“Never sign anything without me reading it first.”

Cautionary words from my husband, an attorney, whose ability to read and interpret the fine print has saved my life, so to speak, on more than one occasion. That all-in-the-family attitude toward a profession is something almost every doctor also knows well. Through me, my husband, relatives, friends, and sometimes acquaintances can get what I call a “healthcare quickie,” a free, two-minute sideline. They can also have the full boat: a thoughtful, comprehensive consultation that serves to either allay an irrational fear or as guidance for legitimate health concerns.

Offering advice to family and friends, many physicians might agree, is one of the most obvious rewards of having a medical degree. Knowing all too well how difficult and frustrating it can be to navigate the medical system, those of us who can facilitate this process for the ones we care about likely feel like it’s a win-win for all involved. But is it? What about the third party player in this scenario? Your friend or family member’s real doctor? 

I had occasion to think hard about this when my father was hospitalized this past Christmas for an acute on chronic problem that I was able to commandeer locally. It was — not unexpectedly — a very mixed experience. With every new professional encounter, I had to survey the landscape; gauge the responsiveness; and tread around egos, hierarchy, and badges.

Probably because most of us have at times been the insider resource, when we’re on the other side of the desk — the physicians who are to provide the actual healthcare service — we can generally sniff out relatives who are “in the healing business” within the first ten or 15 minutes of a new patient encounter. Be they spouses, fathers, sisters, mothers, or brothers, the style of their questions, answers, and especially their interjections give them right away.

In my case, I told my father’s story several hundred times (or so it seemed) to the ER doctors, the specialists, the hospitalists, nurses, physical therapists, and EEG and ultrasound techs. To anyone who cared and listened, I shared all the information we had, using the lingo, offering my opinion, and eliciting theirs. I sounded in turn deferential and sometimes too aggressive.

The impulse to participate as actively as possible in a loved one’s care is well-meaning and logical. After all, we speak the language and are skilled at communicating pertinent positives and negatives. Yet following my recent family experience, I found myself wondering about the shakedown between being constructive and, well, disruptive. I asked some of my colleagues to weigh in. Here’s a sampling of their responses.

“I don’t mind as long as they are reasonable.”

“I feel more pressure to perform well, say the right thing, or do a perfect physical exam.”

“I feel a bit like I am being supervised.”

“It can be helpful because the family member can explain things to the patient.”

To me, their words sound about right. In the end, there should be a unified purpose toward wellness, no matter what side of the desk we might find ourselves on. When we encounter patients who come with that family member doctor, this may mean a little extra patience, remembering that watching a loved one in pain is stressful and confusing, even for those whose profession it is to treat and heal on a daily basis.

Yet just as importantly, when we’re the family members, we must be mindful of the fact that that the “real doctor” is here to help. Therefore, that we need to treat him or her with politeness, appreciation, and respect.

Natalie Azar is a rheumatologist who blogs at The Doctor Blog.