Examining Physicians’ Approaches to Treating Relatives in Primary Health Care Centers: Insights from a Qualitative Study

Introduction: Family medicine physicians take care of a diverse population of patients with a variety of acute and chronic diseases. These patients include family, friends, and acquaintances who may ask for direct medical care or help in accessing healthcare products and services, within or outside of officially approved procedures. This is ethically challenging due to an ambiguous medical code of ethics, but it is commonly accepted as normal behavior by society. Clinical ethics and the moral code of conduct together define how physicians should deal with such requests. However, Saudi physicians, like most individuals in Saudi society, are governed by the societal code of conduct when dealing with requests and favors from others. The aim of this study is to explore family medicine physicians’ perspectives regarding the benefits, difficulties, and ethics of responding to medical care requests and/or favors from family, relatives, friends, and acquaintances and to make recommendations. Methods: The study sample consisted of junior and senior family medicine physicians working in primary healthcare centers affiliated with the Ministry of Health in Saudi Arabia. In-depth semi-structured interviews were conducted to collect data. Using Social Exchange Theory, this qualitative study explores how family medicine physicians perceive and handle requests for medical favors from family members and others. Results: Semi-structured interviews were conducted with 19 family medicine physicians with clinical experience ranging from 3 to 20 years. Data analysis identified three themes: perceived benefits and costs of cultural and social connectedness, shortcomings in patient management and healthcare systems, and recommendations to address challenges between physicians and patients who are relatives. Discussion and conclusion: The study shows that treating others outside of normal access to healthcare services presents several ethical, moral, and professional challenges. Therefore, policy adaptation requires understanding this intricate dilemma and improving laws, system regulations, and guidelines for physicians and community members to improve access to care, reduce system abuse, empower providers, and enhance community awareness and compliance.