Are you up to standard? Treating Self, Family or Others Close to You

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As a medical professional, you have likely gotten used to friends and family calling and texting you for advice whenever they bump their elbow or a mysterious symptom emerges. While many of these requests may warrant a simple response of “get some rest”, others may be more complicated in nature.

When taking care of yourself or your loved ones, you are responsible for determining when it is appropriate to provide treatment and when you should advise them to seek care elsewhere. It is important that all Albertans receive the highest quality care possible and sometimes, unintentionally, your relationship with your loved one can cloud your judgment and make it difficult to remain objective.

In order to help guide you through these challenging situations, CPSA has developed an Advice to the Profession document for Treating Self, Family or Others Close to You.

Defining “treatment”

When providing care to yourself and your loved ones, it is important to remember that all laws, legislation, regulations and CPSA Standards of Practice apply as they would with a patient in a clinical setting. The definition of “treatment” as it pertains to these scenarios encompasses all aspects of medical care, such as history-taking, physical examination, ordering of diagnostic tests, making referrals, record keeping, and provision of medical treatment, including prescribing of medications.

The Canadian Medical Association’s (CMA) Code of Ethics & Professionalism prohibits the treatment of self, immediate family or anyone you have a similar close relationship with unless it is a minor or emergency intervention and only when another regulated health professional is not available. It also specifies that there should be no fee for this type of treatment, so typically you would not be expected to bill for such services.

While you are permitted to provide treatment for minor interventions, you should not provide recurring episodic treatment for diseases or conditions, even if they are minor in nature. In cases where ongoing care is needed, you should ensure care is provided through another qualified health professional as soon as possible.

Evaluating the relationship and associated risks

Sometimes, the nature of your relationship with a person may be more difficult to assess than when treating those in your inner circle. In these situations, you should consider how well you know the individual and how that may impact the quality of treatment you provide, as well as future implications that may be considered personal boundary violations (e.g., providing a requisition to a neighbour at the annual block party could turn into an expectation of continued “unofficial” care or preferential treatment) . You could ask the question: “Would aspects of my personal relationship impact any professional relationship I established?” or “Is it sensible for this relationship to change from a personal one to a professional one?” When you are struggling to define the nature of your relationship with an individual, consider reviewing some questions developed by the Canadian Medical Protective Association (CMPA)—they may help provide you with some clarity.

When evaluating yourself or someone who you care about, one of the primary risks is that you may struggle to maintain the emotional and clinical objectivity required to provide the highest quality of care. It can also create an uncomfortable situation when intimate details are needed, or even cause some pertinent information to be left out.

Information sharing

If you do provide treatment for yourself, a family member or someone close to you, remember how important it is for the treated individual’s primary care provider to be aware of this information. Documentation of all medical treatment is vital for providing safe, high-quality health care, regardless of whether it occurs in a formal or informal setting. Providing this information ensures that patient records are always well-informed and support the patient’s overall healthcare journey. For more information, please see the Episodic Care standard of practice and Advice to the Profession document.

Questions?

The Advice to the Profession document for Treating Self, Family or Others Close to You was published this past July to provide you with guidance on the topic. If you have additional questions or concerns, feel free to reach out to CPSA.

Contact support@cpsa.ca for more information.