Doc, could you take a quick look...

September 7, 2007

Flustered by friends or relatives who ask for medical advice at parties or chance meetings? Colleagues tell the most effective ways to respond.

Key Points

An episode of Curb Your Enthusiasm-the HBO comedy starring Seinfeld writer/producer Larry David as a more neurotic, self-centered version of himself-features this locker room exchange:

Larry: I'm sorry to bother you, Doc, but I've got a little thing on my back and I was hoping you could save me a visit to a dermatologist.

Dr. Wiggins: I'm sorry; I'm running a little late.

Dr. Wiggins: You can make an appointment and come down to the office. I'd be happy to look at it there.

Larry: I mean, it would just take a second. . . . It's like looking at your watch, really.

Dr. Wiggins: What do you do for a living?

Larry: I'm a writer.

Dr. Wiggins: The next time you're in a hurry, why don't you write me a bunch of s-t for free?

Sound familiar? There probably isn't a physician alive who hasn't been approached in a nonmedical setting and asked to hazard a guess about a medical problem or to reassure someone that his doctor, medication, or course of treatment is topnotch.

Unlike the fictional Dr. Wiggins, most physicians manage to decline without losing their cool. But when patients-or near-strangers-are as annoyingly tenacious as Larry, that's not easy.

Small-town physicians are more likely to be accosted-Tammi L. Schlichtemeier, a pediatrician in Coppell, TX, was stopped by the same parent in five separate aisles of a grocery store-but big-city docs also get their share of people obstinately seeking medical advice.

Interrupted in mid-golf-swing by someone who wanted to know what to do about rib pain, Joanne Halbrecht, an orthopedic surgeon in Boulder, CO, attempted to jovially discourage the questioner with the nostrum, "Take two aspirin and call me in the morning." When he persisted, she eventually persuaded him to call for an appointment.

FP Patricia Roy of Muskegon, MI, was at a community fair when a man she hardly knew wanted her appraisal of his 4-year-old daughter's rash. "I told him he should consult with her doctor, and walked away," says Roy. "When he followed me, dragging the little girl by the arm, my husband stepped in and said, 'Pete, this isn't appropriate.' Undeterred, he continued with 'Look, would you just look? Do I really have to take her to the doctor? What's he going to tell me?' "

Most people who request informal medical advice, however, are sufficiently reticent and polite that it's hard to turn them down without feeling like a curmudgeon. "You want to be helpful," says Jeffrey Schultz, an FP in Baltimore. "But this is a minefield. The people who ask often have complicated problems, and someone's backyard isn't the place to get the information you need to give an informed response."

x