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    How to enlist family members to improve patient care

    Nitin S. Damle, MD, FACP, recently saw one of his favorite patients, an elderly woman who had always been active and independent. Yet this time, her daughter and son-in-law came to the appointment with her. They said she was forgetting things, becoming disoriented and even getting violent with her husband.

    During his initial examination, he didn’t notice much of a change in her condition. She seemed to be the same highly functioning woman he’d known for years. Yet because the woman’s daughter and son-in-law had come into the office and spoken up, Damle was able to perform an exhaustive examination, get the woman admitted and then into assisted living, saving her and her husband from a dangerous situation at home.

    “Clearly, without the family bringing this to my attention, it could have gone on for quite a lot longer,” says Damle, president of the American College of Physicians and a practitioner in an eight-physician group in Wakefield, Rhode Island.

    Family members can be a physician’s extra eyes and ears. They can boost patient compliance. They know more about a patient than a doctor ever will. As a result, they can provide crucial information. And they can advocate for their loved ones, advising and steering them toward healing. 

    But having family members in the mix can also create anxiety, introduce the toxins of family dynamics, suck up a physician’s time and create privacy concerns. So how does a physician overcome the challenges and take advantage of the valuable opportunity that arrives with that third person in room? Here’s some guidance from the experts.


    Establish open communications

    If a family member is present, it’s crucial for the physician to set the stage and a tone of honesty and open communication, says Bernard M. Bandman, Ph.D., executive director of the Center for Communication in Medicine in Bennington, Vermont.

    “Good communication is good medicine,” he says. “It leads to more effective care. It leads to strengthening relationships between the physician, the healthcare team, the patient and the family.” 


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