To the Editor:

“Should You Treat Yourself, Family or Friends?” [March 2005, page 41] got me thinking about a recent trip to China with my son's high school band. When my 200 fellow travelers found out I was a doctor, my hotel room (or the bus or elevator I happened to be on) became an exam room.

I had tried not to let on that I was a doctor, but these things have a way of being discovered. Mostly I did triage. The biggest decision I made was to replace a woman's lost blood pressure medication with a similar one available to us – after doing a brief history and physical. Another woman was hospitalized at my suggestion to rule out pneumonia, and the rest of the diagnoses were a variety of minor ailments such as URIs, rashes, labyrinthitis and twisted knees.

I'll probably be asked to chaperone other band excursions, and I'm not sure how to handle it. You can't ethically abandon your buddies while traveling, but you don't want to be bit later on. Any advice?

Author's response:

I would recommend keeping some record of any encounter that involved writing prescriptions for medication. It would also be good to make clear that you are making an exception to your normal practice of not treating friends because of the difficulties of accessing care in China. If future trips are scheduled to less remote locales, you might consider being less willing to act as “band doctor.”