Role conflicts of physicians and their family members: Rules but no rulebook

Chen FM, Rhodes LA, Green LA

OBJECTIVES: To elucidate the difficulties physicians have when a family member becomes ill and to elicit their underlying causes. DESIGN: Using a key informant technique, we solicited chairs of family medicine departments for their experiences with health care provided to seriously ill family members. We then conducted in-depth, semistructured telephone interviews that were than transcribed, coded and labeled for themes. SUBJECTS: Eight senior family physicians whose parents have experienced a serious illness within the past 5 years. All of the subjects reflected on experiences stemming from their fathers' illness. RESULTS: These physicians faced competing expectations: at an internal level, those of their ideal role in their family and their ideal profession identity; and at an external level, those originating from other family members and from other physicians. Reconciling these conflicting expectations was made more difficult by what they deemed to be suboptimal circumstances of the modern health care system. CONCLUSIONS: Conflicting rules of appropriate conduct, compounded by the inadequacies of modern health care, make the role of physician-family member especially challenging. The medical profession needs a clearer, more trenchant understanding of this role.

Chen FM, Rhodes LA, Green LA. Role conflicts of physicians and their family members. Rules but no rulebook. West J Med 2001;175:236-239.