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 clear position on treating friends, family and oneself.

Clause 3.14 Personal relationships of the Medical Board, Good Medical Practice Code of conduct (links to Medical Board) states:

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 to the doctor and patient. In some cases, providing care to those close to you is unavoidable. Whenever this is the case, good medical practice requires recognition and careful management of these issues.

Clause 3.14 Understanding boundaries of the Dental Board, Code of Conduct (links to Dental Board) states:

Good practice includes recognising the potential conflicts, risks and complexities of providing care to those in a close relationship, for example close friends, work colleagues and family members. This can be inappropriate because of the lack of objectivity, possible discontinuity of care and risks to the practitioner or patient. When a practitioner chooses to provide care to those in a close relationship, good practice requires that:

  • adequate records are kept
  • confidentiality is maintained
  • adequate assessment occurs
  • appropriate consent is obtained to the circumstances which is acknowledged by both the practitioner and
  • patient or client
  • the personal relationship does not in any way impair clinical judgement, and
  • at all times an option to discontinue care is maintained (see Section 8.2 Professional boundaries).

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

  1. All medical practitioners should have their own, independent General Practitioner.
  2. Medical practitioners should not initiate treatment (including prescribing) for themselves or members of their family.
  3. In emergency situations or isolated settings where there is no help available, medical practitioners may treat themselves or members of their family until another medical practitioner becomes available.
  4. Medical practitioners should not serve as primary or regular care providers for members of their family, although there are circumstances in which they may work together with an independent medical practitioner to maintain established treatment.
  5. Medical practitioners should not issue medical certificates for themselves or members of their family.
  6. Medical practitioners should not issue death certificates or cremation documents for members of their family.

The standard of care provided to family and friends can be compromised, because the close relationship can cloud professional objectivity and affect professional judgement. It can make it difficult to obtain a complete history and to perform a full and proper examination. It can also lead to an informal approach towards record keeping.

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 we provide as part of our usual practice may be neglected.

Without adequate clinical records there is no documentation of the diagnosis or the patient’s progress. Family and friends can sometimes exert pressure for treatment that is difficult to resist. This is particularly when the practitioner is being asked for diagnosis and treatment outside their area of expertise.

This may lead to risks for both the patient and the practitioner. Practitioner’s may have a role in advocating and supporting family and friends in relation to their healthcare needs. However, practitioners should encourage family members to have an independent and trusted healthcare practitioner who can coordinate their care. They should avoid being the primary treater of a family member but may be required to take on this role in an emergency or when other care is not accessible.

The Medical Board, Good Medical Practice Code of Conduct outlines good medical practice and provides a clear position on treating yourself.

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

Good medical practice involves:

  1. Having a general practitioner.
  2. Seeking independent, objective advice when you need medical care, and being aware of the risks of self-diagnosis and self-treatment.
  3. Making sure that you are immunised against relevant communicable diseases.
  4. Conforming to the legislation in your state or territory in relation to self-prescribing. (note in some states it is illegal to self prescribe)
  5. Recognising the impact of fatigue on your health and your ability to care for patients, and endeavouring to work safe hours wherever possible.
  6. Being aware of the doctors’ health program in your state or territory if you need advice on where to seek help.
  7. 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:
  8. not relying on your own assessment of the risk you pose to patients
  9. consulting your doctor about whether, and in what ways, you may need to modify your practice, and following the doctor’s advice.

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

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

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The materials provided are for educational purposes only. Whilst all reasonable care has been taken in preparing these materials, including the accuracy of the information supplied, MIPS does not accept any liability whatsoever arising out of the use or reliance of the information provided. Contact MIPS 24/7 Clinico-Legal Support 1800 061 113 or education@mips.com.au for specific advice.