Hoping to get other's input on a strange situation I'm having to navigate through. Long story short, I have a really sick patient who is frankly dying, but family conversations regarding impending decompensation and code status is not productive.
Today the family brought in a private "patient advocate" - which I'm fine with as a neutral arbiter, but this person introducing themselves as a doctor is rubbing me the wrong way. They are a midlevel with an academic degree, unknown amount of clinical experience in my field, and I'm in a state that restricts the "doctor" title in clinical settings. The person was also a little cagey when I was trying to ascertain their background and experience, which I was innocently trying to do as they introduced themself as a doctor and I was trying to be professionally courteous until I later learned about their credentials. Don't get me wrong, nurses/PAs etc can help patients and families navigate through complex situations, but the manner in which this is being done, and at a hefty fee for the family, is making me uncomfortable.
I find it to be a very thin line when it comes for this person asking questions or giving advice to the family in the clinical setting because I'm afraid this is a form of medical advice or trying to skirt the patient-physician relationship, especially if the family keeps referring to you as doctor. I think at the best it is misleading and at the worst unethical.
Not sure if others have come across this, hoping to hear other opinions/advice.