Q. I am a happily married, 54-year-old woman and I have a great primary medical provider.
“Rebecca” is a nurse practitioner in a large practice. I’ve been going to her for about four years. Rebecca is personable, interesting, authentic, and has an easy and fun sense of humor. She asks about my family, vacations, etc., and seems to just be a good person.
From day one, I have left every medical appointment wanting to be friends with her. We just seem to have a compatible energy and sort of “click.”
At my most recent pre-op appointment, she greeted me with a huge smile and a very enthusiastic, “I’m so glad you’re finally able to have this surgery! I’m so happy for you!” I have no idea if this is just her typical “bedside manner,” but I was quite touched.
I have a good group of girlfriends, and I deeply value friendship as one of life’s great joys. If Rebecca were not my doctor, I would invite her to coffee, and be open to either making a new friend or not.
But given the boundaries of this relationship, is there any way to figure out if we could be friends, or if this is just how she is with all her patients?
And ethically, can a doctor and patient become friends? If so, it would be worth switching to a different provider in the practice, but I don’t want to make that switch for nothing.
A. The most “appropriate” and ethical stance is for everyone to stay in their boxes; “Rebecca” remaining your excellent and humane health care provider, and you remaining her grateful patient.
The warm personal rapport you two share enhances your medical care; you feel comfortable and communicate well, she obviously listens, remembers details about your life, and cares about you.
Despite the standard of maintaining boundaries, practitioners and patients do step out of these boxes because they are human beings and sometimes human beings just click. The OB who delivers the premature baby becomes a family friend; the oncology nurse administering chemo connects with a survivor.
Making a bid for friendship with your health care provider is somewhat risky because doing so might shift the dynamic between you.
If you want to take a stab at friendship outside the office, do not ask her for coffee (that’s a little too intimate). Contact her via e-mail (not through the patient portal), and invite her to a group event along with other friends — a fund-raiser, hike, or performance.
She can then accept or demur based on her own comfort level, and your professional rapport will be preserved.
Q. My mother-in-law and I have not always seen eye-to-eye on everything, but we are cordial and appreciate one another. As the grandkids have gotten older and there is less of a reason to communicate, I find I am unsure when or if I should to call her.
When I have called in the past to chat, she seems happy to talk to me, but she never calls me. I feel like I should assume if she never calls me she must not want to talk to me.
In fact, once when she was going through a tough time, she actually told me that I didn’t “need” to call her.
However, she lives alone and is getting older, and I occasionally wonder how she is doing. I do remind my husband to call from time to time, and he does.
We see her in person once every month or two, and she has other family members and friends who live closer and see her more frequently.
A. I think these calls you make are important — even if you always initiate. And as she gets older they will be vital ways to check in.
Your mother-in-law may be shy, or a little intimidated. Some people have an actual aversion to making telephone calls — it’s a sort of inertia that can be hard to overcome. From what you write, it seems that she also doesn’t call her son.
Keep it up; it’s the right thing to do.
Q. “Concerned in Suburban Chicagoland” wrote that her 13-year-old daughter burst out laughing and left the room when these parents told her that they were divorcing.
I thought I was the only teen who laughed at the worst possible moment. When my folks dramatically told me my grandmother had died, I burst out laughing. A short time later I realized that this weird response was mainly because I was overwhelmed. I still miss Nana.
A. Laughing in response to loss seems strange, but it does happen.
Amy Dickinson can be reached at firstname.lastname@example.org.