Maintain adequate records.
• Maintain a high standard of confidentiality and assessment procedures.
• Ensure appropriate consent is obtained and acknowledged in the circumstances by yourself and the patient
• Don’t allow your personal relationship in any way to impair your clinical judgement.
• At all times an option to discontinue care needs to be maintained (see Section 8.2 Professional boundaries)
• In emergency situations or isolated settings where there is no help available, you may treat yourself, friends or members of your family until another practitioner is available.
• You should not issue medical certificates for yourself or members of your family.
• You should not serve as primary or regular care provider for members of your family. There are circumstances in which you may work together with an independent healthcare practitioner to maintain established treatment.
• You should not initiate treatment (including prescribing) for yourself or members of your family.

Good medical practices for yourself as a healthcare practitioner

• You should have your own, independent GP.
• You should not issue death certificates or cremation documents for members of your family.
• Seek independent, objective advice when you need medical care.
• Make sure that you are immunised against relevant communicable diseases.
• Conform to the legislation in your state or territory in relation to self-prescribing. (note in some states it is illegal to self-prescribe).
• Recognise the impact of fatigue on your health and your ability to care for patients.
• Work safe hours wherever possible and don’t rely on your own assessment of the risk you pose to patients.
• Be aware of the doctors’ health program in your state or territory if you need advice on where to seek help
• Consult your doctor if you know or suspect that you have a health condition or impairment that could adversely affect your judgement, performance or your patient’s health.

When you treat friend’s family or yourself, risks for both the patient and the practitioner may arise. As a practitioner you may have a role in advocating and supporting family and friends in relation to their healthcare needs. However, you should encourage family members to have an independent and trusted healthcare practitioner who can coordinate their care. You should avoid being the primary treatment provider of a family member but may be required to take on this role in an emergency or when other care is not accessible. For more information regarding the codes of conduct discussed see Medical Board of Australia or Dental Board of Australia

A key object of the MIPS Constitution is to promote honourable and discourage irregular practice. It is recommended and expected that members comply with the regulations and guidelines outlined by the relevant AHPRA health practitioner Board.

Should you have any queries please contact MIPS Professional Services on 1800 061 113 or claims@mips.com.au

Reference

This position is further strengthened by the relevant guideline (PDF) issued by the Medical Council of NSW outlining the key principles

Very similar requirements are outlined in the Dental Board Code of Conduct at 9.2 Practitioner health

Clause 9.2 Your health of the Medical Board, Good medical practice code of conduct