by Emily Miro, MD, MPH
For as big as the University of Utah healthcare system is, it can often feel pretty dang small.
As an employee of the U, I get my care through University of Utah clinics. I recently needed to get a pap (ending my many-year streak of “do what I say, not what I do”-style medicine regarding preventive care guidelines) and logged onto my MyChart to schedule an appointment. The majority of women’s healthcare providers are at OBGYN and Family Medicine clinics. OBGYN clinics were booking months out, and Family Medicine clinics are staffed by….my co-residents and attendings. I would be lying if I said that this didn’t contribute to my lack of enthusiasm. One day, my co-resident and I had free time at the end of clinic. Our clinic staff booked me an appointment with her, and the whole thing was over in less than a minute. And it was actually kind of nice to have my friend do my pap. It felt casual and subsequently a little more comfortable, and I knew that I was getting good care.
That got me thinking, how does it feel for my friends when I am their PCP? I love seeing my friends in the office. I find a lot of joy and satisfaction in knowing that my friends trust me to take care of them.
But it can be tricky providing care for co-residents. If someone tells me that they already talked to a resident or attending in another specialty, do I still refer them? (The answer should probably be yes.) How do I deal with the repercussions of a misdiagnosis or less than optimal management in someone who is also my friend? (I am in training, after all.) How do I tell my peer that I don’t agree with their self-diagnosis? (Gently.) Or recommend they change the way they care for their child? (Even more gently.)
There are many boundaries I wouldn’t cross with a friend who is my patient, and I recognize the importance of facilitating quality care from an alternate provider when I am out of my scope, or one of us is out of our comfort zone. That being said, these interactions further teach me how to navigate delicate situations and recognize my limits as I progress through my training.
In the past, attendings have told me that they typically prefer to separate their personal and professional relationships, and that they suggest their friends see someone else as a PCP. That seems like a simple, easy solution. A good way to avoid the aforementioned examples. But I don’t think that’s the best solution for me. I really enjoy being my friends’ PCP. Providing care for my friends adds something unique and special to our relationships, and helps me feel fulfilled and fortunate to provide primary care. It is my hope that I can help my friends/patients/friend-patients feel comfortable and cared for when they go to the doctor, just like my co-resident did for me.
Dr. Miro is from Hillsboro, Wisconsin. She received her undergraduate degree in Kinesiology at the University of Wisconsin. She spent a wonderful year with AmeriCorps in Laytonville, California, teaching health classes and connecting community members with health resources, before moving to Phoenix for medical school at the University of Arizona. She completed a Masters of Public Health while at the U of A. Her medical interests include sports medicine, public health, maternal-child health, and community outreach. Outside of medicine, she loves trail running, hiking with her partner Paulo and cute pup Bodhi, and having only moderate success with new baking experiments. While on the interview trail, she fell in love with the University of Utah’s perfect mixture of academic and community medicine, friendly and supportive faculty and residents, amazing sports medicine opportunities, and unparalleled access to the outdoors!