It’s something not taught anywhere near enough in medical school: how to communicate with patients’ families. Especially in hospital medicine, you’ll be interacting with your patients’ family members just as much as with your patients themselves. These loved ones will include spouses, children, parents and siblings, not to mention healthcare proxies who aren’t actually related to the patient. Whomever you might encounter, it’s your job to communicate with and educate them. Here’s how.
Establish Contact and Set Expectations
Early on during any hospital admission, determine who the patient wishes the main point of contact to be. This is crucial because so much confusion can result if information is shared with multiple family members. Assign one volunteer who can then share information with the rest of the family.
Ideally, during the first interaction, the assigned family member will already be present, but this may have to happen over the phone. In either case, establish what the diagnosis is, as well as the immediate treatment plan and prognosis. Give them an overview of any important decisions that the patient may need to make. Allow the family member to ask questions.
Be sure to let them know that you’ll need them to be available to receive regular updates. Before going any further, confirm that they’re still the best contact, or whether they think another family member may be more appropriate, given the expectations. For instance, it could be better for you to be in communication with someone who lives close by and will be visiting regularly.
Keep Them in the Loop
During the hospitalization, strive to update the family member every day on what’s happening, confirming with the patient first that it’s OK to do so. After I’ve examined a patient, especially an elderly one, I like to call their family member from the bedside using the speakerphone. If the family member is visiting and it’s feasible, I’ll arrange to see the patient when their loved one is present, too.
Communication with patients’ families can sometimes present unique challenges. Expect to be asked questions that your patient themselves may not be asking, and understand that family members may be looking at things from their individual point of view — for instance, how they’ll take care of the patient at home afterward and what to look out for.
If a family member is in the healthcare field — a frequent scenario — this will also understandably lead to them asking more detailed questions. These discussions should always be held with the patient in mind, respecting that they’re also OK with and understand everything you’re saying.
Embrace Your Responsibility
Some doctors see the responsibility of “speaking with family” as an extra part of the job and a bit of a drag. That’s an unfortunate attitude, as fewer things could be as important to your patient as solid communication both with them and their families.
I’ve always taught medical students to imagine themselves in a position where the person they love most in the world is sick in the hospital. Think about how much you would appreciate a good doctor who kept you in the loop and fully respected your right to know what was happening. Be that physician — the one family members appreciate for always communicating and for understanding that they’re also sharing this journey.
Being admitted to the hospital is a confusing and hazy time for anyone. Our patients’ lives have been turned upside down by illness; they’re in a place they don’t want to be, surrounded by busy professionals wielding medical terminology and dispensing advice that isn’t always fully understood. That’s why it’s so important for your patients to have the support of their family with them, and for you to understand that you’re not just treating the patient but their loved ones, too.