Alhamdan Manal R, Aloudah Nouf M, Alrajhi Saleh
Family Medicine Department, King Fahad Medical City, Riyadh 12231, Saudi Arabia.
Clinical Pharmacy Department, King Saud University, Riyadh 11421, Saudi Arabia.
Healthcare (Basel). 2024 Oct 11;12(20):2021. doi: 10.3390/healthcare12202021.
Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. The aim of this study was to explore family medicine physicians' perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using social exchange theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Semi-structured interviews were conducted with 19 family medicine physicians (six focus groups) with clinical experience ranging from 3 to 20 years. The data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. This study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance.
家庭医学医生负责照顾患有各种急慢性疾病的不同患者群体。这些患者包括家人、朋友和熟人，他们可能会在官方批准的程序内外寻求直接医疗护理或获取医疗产品及服务的帮助。由于医学伦理准则模糊，这在伦理上具有挑战性，但社会通常将其视为正常行为。本研究的目的是探讨家庭医学医生对于回应来自家人、亲戚、朋友和熟人的医疗护理请求和/或帮助的益处、困难及伦理问题的看法，并提出建议。研究样本包括在沙特阿拉伯卫生部下属的初级医疗保健中心工作的初级和高级家庭医学医生。通过进行深入的半结构化访谈来收集数据。本定性研究运用社会交换理论，探讨家庭医学医生如何看待和处理来自家庭成员及其他人的医疗帮助请求。对19名临床经验在3至20年之间的家庭医学医生（六个焦点小组）进行了半结构化访谈。数据分析确定了三个主题：文化和社会联系的感知益处与成本、患者管理和医疗系统的不足，以及应对亲属医患之间挑战的建议。本研究表明，在正常医疗服务途径之外治疗他人会带来若干伦理、道德和专业挑战。因此，政策调整需要理解这一复杂困境，并改进针对医生和社区成员的法律、系统规定及指导方针，以改善医疗服务的可及性、减少系统滥用、增强提供者能力，并提高社区意识和合规性。
