My parents’ doctors didn’t always welcome me. Here’s how I engaged them.
Patients' children have questions and observations that can be crucial to their care, but some work on your delivery may be needed for certain physicians.
When I used to accompany my aging and ailing mother and stepfather to their medical appointments, I was never sure whether their doctors would treat me as a helpful partner or bothersome critic.
Some greeted me warmly upon entering the medical exam room, listened carefully to my questions and concerns, and considered my observations about my parents’ conditions. My mother’s wonderful internist always made me feel like we were working together — even inviting me into his office to strategize how to encourage mom to use her walker.
Other physicians were cordial but distant. They seemed uncomfortable that a family member was present. They neither sought my viewpoint nor necessarily listened to what I shared.
During one medical visit a couple days after my stepfather, Steve, was discharged from the hospital, his neurologist’s line of questioning suggested he knew nothing about the hospital admission.
“Steve just got out of the hospital,” I said, but the neurologist gave no indication that he heard me.
“Steve was just in the hospital,” I interjected again a minute later, but still the doctor kept asking routine questions.
Finally, when I interrupted a third time, the neurologist paused as if suddenly registering that I had said something important. He finally asked what had happened.
Like all adult child caregivers, I wanted to do a good job with caring for my parents. I saw sharing what I knew about them with their doctors as an important component of that. After all, I spent a lot of time with them in their apartment, seeing how they walked, talked, slept, and ate. I had a good idea of whether they were taking their medicines as prescribed, and if they were depressed or content. Shouldn’t doctors want to learn that information to better treat their patients?
» READ MORE: Being Mom’s caregiver is hard. Caring for her together with siblings is harder.
I had a personal stake in this. The care my parents received for their chronic illnesses directly impacted how much caregiving I had to do.
I also had a professional interest. From 1994 to 2018, I was a psychologist faculty member of the Crozer Health Family Medicine Residency Program (now part of Penn Medicine). In this role, I was responsible for teaching the doctors-in-training about how to develop good working relationships with family members, as well as patients.
I knew that physicians should introduce themselves to a family member, ask about their role with the patient, and treat them as a vital ally. I knew they should look at family members, not at their computer screens, when soliciting and responding to questions. Half of my parents’ doctors implemented these basic practices; the other half didn’t.
As a clinical psychologist who has specialized for over 30 years in supporting family caregivers, I’ve learned that those who come on too strong only irk and potentially alienate doctors. Instead, family caregivers can approach their loved ones’ medical visits strategically.
For starters, it’s crucial to exude a friendly demeanor and a cooperative spirit. Doctors’ hurried work days are stressful enough. They appreciate it when family members provide information or ask questions to help improve a patient’s treatment plan, but not when they harshly criticize or insinuate the doctor is incompetent.
They want family members to understand that patients have the right to limit the amount of information the family receives and that family members shouldn’t try to pressure physicians to reveal more than that.
Other ways family members can gain physicians’ attention and respect:
Show up at medical appointments with a yellow legal pad containing written questions. Why the pad? Because it is an unmistakable visual cue for time-conscious physicians that the family member has questions they need to address before the session wraps up. I’ve seen doctors literally grab the pad out of family members’ hands to get to those questions as quickly as possible.
Offer to be an observer and informant for the doctor by saying, for example, “Would you like me to let you know how mom is responding to the medication you prescribed?” The caregiver can attend the patient’s medical appointment with the patient’s blood pressure readings, sleep schedule in hand, or send that data to the doctor before a scheduled visit. This gesture goes a long way to demonstrating that the family member can be a useful team player.
Ask the physician about their preferred mode of communication between visits, then respect that preference. Some doctors will want all messages to come through the online portal. Others prefer receiving calls. Some want all questions except the most urgent ones held until the next medical visit.
None of these strategies are foolproof. The doctors intent on focusing solely on their patients and keeping family members at arm’s length will continue doing so. All that family caregivers can do is to keep demonstrating their willingness to help and hope that the physicians take notice.
Barry J. Jacobs, Psy.D., is a Media-based clinical psychologist and family therapist. He and his wife, psychologist Julia L. Mayer, Psy.D., are the coauthors of the recently published book, “The AARP Caregiver Answer Book.”