The danger of being a friend: Lessons from Matthew Perry’s tragic death

5 people including 2 physicians have now been implicated in Matthew Perry’s untimely death from a Ketamine overdose. How are physicians (dentists and health professionals) lured down a path that could result in ignoring good judgment and thebasic principle of the Hippocratic Oath of “do no harm”? And how can a slide down this slippery slope be avoided?

Mrs. Jones has had trouble sleeping for years. She sees many physicians as she has multiple medical issues. But one physicianin particular, her cardiologist, is more of a “friend”. He’s the doctor with whom she is most comfortable, is most approachable, and who she feels cares about her most.

That’s why she asked him to help her with her sleep issues. And, caring for her as he obviously did, he prescribed medication to help her sleep. And he did so for quite a while.

Eventually, she ran out of the medications, to which she was probably addicted to, and asked for more. For whatever reason, perhaps it was the issue of addiction, perhaps it was the interaction with the many medications she was now talking, or the fear that these medications are being monitored and scrutinized, he said that he couldn’t an longer and referred her to a psycho-pharmacologist.

Mrs. Jones was infuriated at the cardiologist! “How dare he stop caring for me!” “He’s no longer my friend.” “I’m going to find another cardiologist.” Those were her reactions.

Desperate for a good night’s sleep, she finally acquiesced and went to the specialist. And, after seeing him, she understood that the cardiologist still cared about her. She’s no longer seeking a new one.

Healthcare professionals, for the most part, go into the field to help people. The best deeply cares for their patients. And yet, this ‘need to care’ comes with a risk. That risk is not being able to say “NO” when a patient asks for something.

They might ask might be for a financial discount, an accommodation involving special times for appointments, or a prescription for a medication that’s for something other than what’s in that doctor’s area of expertise or in the patient’s long term best interest.

As doctors, we’ve all been there. The friend who imposes on your non-office time. The patient who can only come in 1/2 hour before normal office hours. The family member who asks you to refill a prescription for a medication prescribed by another.  As practitioners of dental sleep medicine, we might be asked to make an appliance for an undiagnosed friend.

And its often relatives who are the most egregious in requesting special dispensation.

When does a doctor or dentist draw the line? Where should thatline delineating professional responsibility, friendship and caring be?

Here are some Factors to Consider:

Here are some suggestions how to manage the situation:

In essence, a doctor must change their perspective of what is truly in the patient’s best interest and decline requests that conflict with their professional and ethical responsibilities, even if it may disappoint the patient and even if that patient is a friend or relative. The guiding principle is to prioritize patient safety, quality of care, and adherence to professional standards.

Once the line is crossed, sliding further down the path meets less internal resistance. So, it’s best not to start. Or, if one has already crossed the line, take a step back and reevaluate. And let those around you know WHY you’ve decided to change your behavior. Your friends and your team, when given your rationale should respect you and help you enforce your new path.

And, this “friend” phenomenon isn’t limited to doctors. Our teams often are composed of “people pleasers”. Hence, sometimes the bend over or neglect office protocol in order to help people.  Seemingly little things like saying “that’s OK”, when a patient cancels an appointment, sends the wrong message.  It might have been said in an effort to be nice to the caller but it sends a wrong message, that it’s OK to cancel, to the patient.  It can encourage behavior that is a profit-killer for the practice.

Want to give your team the resources they need to help them realize that being a friend is great but that with NO MONEY, there’s NO MISSION, and no salary increase?

Join The Liberated Practice today and help your team help you and your patients. In this instance, being a friend, by giving them a gift membership shows you care. Let The Liberated Practice be your companion along the journey to success.  And when you use code “Liberated24”, you’ll get $500 off a yearlymembership.

To friendship and success,

Michael