Neighbors, friends can note health risks

While I’m away, readers give the advice.

On helping a loved one whose health is at risk: I often wish advice columnists would counsel neighbors, family and friends who are concerned about someone to send a letter to the patient’s doctor. It’s usually easy enough to find out names of people’s doctors: Most people keep their meds in the bathroom medicine cabinet or on the kitchen counter, and the doctor’s name and phone number are right on the pill bottle. If not, “New neighbors just moved in down the street and asked about good doctors but mine doesn’t take their insurance. Your doc has always seemed great – what’s her name again?” works too. Include the patient’s full name, date of birth and/or address so we can connect the letter to the correct patient’s file, and then be as specific as possible about any observations and concerns. We can’t respond to the letter because of HIPAA regulations, but a reputable doctor will take it under advisement. If the letter writer wishes, s/he can request anonymity.

This could be useful for concerns about driving safety, dementia, mental illness, elder abuse, domestic violence, sexual abuse, child abuse or substance abuse. These are all situations in which neighbors, friends and family are well positioned to provide collateral history that patients may hide, and thus doctors may miss unless prompted.

Physicians are legally obligated to report cases of potential child abuse, so a credible letter about that may trigger an alert to the authorities. For patients with drug and alcohol problems, we can choose medications less likely to have harmful interactions. For victims of physical abuse, we might think twice before prescribing blood thinners or order an additional X-ray to check for internal trauma. Writing a letter probably won’t fix the immediate situation, but it could help us do everything possible until they’re ready to choose the help they need. – A Physician