Say your child requires surgery. It’s very dangerous and difficult surgery, but there’s no alternative.
You’re the best-skilled to do the operation, but other surgeons are sufficiently qualified if need be. Would you rather perform the surgery yourself, or have other surgeons do it?
I’d let another surgeon do it but I’d stand over their shoulder and “back seat operate”. Maybe tap my foot and groan randomly.
Just kidding, seriously, I’m not a surgeon or a parent but if I was I’d operate on my kids just for practice.
Right out of The Abominable Dr Phibes. You ha e to do what you have to do.
If I was confident that I was able to perform the procedure, I’d do it. If I can do it to a random person, I could operate on my own child.
I’d want the best surgeon available to do it. If that surgeon was me I’d be the one doing it.
If the hospital would *let *me perform the surgery, I would do it, but that’s a really big if. It’s unlikely the decision would actually be in my hands. I certainly wouldn’t prevent the next-best surgeon from doing it, nor would I waste a lot of time trying to argue with the Administration and Ethics committees about it.
^ this
Aren’t there ethical issues WRT this? I thought that treating relatives is strongly discouraged except in an emergency.
This was the first thing I thought of.
And while that situation turned out well, in real life it hasn’t always worked out as hoped.
The official A.M.A. ethics statement opposes physicians examining/treating/prescribing for family members. The non-binding nature of this position becomes obvious when you consider how many docs ignore it (though a survey years ago suggested that performing surgery on family members was considerably less common).
It would be interesting to see the ages of the folks voting on this.
My guess is that the “I’d do it myself” vote comes from those younger than the “I know better” voters.
(why yes, there WAS a value judgement in there, wasn’t there?)
I answered let someone else do it before reading “You’re the best-skilled to do the operation”.
If I was the best-skilled, then “If you want it done right, do it yourself”!
But frequently with surgery, there are surgeons who specialize in various things and are the best. No one surgeon is the best at everything. So unlikely I would be the best for the specific operation my kid needed - thus more likely I would have someone else do it.
I would expect the same correlation, but for a different reason: in years past, doctors were trained to be very autonomous, and answer only to themselves. Therefore, strong ethics like, “you make a shitty doctor for yourself or your immediate family” were pounded in pretty strongly during training.*
Today, as my post alluded, individual doctors don’t need to worry about that so much. Especially for surgery, there’s just almost no way a hospital will let that happen. The ethics is being minded by the administration and ethics boards, so we don’t seem to emphasize it so much in current medicine training.
*And still, many/most of them ignored it, but they know to *say *that they wouldn’t doctor their own. Then they’d have a partner write their kid a scrip for amoxicillin, because who needs to take a kid to the doctor for an ear infection when you know it’s an ear infection? They don’t consider that “treating” family, but it is. (And poorly, too.) And that still happens very frequently, with doctors of all ages. I *hate *getting patients who have family members who are doctors.
I’m a doc, I’ve first-assisted in major surgeries and done plenty of minor surgeries in the last 3 decades and change.
No way in hell I’d do significant procedures on family members unless it was an emergency. Not even if I was the ‘best’ (a ludicrous and highly suspect title in the first place, for almost anyone.) Emotions affect judgement and judgement is incredibly important during critical technical interventions.
And the longer I’ve been in the business, the less I want to handle the other non-emergent stuff for family, too. It’s not worth it, and it interferes with good care in the long run. And occasionally comes back to bite you in the ass. Either in bad outcomes or heightened expectations, or both.
That was a bit much of a handle, so people just called him “Bad Phibes,” man.
Anyhow, I voted to let someone else do it, but on re-reading the OP, I’ve changed my mind.
On the whole, my attitude is that if I were a surgeon, I’d want someone else to operate on my kid, as long as there was no reason to think they’d botch it. In most situations, that would mean that they were qualified and competent and had experience with similar surgeries.
But per the OP, it’s a particularly difficult and dangerous surgery, which to me means that you want your ace surgeon in there. If that happens to be me, which is what the OP says, then I’m going to have to do the operation.
But here’s the deal. IME, medicine is a small town, and hyper-specialized, very talented medicine is a very small town. I’m in Texas and my sister was in a bad accident, broke her back. I have an uncle who is a neurosurgeon clear on the other side of the country–but he has a former resident who is a Very Big Deal here, and knows everyone , and it was a matter of a couple phone calls for the family to feel confident we’d gotten an extremely competent person to take care of the surgery.
I really suspect that if you are the best in the world at a surgery, you know numbers 2-5 personally–not just by reputation, but you’ve sat in bars and talked shop with them, and you know which ones you like and trust. I also suspect that if your kid is in danger, one of them will come out to do the procedure as a professional courtesy.
I’ve heard of things like ER doctors treating a relative in a mass casualty event, or missionary or MSF doctors performing cesarean sections on their wives because there was nobody else around to do it. Otherwise, I can see where you’re coming from.
This.
“He can be the boy’s father because the surgeon is the boy’s mother!”
No, I would not. I would probably not be able to remain calm or steady during the operation. There’s a damned good reason it’s frowned upon to treat a relative, except in an emergency. Even if I was the best at that particular type of surgery, I probably wouldn’t be at my personal best in that particular situation.
I am not a doctor, but this seems like the only possible answer.
I will say this: my physician DIL does give me general advice (she thinks I shoudn’t lose more weight–but neither does my doctor) but would not treat me. Except in an emergency.