Physicians use complex process in addressing non-patient requests

When confronted with a medical request from family or friends (non-patients), physicians follow a complex process in deciding how to respond.

According to a focus group study of 33 family medicine residents and 16 senior physicians, physicians first orient themselves to the situation: who is this person; what is he or she asking of me, and where are we?

They also consider the nature and strength of the relationship with the non-patient, their level of trust in their own knowledge and skills, potential consequences of making mistakes, the importance of work-life balance, and the risk of disturbing the individual's relationship with her/his physician.

Senior physicians apply more nuanced considerations when deciding whether or not to respond; residents experience more difficulties in dealing with these requests, are less inclined to respond, and are more concerned about disturbing the existing patient-physician relationship.

Although non-patient requests of physicians are common, they are rarely formally discussed. The authors suggest developing facilitated group discussions to help residents gain an understanding of and confidence in addressing such issues.