Interview with Dr. Gurpreet Dhaliwal on Why it is Important to Include Families in Patient Care
“They’re the key to healing the person,
not in the thirty minutes that we spend with them in the day,
but the 23 hours and thirty minutes that they’re home together without us.”
Gurpreet Dhaliwal, M.D., is a clinician-educator and Professor of Medicine at the University of California, San Francisco. He is the site director of the internal medicine clerkship at the San Francisco VA Medical Center, where he teaches medical students and residents in the emergency department, urgent care clinic, inpatient wards, outpatient clinic, and morning report. His academic interests are the cognitive processes underlying diagnostic reasoning and clinical problem-solving and the study of diagnostic expertise.
Why is it important to include families in patient care?
Dr. Dhaliwal: I’ve come to learn that including families is essential because they often times share the burden of illness, even if the patient is the locus of disease, the burden is shared in the family and that can be psychological, it can be financial, it can be time, but illness is oftentimes a family experience. On top of that, I actually think that we sometimes get our very best information from family members because they have a different perspective on the person’s illness. I take care of a lot of old men, and very frequently a situation will be like this where I hear about the patient having chest pain and I’ll say, “Sir, tell me about your chest pain,” and he’ll say, “Ah, it’s not that bad, you know, it bothers me a little bit from time to time, and I take nitroglycerine and I get on with my day,” and then I look over at the wife, and the wife’s like, “nuh-uh,” she says, “Doc, when he walks out to the barn to tend to his horse, he takes twice as long. He’s stopping non-stop, in fact that walk to the barn takes him four stops because of his chest pain and he’s just too tough to tell you.” And the patient may not like it, but in my goal of getting the patient better, the family members’ input is essential. And it goes beyond just getting the diagnosis right. That’s happened countless times where the triangulated history from the family member’s really what tells us the severity or really the right diagnosis, but when we’re done diagnosing and we’re switching to treatment, often times the family member’s our partner in it. They’re the one who are going to keep track of the appointments or medications. They’re the one who are going to bring the patient back. They’re the key to healing the person, not in the thirty minutes that we spend with them in the day, but the 23 hours and thirty minutes that they’re home together without us.