Listen to the podcast here: When Friends & Neighbors ask for free medical advice
Episode Summary: In this episode, Phil and Marina tackle the all-too-common (and often frustrating) reality of curbside consults from friends, neighbors, and anyone with your phone number.
They unpack the emotional tension behind these requests—why they can feel draining, where boundaries get crossed, and how this dynamic impacts both physicians and relationships. More importantly, they share practical, real-world strategies for responding with clarity and professionalism—without damaging personal connections.
If you’ve ever felt torn between being helpful and being taken advantage of, this conversation will hit home—and give you a better way forward.
👉 Read the full breakdown to learn how to handle these situations with confidence and protect your time, energy, and expertise.
Welcome to DPC Pediatrician. We’re Dr. Phil Boucher and Dr. Marina Capella, two DPC pediatricians who are on a mission to share our love of direct primary care with you.
Hey everyone, welcome to another episode of DPC Pediatricians. We today are talking about the curbside consults, not from your colleagues, but from your neighbors and people with your cell phone number. It’s a common issue in pediatrics in general because most people that are pediatricians have friends with children and it comes up often and it can be a source of frustration and soreness for pediatricians.
And I think we’ve all at times felt a little bit used by friends and family that just kind of want our advice rather than like the check-in or the how are you it’s like hey my kid has this thing and it’s easier for me to just take advantage of the fact that i have your cell phone number than to do the work of like contacting my own pediatrician or going through the proper channels and those sorts of things and it comes up frequently like in the the facebook groups from time to time on what how do you approach this or what do you do And I think it’s something that at first, when you’re not busy, it’s like, oh, people need me. I’m going to help.
And then when you start to get busier, it’s like, I don’t really want to give out free advice. And all my patients are happily paying for my advice. And you, good friend, just want me to tell you if your kid needs stitches or what to do about their stuffy nose or if we’re seeing this or that or the other thing around. so that you can avoid the hassle of contacting your own doctor.
So I guess, Dr. Marina, how do you handle these requests or what are your takes on the, hey, do you mind if I just ask you a question over text message or in the parking lot at church or Target or wherever it might be?
Well, first of all, I’ll say I don’t always handle them optimally. And I think most of us can probably say that, that we’ve in the beginning been eager to offer help and then reached a certain point where we start to feel resentful because it’s crossing a certain line or maybe we’re already exhausted and then we’re being asked to expend extra energy that we don’t have on someone who’s not paying us or giving us anything in return, right?
And so I think that that issue with the reciprocity or lack of reciprocity is where we get into trouble, right? When someone is always asking, asking, asking, but they’re not offering us anything in return, right?
For our time, for our help.
If I had a friend that was an accountant and I texted him and I was like, what should I put on line 27 of my 1040? He’d be like, you should talk to your accountant. Like, I can’t give you advice on your accountant. But it’s like, what’s this rash?
Uh-huh. Yeah. So I haven’t always handled it optimally, right? Sometimes I have given in and given advice and then later felt kind of used, right? Or resented the time that I didn’t have or energy that I didn’t have that I gave anyway. But sometimes I have felt like, okay,
this is a unique situation where I feel like I do have a little extra energy to expend. Or this is someone who has done really nice things for me in the past. And I feel like I can repay the favor. Just a couple of weeks ago, in fact, there’s this lovely Polynesian family that lives near us.
And they had a close relationship with my husband, even when he was growing up and his parents. they helped plan both of their funerals. They have always come out in times of need. When a tree fell down in the yard, they came and they were there with their four kids, like helping to clean up the mess.
So this is a family where I really feel like, okay, if I can ever offer something in return, this I’m going to, right? And so the grandmother called me, I was headed home from work already. And it was like, 7.30 PM on a Friday evening or on a Thursday evening. And I was tired.
And she said, my little grandson, they were at this church gathering at this party. And my daughter, who was a teenager, was like swinging him and he injured his elbow. And I was like 90% sure that this was a nursemaid’s elbow just by the description that he’s like holding his arm.
I saw plenty of these in urgent care, et cetera. And so I was like thinking through it as I’m on the phone with her, like, I’m exhausted. I don’t really want to have to like go back to the clinic. And this is someone who’s not my patient. This is her grandchild.
And so I thought really quickly in my mind, how can I do this in a way that still reciprocates what they’ve given to me, but also doesn’t take too much of my time or energy? And I said, you know what? Are they willing to meet me at my house? Because I’m 10 minutes away. I’ll be home.
And if they meet me there, then I can see him and at least tell you, okay, this needs to go to urgent care because it’s a fracture or this is a nursemaid’s elbow and I can fix it. And so they ended up meeting me 15 minutes later at the house.
And I spent 10 minutes fixing this kid’s nursemaid’s elbow. In fact, just like five seconds. But then I like to observe them for a little while to make sure that…
You can’t make it look too easy to get the nursery. Exactly.
Yeah. And they were so, so grateful, really appreciative. The grandma brought me flowers the next day. It was, that was an interaction where I felt good. It was only 10 minutes of my time in the big picture of things. And I was reciprocating something that I felt good about.
Now on the other end of the spectrum are people that you hardly know or friends who haven’t talked to you for three years or five years. And then they text you with this barrage of medical questions, right? Expecting you to drop everything and help them.
And that’s where I feel like I’ve gotten better over time at drawing the line and saying, you know what, I’m sorry. We can hide behind our medical malpractice. Like we can say something like, I can get in trouble with my malpractice carrier if I give medical advice to people who are not under my care.
So you can find something like that to say that helps give you an easy out if you need to. How about you, Phil? Do you have easy outs for those sorts of situations?
I mean, I think if we were willing to have those difficult conversations, the conversation would look like, Hey, it doesn’t feel right for me to give you medical advice because I’m not your doctor. And I would like to maintain our friendship and not have any resentment builds and any chance that something could go wrong.
But I think most people feel uncomfortable enough about confronting somebody, especially over, it’s usually over text message. Let’s be honest, where they have texted you. They haven’t talked to you in five years and out of the blue, they’re text messaging you wanting to know about a rash or a fever or something along those lines.
And so I think the easy out for me is number one is just to ignore it. and that’s mostly what i do is just be very slow to respond if i respond ever or at all but it does leave a little bit of lingering resentment of hey like i haven’t
heard from you in five years you text me out of the blue to find out about your kid’s fever there’s no how are you how is your family it just feels very transactional with me getting nothing out of it except putting my medical license and peace of mind and quiet
evening on the line to help you and your child through a difficult moment that you do have the channels they’re just not as readily accessible and so i i will ignore them or I’ll say medical malpractice. I just can’t, my malpractice will,
will not allow me to like take care of patients that aren’t under my care or I’m not their pediatrician, but I would certainly reach out to your pediatrician about that. Yeah. That seems, that seems legit. You should reach out to somebody is the nice way to do that.
I think those would be my main approaches when those sorts of moments come up. But I, I think In general, it really depends on how much of an inconvenience it is to me if I’m going to respond or reply. Just yesterday, a friend who isn’t a patient,
but that we go to church with had sent me a picture of her kid’s lip and it was just split open on the inside. And I was already like 97% sure just from seeing, I mean, we do a lot of text messaging. I was 97% sure that this didn’t need anything.
And I was at the office and I had to wait to go pick my kids up. Like I wasn’t doing anything other than just seeing a couple of patients. And I knew that they could just swing by. And I offered that to them because it wasn’t a big deal for me. If it had been two hours later,
I would not have offered to see them because I would have been at home with my family and I probably wouldn’t have seen it to respond. And then I would have texted them the next day, oh, sorry, totally missed this. I hope everything worked out okay or something along those lines.
I think if it’s going to be an inconvenience to me or it’s going to put my family out or something that we had planned, then I’m very reluctant to ever respond. like break that boundary. But if it’s not too inconvenient and I can really help and it’s not going to be too big of an ask,
then sometimes I will allow that boundary to be breached. And yeah, here’s what I would typically do. If it’s something that’s very straightforward, I’m not going to work up your kid’s 103 fever over text message and just be like,
nah, it’s fine.
Just give me some Motrin and keep going. But if it’s something that’s very straightforward like that, I’ll try to help when I’m able to knowing that hopefully it will come back around and karma will be in my favor at some point.
Yeah, I agree with that kind of general sentiment. If it’s something that literally takes a few seconds, I also don’t, don’t sweat it too much. Like if, I happened to see this text. I’m going to reply something quickly. And then that’s done right now.
If that were to become a repeated pattern of someone who’s not giving me anything and every week or every month they’re texting me a question, then that comes into problematic territory for me because it’s like, okay, you just want to have the benefits of a membership without giving me a penny. And that’s when I would probably say,
hey, I’ve been okay giving you advice a couple of times, but I feel like if you have this many questions, here’s the option to join as a member. Like I can’t keep. And I think a lot of us are too afraid to be honest because
Yeah,
I have a lot of conflicted feelings about that because I know sometimes like in the physician Facebook groups, like people will say, oh, I just ghosted that patient or I just didn’t respond or I just are there times when that is appropriate? Yes. But I would say honesty is also a really good policy and making it short,
making it sweet, making it to the point. making it professional and kind. There are ways to do that. I think sometimes it really comes down to our own discomfort and the story we tell ourselves about what that means if we set a boundary or we insist on respecting a boundary, right?
But I think the more that we do that, the more we practice doing that, the healthier it is for us long term, because by the 10th, 20th, 50th time we do it, then it’s nothing. Whereas the first the first couple of times are always a little more painful to remind people about that boundary.
It breeds a lot of resentment when you don’t do it honestly, or you just ghost them or you don’t reply. Like, as you’re saying all that, I can think of somebody that will text me things that are completely not necessary to text, like about ear piercing or sending a picture of their kid’s earring.
Like those things just add to the resentment of, Hey, it would be appropriate. It would be. more appropriate if you reached out to my office if you actually need help or hey i can understand where you’re coming from but it’s really important for me to keep
these boundaries between friendship and clinical care i do take care of friends in my practice but it’s through my practice and not over my personal messages and those sorts of things and i think that if you felt comfortable with that like even
if you just had a script like a dot phrase that would be helpful and maybe that’s something that we could develop is just like a little dot for to deal with the discomfort of being kind but firm with, hey, this is not exactly the relationship that I’m looking for.
Because there is no one else that you, like I would feel so uncomfortable. My office manager’s husband is a mechanic. And I know that I could text him about my car making a funny noise, but I would feel so uncomfortable about doing that, that it’s just shocking to me how people will just text because they assume that
you’re a helper and you just help out of the goodness of your heart, which you do, but that they can just take advantage of that over and over again. So I think that leads to a lot of resentment when you don’t just say, hey, yeah, I think you should see your doctor.
Yeah, oh, exactly. Yeah, that and that resentment, it does build man, it might just feel like a tiny bit of resentment at a time, but that stuff builds up over time. And then, and it’s that phenomenon of like, okay, resentment the first time, a little bit the second time, a little bit the third time.
And by the time you get to the 10th time, you suddenly find yourself wanting to explode back at the person who they didn’t know they did anything wrong. And why are you exploding at them? But it’s not actually because of what they did in that isolated circumstance.
It’s because of the resentment that you allowed to build over those 10 times. And I know that I’ve experienced this myself, right?
Oh, I’m sure everyone that’s listening right now can say, yep, been there, done that. I can think of three people off the top of my head that I hold that grudge against that they don’t know because they have sent me silly text message medical questions that were not appropriate.
Right, exactly. Yeah. So we’ve kind of talked about kind of the two extremes of like, sometimes it’s appropriate to ghost on one extreme of things or just not respond, right? Most of the time you want to do maybe something in the middle or on the other end of things, just be really direct and be really honest.
Now, I would say in between is also the give it time. Don’t respond right away. Right. You could have been at the gym. You could have been traveling. You could have been they don’t know. Right. You could have been really busy dealing with patient visits or meetings.
And so if you give it a couple of hours to before you respond, sometimes they will have had to find an alternative to answer their question. Right. And then you don’t have to be in the same position of being the first line needing to address their question. Right.
So if you give it like five hours and you’re like, oh, sorry, just saw this. Do you still need advice or did you figure it out? That gives you an opportunity to give to kind of nudge them to find an alternate solution than just relying on you. Have you ever done that?
I’ve done that for sure of, Hey, how did this work out or something like that? Just saw this. How did it work out or something along those lines? As you’re saying all that, I’m thinking of the snarky thing to do nowadays would be to schedule a message to like,
they send you a message at 8 PM and you schedule a reply to go out at two in the morning or something like that. Just be like, oh, yeah, that is inconvenient to get woken up to a text message like, oh, yeah, I’m so sorry. I just saw this. That sort of thing. I wouldn’t do that.
But it is tempting now that I’ve thought of it.
You just fantasize about it to feel a little better. Yeah.
Yeah, I think it is. But it is something that like from a longevity of practice standpoint, you do have to put those boundaries in place. And it is really important to value your own privacy and peace of mind that comes from being able to put those things up and not having to feel like you have to
constantly be on because you and DPC probably already do feel like you have to be on a lot of the time. And so you should be on for your patients to the extent that you’ve set those boundaries around, but you shouldn’t just be on and available for anybody that needs it. And people shouldn’t have that expectation.
It’s not up to you to change their expectations, but you can still have those boundaries.
I will add another little note here in this conversation. Obviously, both men and women can experience this. I think for many women, there are added levels to it, right? Because as women, there are just different social expectations of we’re supposed to always be helpful. We’re supposed to always
go the extra mile for others, we’re supposed to always be nice, right? And so as women, when we try to set those honest and frank boundaries, it can be received a little differently. Not to say that it can never happen for men, but I would say on average,
it can be a little harder for women to be direct and honest in their replies about that boundary being overstepped. because of the way that we’ve been culturally conditioned. And so it becomes even more important for us to really examine, okay, what are the beliefs that I hold about myself or what are the habits that I’ve
developed over my lifetime Even just unexamined kind of thought patterns around this whole thing. What is it that makes me uncomfortable? What am I afraid of? Why am I reactive? And how can I come up with just like two or three pre-thought out phrases that I have always at my disposal?
that I can pull out when these things happen. Because if you think about it in advance and you already have a plan for what you could say in these circumstances, it’s gonna be a lot less stressful when the circumstances actually happen and you’re gonna feel more comfortable setting that boundary or respecting that
boundary that you’ve created for yourself of like, okay, I’m going to think through 10 scenarios or just a couple of scenarios, just like we’ve talked about today. What if this happens? What if that happens? How will I respond? And again, if you’ve already thought that out,
you’re already going to have a response pre-thought out and you’ll be able to pull it out of your pocket, type it out and make it less overwhelming for yourself.
Totally. Cause it is the thinking like you’ve, you’ve spent so much time thinking about it that you might as well just tell them that they don’t need stitches rather than like craft this perfectly worded thing of like, you should talk to your own doctor. But I,
I completely agree with you that if somebody texts me and I say, Hey, I’m trying to spend time with my family right now, but I would talk with your doctor. They’ll be like, Oh, What a good dad, he really wants to be present for his kids. And if a mom had sent the exact same message,
I could see the person replying like this, can’t you just give me two minutes of your time or something like that because of the way that society has set those unreal and unfair expectations. So I definitely realize that it’s easy for me to say those sorts of things compared
to our female colleagues that deal with it in a much different way than I do. all of that so yes that is 100 true and i think that speaks to like what you were saying like a dot phrase essentially on your phone then you can have a dot phrase
for distant people that you haven’t seen in five years a dot phrase for people that you see at the school pickup line or at church or wherever and then a dot phrase for your closer friends that all communicate the same message lovingly respectfully and allow you to then not get stuck on that
Yeah. And if that’s hard for you to do right away, give yourself some time, let time buffer, right? Wait a couple of hours before you respond, right? Because you have no obligation to this person who’s not a thing member to reply right away, right? Just remind yourself of that. Give yourself some grace around it.
And also give yourself some opportunity to experiment. Say, okay, I think I’ll start replying this way. Try it. See what happens. If you don’t like it after a couple of times, you can change it up. Give yourself that grace to say, this is an experiment in a new way of communicating and new way of respecting my boundaries.
And I can iterate. I can try new things over time and get more comfortable with it. So, yeah. So hopefully you’ve found some of this helpful. This episode topic really came out of some conversations in the Facebook groups that we’ve seen over the couple of years, you know,
as physicians basically saying this family member or this friend or this neighbor keeps reaching out and asking for free advice and I’m tired of it. What do I do? Right. And just know that there are things that you can do. that don’t take a lot of emotional energy if you just spend a little time thinking about it.
Yep. Take some work though.
Absolutely. All right. Thanks everyone for listening until next time.
