Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Going the extra mile for patients: How friendly is too friendly?

Claire McCarthy, MD
Physician
November 22, 2013
Share
Tweet
Share

Recently, a family in my practice decided to move out of state, back to where they had lived before. When we said goodbye, the mother said that she was sad to change pediatricians. The pediatrician they would be returning to, she said, “only takes care of strictly medical things.”

Clearly, she meant that I take care of more than the strictly medical things. I was flattered, especially since this was something she was sad to give up — but it got me thinking: am I too friendly?

Obviously, there’s more to health than the “strictly medical.” Lots of things, like stress, home environment, resources or lifestyle affect our health — and since as the doctor I’m in charge of health, I figure that stuff falls under my purview. It’s especially true, I think, in pediatrics. A child’s family, community, friends and school all have a big effect on how their lives play out in the short-term and long-term. I need to make that stuff my business, and I do.

But I kept thinking about that mother when I read a post on the New York Times’ Well blog called “When The Healers Get Too Friendly.” The author, a doctor, writes about how when she gave a patient a laptop she wasn’t using (that he needed), she did it on the sly, because “… gifts to patients, well, we don’t usually do that.” She pointed out that “… aside from indisputable sexual and financial depredation, no one agrees exactly where the boundaries lie.”

I am definitely someone with looser boundaries than most. I have given my personal cell number to certain families (the ones who really need it). I share stories about my children and my life, when it’s pertinent (shared experience, I’ve found, can make a difference). I have given clothes to families who needed clothes. I lent one mother my baby swing (it helped her colicky baby). I have gone to weddings, baptisms and funerals; I have visited dying children or grieving parents at home. I have given money sometimes, like the Friday night years ago when a mother told the nurse and me (long after other staff at the health center had left) that she didn’t have enough money to feed her children that weekend–and nowhere to get any money. Esther and I looked at each other and wordlessly went for our wallets. We couldn’t let them go hungry.

That’s the thing: being a health care provider can put you face to face with raw human need. Sometimes you can call a social worker or agency to help. But sometimes you can’t — and sometimes, simply being human requires that you respond.

We get warned about this issue of boundaries as doctors a lot, and it’s one that worries, puzzles and intrigues me. It sounds right, to keep boundaries — but in practice it’s far less clear how to do that, and why. Is it that being friends with our patients might cloud our judgment?  Is it that we might be more reluctant to ask or say something to our patients — or that our patients might be more reluctant to ask or say something to us? Do we — and this I think about a lot — run the risk of wanting patients to take care of us?

I don’t have the answers — maybe because the answers are likely different for each doctor, each patient, each family and each situation. Relationships are intricate and tricky things — but the power of relationship is real too. Good relationships build understanding and trust, which are both crucial for good care. I am careful and set limits where they are needed. I don’t know if I get it right every time, but I’d rather err on the side of being too friendly.

I made some inquiries for the mother, and found a pediatrician near their new home that a colleague described as “a good egg who goes the extra mile.”  That’s what I want for the family — it’s what I’d want for any family, including my own. When it comes to our doctors, the people who know our secrets and have such power over our well-being, we all deserve someone who will go the extra mile — and be our friend.

Claire McCarthy is a primary care physician and the medical director of Boston Children’s Hospital’s Martha Eliot Health Center.  She blogs at Thriving, the Boston Children’s Hospital blog, Vector, the Boston Children’s Hospital science and clinical innovation blog.

Prev

Tips for treating patients suffering from chronic pain

November 22, 2013 Kevin 0
…
Next

Will any of these solutions save primary care?

November 22, 2013 Kevin 27
…

Tagged as: Pediatrics

Post navigation

< Previous Post
Tips for treating patients suffering from chronic pain
Next Post >
Will any of these solutions save primary care?

ADVERTISEMENT

More by Claire McCarthy, MD

  • Sometimes, talking to strangers is necessary

    Claire McCarthy, MD
  • Maybe God made teenagers difficult so we can let them go

    Claire McCarthy, MD
  • 4 mistakes parents make in the pediatrician’s office

    Claire McCarthy, MD

More in Physician

  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • From burnout to balance: a neurosurgeon’s bold career redesign

    Jessie Mahoney, MD
  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • How New Mexico became a malpractice lawsuit hotspot

    Patrick Hudson, MD
  • Why compassion—not credentials—defines great doctors

    Dr. Saad S. Alshohaib
  • Why Canada is losing its skilled immigrant doctors

    Olumuyiwa Bamgbade, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy
    • Who will train the next generation of primary care clinicians without physician mentorship? [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • From stigma to science: Rethinking the U.S. drug scheduling system

      Artin Asadipooya | Meds
    • The gift we keep giving: How medicine demands everything—even our holidays

      Tomi Mitchell, MD | Physician
    • The promise and perils of AI in health care: Why we need better testing standards

      Max Rollwage, PhD | Tech
    • From burnout to balance: a neurosurgeon’s bold career redesign

      Jessie Mahoney, MD | Physician
    • Healing the doctor-patient relationship by attacking administrative inefficiencies

      Allen Fredrickson | Policy
    • Who will train the next generation of primary care clinicians without physician mentorship? [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Going the extra mile for patients: How friendly is too friendly?
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...