Patients who come with a family member doctor

“Never sign anything without me reading it first.”

Cautionary words from my husband, an attorney, whose ability to read and interpret the fine print has saved my life, so to speak, on more than one occasion. That all-in-the-family attitude toward a profession is something almost every doctor also knows well. Through me, my husband, relatives, friends, and sometimes acquaintances can get what I call a “healthcare quickie,” a free, two-minute sideline. They can also have the full boat: a thoughtful, comprehensive consultation that serves to either allay an irrational fear or as guidance for legitimate health concerns.

Offering advice to family and friends, many physicians might agree, is one of the most obvious rewards of having a medical degree. Knowing all too well how difficult and frustrating it can be to navigate the medical system, those of us who can facilitate this process for the ones we care about likely feel like it’s a win-win for all involved. But is it? What about the third party player in this scenario? Your friend or family member’s real doctor

I had occasion to think hard about this when my father was hospitalized this past Christmas for an acute on chronic problem that I was able to commandeer locally. It was — not unexpectedly — a very mixed experience. With every new professional encounter, I had to survey the landscape; gauge the responsiveness; and tread around egos, hierarchy, and badges.

Probably because most of us have at times been the insider resource, when we’re on the other side of the desk — the physicians who are to provide the actual healthcare service — we can generally sniff out relatives who are “in the healing business” within the first ten or 15 minutes of a new patient encounter. Be they spouses, fathers, sisters, mothers, or brothers, the style of their questions, answers, and especially their interjections give them right away.

In my case, I told my father’s story several hundred times (or so it seemed) to the ER doctors, the specialists, the hospitalists, nurses, physical therapists, and EEG and ultrasound techs. To anyone who cared and listened, I shared all the information we had, using the lingo, offering my opinion, and eliciting theirs. I sounded in turn deferential and sometimes too aggressive.

The impulse to participate as actively as possible in a loved one’s care is well-meaning and logical. After all, we speak the language and are skilled at communicating pertinent positives and negatives. Yet following my recent family experience, I found myself wondering about the shakedown between being constructive and, well, disruptive. I asked some of my colleagues to weigh in. Here’s a sampling of their responses.

“I don’t mind as long as they are reasonable.”

“I feel more pressure to perform well, say the right thing, or do a perfect physical exam.”

“I feel a bit like I am being supervised.”

“It can be helpful because the family member can explain things to the patient.”

To me, their words sound about right. In the end, there should be a unified purpose toward wellness, no matter what side of the desk we might find ourselves on. When we encounter patients who come with that family member doctor, this may mean a little extra patience, remembering that watching a loved one in pain is stressful and confusing, even for those whose profession it is to treat and heal on a daily basis.

Yet just as importantly, when we’re the family members, we must be mindful of the fact that that the “real doctor” is here to help. Therefore, that we need to treat him or her with politeness, appreciation, and respect.

Natalie Azar is a rheumatologist who blogs at The Doctor Blog.

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  • SBornfeld

    Yes, the “real doctor” is here to help. And yes, being emotionally too close to the patient can cause problems in decision-making.
    But as these blog comments demonstrate all too often, physicians are buffeted, sidetracked, waylaid, and confounded by bureaucracy, record keeping, insurance companies and all the other not-so-minutiae that can directly impact decision making regarding patient care.
    You, on the other hand, have only one motivation–and that’s to see that your dad gets the best possible treatment.
    My dad died suddenly last month of a presumed pulmonary embolism. He was seen at his internist the day before (multiple calls to his office the day before that went unanswered. We were about to call for an ambulance when dad began to feel better). Blood drawn and EKG taken, it was recommended he return 2 days later when the cardiologist would be in the office.

    Dad died late that day or early the next. Should I have insisted he be admitted for a cardiac workup? I chose not to insist. I don’t know if it would have made a difference.
    Point is, you may not know more (or you may), but you do care more–and that can make all the difference in the world.

    • rbthe4th2

      Just wanted to say I’m sorry for your loss.

      • SBornfeld

        Thanks for the kind words–much appreciated.

  • leslie fay

    my husband and I are in the “healing business.” certainly not at the top of the business, we’re respiratory therapists, but educated none the less.
    when my husband was diagnosed with cancer I went to every appointment with my list of questions, and pertinent info that might be useful in guiding treatment going forward. When we ran into issues, usually when we were seeing a new doctor that hadn’t figured out we weren’t lay people, I always began my questions with “educate me. tell me why…..” that way it didn’t seem threatening. It seemed to work well. All were thankful that they didn’t have to translate medical terms. One even told us we were the perfect patients, knowledgeable and capable of dealing with all of issues that come with cancer surgery. My husband is now living with NED and I have to say that we had a wonderful group of caring, really excellent physicians. They worked with us as well as each other, frequently calling one another to discuss issues during our appointment so when we left we knew what the next steps were instead of waiting for answers-and waiting is the absolute worst. After almost 40 years in health care I can say that I am stunned to be able to say that. There are a whole lot of doctors that I wouldn’t let treat my cat.

  • rbthe4th2

    Loved the post. One of my favorites on kevinmd. That being said, I’ve had docs who HATED me for asking logical questions.

  • rbthe4th2

    As long as it is third party and not paid for by the hospital.

  • rbthe4th2

    Yes but unfortunately you are in the “frat”. For those of us who aren’t and have had docs blow us off or worse, because we asked, it becomes the biggest problem.