Doctor, boss, or both?

How do doctors feel about treating their own employees as a professional courtesy? To find out, we recently polled our "Kitchen Cabinet," a group of physician-readers who serve as the magazine's informal sounding board. What we found: The majority of respondents do treat their staffers, and many are enthusiastic about it. Says Robert Matthies, an FP in Prescott, AZ, "I consider it a sign of respect for my competence that they ask me to provide care for them."

Among the common arguments for providing care for staffers: It's a valuable benefit that helps attract and keep good employees; it reduces the time they have to take off from work for medical appointments; and they're more likely to take advantage of such convenient care, which will keep them healthy and reduce absenteeism. In rural areas, in particular, there may not be other physicians within a reasonable distance.

But doctors' concerns about treating employees were equally compelling.

Why some doctors are ambivalent

Jeffrey Pearson, an FP in San Marcos, CA, limits treatment for staffers to quick consults for minor medical problems, particularly if they can't reach their own doctors. "It's the same kind of things that I often diagnose for patients by phone," he says. "But I won't adjust medications, or do any extended treatment."

"I'd rather we didn't have to treat our staff," says Andrew Alpart, an FP in Slingerlands, NY. "I'd prefer that they kept their professional lives distinct from their personal lives. But sometimes, it's simply necessary because of the circumstances." The danger, he says, is that "my day will be disrupted by staff members who feel that they can seek care on an informal basis rather than making an appointment. I refuse these overtures because I believe they lead to hurried, undocumented care, which poses both a quality and a liability hazard. I won't be put in the position of providing half-baked care for someone with whom I have no regular doctor-patient relationship."

Michael Christian, an FP in Moses Lake, WA, has the same policy. He treats his staff "only if I'm their regular primary care physician. I won't treat them just because they can't get an appointment with their own doctor."