BY GLORIA BUTLER BALDWIN

The biblical proverb, "Physician, heal thyself" sounds good, but as a physician, if you really try that in today's world, you'll be in big trouble.

Although the idea that you should address your own problems before someone else's works well in life, it won't fly in the world of medicine.

The American Medical Association and the State of Tennessee have strict regulations in place that specifically address self treatment and family treatment.

The Tennessee Board of Medical Examiners policy on prescribing to yourself and your family states that only in a dire emergency can you prescribe and schedule IV drugs and never, ever, are you allowed to prescribe, administer or provide Schedule II and III drugs to yourself and your family under any circumstance.

It also requires that you keep a record of all prescriptions or administration of meds written or given to yourself and your family in those emergency situations. In essence, the policy states, you can't have a bona fide doctor/patient relationship with yourself.

That stated, the bottom line is that when you are ill, you have to take off that lab coat, shed that physician persona and put on your humble patient gown to go see a doctor yourself. You believe you know the diagnosis, you know the necessary protocol, and yet you're in a place of vulnerability. But it's even more difficult to trust your family's healthcare to another doctor.

In a world where ego is far from unheard of, that can be awkward to say the least. But it really gets sticky when a physician disagrees with a diagnosis. What happens when partners exchange healthcare and there's a conflict and you have to work with them everyday? Or what happens when your physician friend just seems to not have a clue about how to treat you or your family member or has a treatment style that isn't exactly what you had thought?

The doctor/doctor patient dynamic can be strained or a little uncomfortable on both sides of the table. Can it damage your partnerships or friendships? You bet. Doctors all over feel your pain. On the flip side, it may not be all bad.

Dr. Steve Samudrala, medical director of the American Family Doctors Walk-In Clinic in the Brentwood, Tenn. office, said when he needs medical treatment, he usually does see his partners for convenience.

"It's not easy to see a doctor who is also your good friend," admitted Samudrala. "It is a little strange (having to see a doctor when you are one), but we want to enjoy the experience of being pampered as a patient occasionally."

Chris Dodson, DC, Cumberland Medical Clinic in Pine Bluff, Ark., said although the rules of treatment are somewhat different for chiropractors such as himself, there are some benefits to being any kind of a doctor when you have to go see one yourself.

"If I need adjustment, I prefer going to a doctor I went to school with because I know they were trained the same way," Dodson said. "Being a doctor (of chiropractic) helps. It really doesn't hurt because you know more about the body and can be more specific in helping them determine what's going on. It's just like with patients. If a patient knows a lot about their body, it's helpful in describing their symptoms. But, if the service isn't there, you have to find someone else. It can interfere with a friendship, I guess. But usually that doesn't happen when you're trained the same way."

Dr. Mike Lacy, pediatrician at Memphis Children's Clinic in Southaven, Miss., agreed that it is a two-edged sword. On one hand, it can be a tough call when seeing someone you know, especially when family is involved. But there is also an added benefit to be able to communicate with each other as physicians.

"We've been fortunate. We haven't been in any situations that were potentially conflicting," Lacy said. "I've been on the other side where I was brought the children of residents, nurse practitioners, obstetricians, ear, nose and throat doctors and others. My wife is even an ob/gyn. But it helps in that because they are doctors, you can lean on them just a little bit by them being able to identify what they think is going on. Since they have more knowledge, everything is more straightforward. There's an element of understanding that pediatricians need to help educate parents in lay terms what's going on, so we spend a lot of time explaining things. I don't have to do that training with another doctor, so it can make things smoother."

Lacy said when it comes to their children, even doctors are more willing to listen to each other and get those objective professional opinions.

"They have a much more hands-off approach about their children," Lacy said. "They want to make sure they're not missing something and want that objective view. Working in the medical community, you're going to develop ties and friendships with people in other areas. It can be a tough call at times to back off and let another physician make the call. But it also helps who you know."

Physicians all seem to agree that knowing another physician's educational background is also important, as is knowing his or her personality and treatment style. Physicians tend to migrate toward those like themselves — their buddy from Wednesday's golf game or the one they joined on a ski trip in Vail.

However, there are situations in which doctors might want to bypass that friend with a great bedside manner for reasons other than the potential conflicts it could create. Maybe there are times when physicians need someone won't succumb to niceties and sugar-coating just because of a friendship.

As physicians who have to treat the seriously ill all day without getting too emotionally involved, you must sometimes reach out of your comfort zone to an expert who doesn't know you and your family and can look at the real picture without emotion as an ingredient. Then, on the other hand, it is nice to have someone to cry with you.