Eyeworld

September 2016 • Ophthalmology Business 17 in peer-reviewed journals of various medical specialties every so often. 1,2 In general, the American Medical Association (AMA) states that "phy- sicians should not treat themselves or members of their own families. However, it may be acceptable to do so in limited circumstances." 3 These include emergency or isolat- ed settings and for minor medical problems. Concerns presented by the AMA include the possibility of a lack of objectivity on the physician's part and a reluctance to disclose sensitive information on the patient's part, among others. Richard Tipperman, MD, Wills Eye Hospital, Philadelphia, said he has operated on people he knows well, though not immediate family members. "For me, it was mentors, peo- ple who trained me ... who became mentors, personal friends, and then when they needed surgery, I did their cataract surgery," Dr. Tipperman said. "The issue always is if you're taking care of someone who is close to you, will emotions alter your judgment?" However, Dr. Tipperman said he thinks the situation needs to be indi- vidualized between the surgeon and patient—there is no blanket rule. J ohn Berdahl, MD, Vance Thompson Vision, Sioux Falls, South Dakota, per- formed cataract surgery on his grandma, PRK on his mother, LASIK on his brother, and Descemet's membrane endothelial keratoplasty (DMEK) on his dad, to name a few of the procedures he has done on family members, colleagues, and friends. Practicing in a more rural area where there are fewer options is one factor that might have contributed to a higher volume of familiar faces in the operating room, but Dr. Berdahl said much more plays into this situa- tion as well. "I don't think there is something inherently wrong in doing it," he said. "Just like any patient that you see, if you feel like you are the best person for the job, or can do it as well as other people in the field, and you don't think the emotional com- ponent of it will get in the way, then it's reasonable. Just like any other patient, if you think there is a better alternative than you, you should offer that alternative surgeon." The ethics of treating friends and family is a relatively common topic. Medical associations in many countries have position statements on this practice, and opinions appear continued on page 18 Should you? Shouldn't you? From family members to colleagues to neighbors, what to consider when they want you to do their surgery

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