Please try to understand I’m not your doctor
January 1, 2018 11:37 AM   Subscribe

How can I convince my father to stop treating me like his own personal physician?

My parents, both in their early 70s, tend to rely heavily on me for medical advice as I am a mid-level provider. They both have complicated medical histories. My father also has untreated generalized anxiety disorder and one of the ways it manifests is as an obsession with his health. He will not treat the GAD. We have begged and pleaded for years. It will not happen.

He got a cold about two weeks ago and has been texting me and it calling about his symptoms nearly every single day. Most times he is repeating something he has already talked to me about. Nothing about his symptoms has changed but he keeps asking me directly for advice or, if there isn’t a direct ask for advice, the subtext of his report on his symptoms is that he wants advice. My last text response to him was “My advice is still to call your primary’s office and schedule a time to see her” as we had just talked yesterday and I said he should call his doctor. He didn’t respond and I know that means he was offended.

I don’t know how to explain to him that he can’t expect me to be his concierge clinician. I’m not a general clinician and even if I was 1) his heath history is complicated beyond that with which I feel comfortable handling and 2) I don’t want to treat family, ever. The idea that I could be responsible for some poor health outcome is awful to me. So I cannot take on personal responsibility for his health.

They are planning on moving in with us soon and while I’m happy to help offer opinions on their treatment and coordinate their care (when they are unable to manage that on their own) these last two weeks have terrified me with the prospect that I will be coming home to a barrage of medical questions every day. He’s trying to keep me informed about the status of his constipation for god’s sake! I can only imagine how much worse this will get in the future.

He is sensitive to any kind of criticism and me saying to him that this is too much will most likely equate to “Daughter doesn’t care about our health. She’s ungrateful. We should never talk to her about it again.” But really it’s that I am not his doctor and being asked a million health questions makes me feel anxious myself. I love my father. He is a good man and a good dad/grandfather. Those close to him have had to help him manage his anxiety for his whole life. As he ages it has understandably gotten worse and I am tired of taking on his anxiety and helping him work through it. He will not see his behavior as a symptom of his GAD, by the way. I work more than full time, have small kids, a spouse, and very (very, very, very) little time to just exist without demands on my time or mind. I’m exhausted by life right now.

I’m hoping for a script I can use with him to explain why he can’t treat me like his doctor and a script to respond when he does treat me like his doctor. I love him and I want to help with his health as he ages but I cannot be his personal clinician. So how can I explain this as gently as possible and in a way that someone with GAD and a general sensitivity to criticism will understand?
posted by teamnap to Human Relations (10 answers total) 3 users marked this as a favorite
I would actually explain it in fear based terms an anxious person should understand, i.e. “It makes me too nervous to answer your medical questions — doctors don’t treat their own families because of the fear of giving a family member advice that goes bad. Can you imagine if I gave you advice that kept you from seeing your primary and then it turned out you had pneumonia or something and had delayed treatment and it was my fault? Whoa, that would be so awful for both of us. I love you and I can hear that you are wanting medical advice, and I want you to feel comfortable and satisfied. Want me to look up the phone number for your advice nurse?”

Then the next time I’d say “Still too nervous to treat a family member, Dad!”
posted by hungrytiger at 11:52 AM on January 1, 2018 [37 favorites]

If it were at all possible I would also try to get my parent into a situation where they did have a concierge clinician or at least a 24/7 advice nurse line.
posted by hungrytiger at 11:54 AM on January 1, 2018 [4 favorites]

Your boundaries are going to have to be absolutely crystal clear and most importantly consistent .

Give him the boundaries upfront: I will not talk to you about your health, I will not answer texts about your health. I care but it is not my job to be your doctor. Talk to them.

Then stick with it.
If you don't want to answer to give him a clue you can say things like repeat I cannot answer that, call your doctor. And hold too it. And if he asks again, just do not respond.

If you don't want to talk about his health then do not engage about his health.
posted by AlexiaSky at 11:56 AM on January 1, 2018 [4 favorites]

I relate to this so deeply, as my own father has come to me for similar issues and, for the sake of my own sanity, I was forced to set boundaries. My father similarly pulls the "daughter doesn't care about us" card when I do this, which I find hurtful and a little manipulative. I truly empathize with you.

It sounds like you already appreciate that he, as an adult in possession of his faculties, is ultimately the one responsible for his care. He is asking you for advice, and your advice is clearly that he should see his primary care physician. He asks repeatedly, hoping that you'll perhaps give him a different answer.

It is probably at least partly driven by his anxiety. He can't stop fixating on his medical issues, and he wants some reassurance either that things are going to be okay, or that his concerns are valid. Perhaps you could incorporate some acknowledgement of his concerns into your response? "I know this is stressing you out. I can't tell you what's going on, but obviously, it's concerning you. I think that seeing your doctor will help answer your questions and make you feel a little less worried." Or something to that effect.

I definitely, definitely agree with others' suggestions on continuing to set hard, clear boundaries from which you never deviate. This will probably be even more challening once he moves in, as you are already anticipating.

Is there any way you can call his doctor's office and make an appointment for him? Do you think that would help, or would he view it as you weakening your boundaries?

Lastly, I know we all want to respect and appreciate our parents, and we all have our own ways of doing this. But I think it's appropriate to stonewall in this circumstance. When he keeps trying to ask you things you have previously blocked, raise your hand and keep repeating a phrase you have chosen ("Dad, you know I will not talk to you about this. See your doctor."). He may never follow this recommendation. But hopefully, he will ask less.
posted by aquamvidam at 12:22 PM on January 1, 2018 [1 favorite]

Can you go to an MD appointment with him and his doctor and then have his MD review the ethical implications of treating friends and family members? The AMA has advised against it for...hell, as long as the AMA has existed, pretty much.

Also does his insurance come with an advice nurse service? If his doctor can talk that up at the same appointment then you can also remind him of it when he comes to you with medical questions.
posted by elsietheeel at 12:38 PM on January 1, 2018 [2 favorites]

I'm a physician with a parent who has significant lifelong anxiety. I've been dealing with these sorts of questions ever since medical school. It sucks.

The only thing that I've found works, over the last decade of having to answer these questions, is to be really upfront about the ethics of the situation. Like, it is unethical for me to treat a family member; the American Medical Association, as well as my specialty board, is very clear on this. As a mid-level provider, you may or may not be licensed to practice independently (states differ) -- you could lose your license. Tell your parent this. They genuinely might not know.

On a practical level, I will say things like, "Wow, that chronic cough sounds awful. I really think you should mention to your doctor. Would it help if I came with you to the appointment?" Validate the concern, suggest a plan of action, support them to complete the action.
posted by basalganglia at 12:38 PM on January 1, 2018 [22 favorites]

As someone with some level of anxiety, sympathy helps. I'm making the same recommendation as above, consistently setting boundaries, but with more focus on "I know you're suffering." Anxiety really sucks, as you know. "Oh man, it sounds like you're really worried about that cough, huh? I'm sorry I don't know what it is / that I can't be the one to help you figure it out. Have you called your local doctor?" Could you treat every update on his symptoms as a text saying "I'm so worried and stressed out" and send replies like "I'm sorry your cold is still causing you worry. That sounds stressful. :( Love you, hope you feel better soon!"

I've occasionally been on the receiving end of this approach -- sympathy combined with putting the problem back in my lap -- and found it to be one of the things that is most likely to lead me to try something new (in his case, maybe even to seek treatment? Probably not). I become more aware of what I'm feeling (e.g., worried) and that I don't need to be feeling that way, and I feel like it's my problem to solve, but I feel supported in doing so.
posted by salvia at 1:30 PM on January 1, 2018 [3 favorites]

Because your father isn’t asking for a recommendation, he may in many cases be making conversation with these symptom updates.

He probably doesn’t have much going on except this medical stuff. That’s not uncommon for seniors. They also lose what we might call the filter of what’s appropriate for conversation. (Would you like to hear about every particle removed from my father’s teeth with the water pic? 3x/day? I can make that happen for you!) The result is awkward, annoying, and ripe for missed communication.

You can try to convince your father not to talk about these things with you. But it is natural for him to do so. :). What you can do perhaps is give him the responses that a patient layperson would give: empathy first, then calm, then distraction. You have the benefit of being able to know if alarm is warranted. Great. But that isn’t the job you’re being asked to do here. You’re just being asked to be the adult child. Not saying that’s easy, but we get through it.

Qualifications: my sibling is a doctor. They bristle when anyone speaks of a medical thing and especially my parents. My parents are looking for empathy; they get something like go to the doctor if dying, I can’t help you. Sibling is far from heartless but has stopped listening. It’s not a wedge that gets smaller with time.
posted by Kalatraz at 7:53 PM on January 1, 2018 [2 favorites]

Is your dad definitely asking you for medical advice/a diagnosis/a treatment plan, or is he more complaining about his symptoms/anxiety and hoping for empathy? This sounds a lot like many conversations my grandma has with my mom, and my mom is not a doctor (or any sort of medical professional). It's just that my grandma has gotten to an age where a) she has a lot of health issues and b) she can't totally coordinate all of these health issues on her own. While it is certainly not your job (and as you point out, would be unethical) for you to actually treat your dad, it's not a strange thing for the adult children of seniors to listen to/sympathize about health issues and then help them navigate the health care system.

When your dad updates you on his symptoms, I would try to empathize, tell him you're sorry he's not feeling well, hope he is doing better soon, etc. When he asks advice and your honest advice is "go see your doctor," maybe try helping him schedule the appointment, help him arrange a ride, possibly go with him if possible, etc. Or, if he has access to this, try calling the nurse help line for his insurance WITH him (maybe on speaker phone) so you can both hear the answer the nurse gives together. As he ages, and especially if he's living with you, the reality is that you WILL be more involved in his medical care -- not as his provider/doctor, but in helping him coordinate everything, because many seniors do need this in some capacity. So I would figure out what that relationship looks like where you can facilitate your dad getting medical care he needs without being the one who provides it.
posted by rainbowbrite at 9:13 PM on January 1, 2018 [1 favorite]

Try to sort out how much is him wanting you to listen and reassure, which is a parent-child issue, and how much is asking for real medical advice. Dad, I can listen to you when you're worried about your health because I'm your daughter and I love you. But I have to be clear that I'm not your doctor and not your health care provider, and I have to know my limitations and boundaries. My Mom talked about her health in great detail and sometimes I just had to say Mom, that's more than I need to know about your bowels. I drove her to her 1st Radiation Therapy appointment and she talked non-stop about how nervous she was. At the appt., she barely said a word, and when I brought up the issues she raised in the car, the doctor kind of thought I was odd, but the questions got answers. Your Dad may be bored and hyper-focused on health. New hobbies or interests might help. Ask him what his doctor recommends regarding diet and exercise and help him focus on the things he can do to be healthy. Define you boundaries and stick to them and you can be an advocate, a listener, a caring daughter.
posted by theora55 at 9:41 AM on January 2, 2018 [2 favorites]

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