Everyone understands how important it is to have one primary care physician who monitors the health of each patient. In Canada, such a doctor is called a family doctor. This is the doctor that a patient turns to first if they have any health issues. This saves a lot of time because the doctor doesn’t have to gather all the patient’s information every time; they already have the patient’s history on hand, which includes all their specific details and previously diagnosed problems.
It’s clear that a doctor you see for the first time in a walk-in clinic or emergency service cannot replace a family doctor. In just a few minutes, such doctors can only identify your immediate problem and try to address it, assuming that you have some unknown issues. However, this will be a purely symptomatic solution and usually only works for acute urgent problems. Afterwards, it’s better to return to your family doctor and inform them about what happened so that they can update your medical record.
A family doctor also typically conducts scheduled preventive examinations, compares the results of these examinations, and monitors changes in test results. They should promptly refer patients for further tests to specialists if any test results cause concern. They also gather the results of examinations from all specialists if the patient’s health condition requires the involvement of multiple specialists, and make a final decision based on their recommendations.
Although everyone refers to this doctor as a family doctor, it doesn’t necessarily mean that the doctor treats the entire family of the patient. However, it is better if such a doctor treats all family members, and now I will explain why this is the best solution.
Treatment of common diseases in the whole family
Since I already have experience working with whole families, I want to share with you the advantages such families have.
- The ability to prophylactically prevent the development of several diseases in children if they are found in parents and vice versa;
- Diagnosis, treatment and prevention of common problems in siblings;
- Treatment of common infectious diseases in the whole family;
- Diagnosis and prevention of problems related to the environment, since usually the whole family lives under one roof.
Treatment of the whole family often helps to identify problems that otherwise would not attract the attention of doctors for a long time. Here are just a few such examples:
- If the family has a history of early heart attacks and strokes, all relatives should report this to the doctor and get tested in advance. The principle does not work here: you are still too young to have such problems; if the father had a stroke at 30, the son should be checked long before this age. For heart concerns, it might be a life-saver to learn information such as how long does it take for entresto to work.
- If someone in the family has Lyme disease or H. Pylori, you need to pay attention to other family members.
- If any children have neurological problems, other children should also be tested. Most likely, they also have problems; they have not yet manifested themselves enough for other children to receive a diagnosis. Many problems can be avoided if you examine the brothers and sisters of such children in advance.
- If someone in the family has an autoimmune problem, other family members will also be predisposed to autoimmunity. It is much easier to prevent autoimmunity than to stop and reverse the autoimmune process already started by the body.
- We all know that the same depression is often “passed on” by inheritance, but here it is more correct to talk about problems and not about a symptom, depression. If you identify problems in advance, you can prevent the development of depression.
- Celiac disease, Gilbert’s syndrome, Thalassemia, and Hemochromatosis – are also problems that can be inherited.
- Dementia, Parkinson’s disease, epilepsy, psychosis, cancer – all these and many other problems are, to some extent, hereditary. However, there is more need to discuss hereditary predisposition to these problems.
- CIRS is a disease associated with mycotoxin intoxication. Since members of the same family live under the same roof and have a shared predisposition to certain kinds of problems, environmental problems often react to several family members.
Of course, you understand that a husband and wife will often not have genetic problems in common, but children will inherit some of the problems from mom and some of the problems from dad. Also, siblings have many health problems that overlap.
Group visits to the doctor
Given all the points mentioned above, there are many shared problems among family members. Therefore, group sessions can help identify common family issues and save time and money on specialist recommendations.
To conduct group visits, each family member must have an initial individual visit and then give their consent for their problems to be discussed among the other group members. Additionally, they are required to sign a document stating their commitment to maintaining the confidentiality of the information shared.
Medical history
One of the unpleasant aspects of changing doctors or having different family members visiting different doctors is the need to repeatedly retell your medical history. When you have one doctor for the entire family, that doctor will already have access to the complete medical history and conditions of the entire family.
Is it ethical for one doctor to treat the whole family?
On the off chance that the individual from the family needs to keep their issues private from other relatives, there is a radical position that one doctor should not treat the entire family to protect confidentiality. In reality, this is not an issue. Doctors maintain confidentiality regardless. If a group visit is conducted, the doctor simply discusses general issues without delving into personal details. However, if any family member wishes to share their personal information, they can do so themselves.
Anything that family members do not wish to discuss openly should be addressed during individual visits. Such situations always arise. That is why even if a patient gives permission for others to be present during a visit, they have the right to revoke that permission at any time and ask everyone to leave the room to discuss certain matters. The doctor should never disclose this information to anyone without the patient’s written consent.
Confidentiality of Information
Confidentiality issues are nothing new; doctors are well aware of what can and cannot be said. The doctor can’t even mention that someone visited him. Not to mention transferring the information received during the visit to someone. This is not a problem because doctors usually don’t remember what you tell them. They record everything during the visit and review this information before your next visit. To remember such a flow of information from different patients and not confuse anything is impossible, so it is not difficult for doctors to maintain confidentiality. The doctor will only view your individual information if you schedule a new visit with him.
Confidentiality and Conflict of Interest
However, there is a real problem when family members have different perspectives on the same situation. In such cases, the doctor must trust the words of the patient they are currently working with. Many things are subjective, and everyone looks at them from their own position. The doctor must recognize the patient’s right to their version of events and take it into account in each specific case.
If the versions of two family members are so contradictory that it is impossible to discuss the matter during a group session, the doctor should clarify this during the first individual visit with each family member and not bring up this issue for group discussion. The doctor is not an investigator or a lawyer; it is not their responsibility to search for absolute truth. Their task is to help patients feel better. If a patient does not want to discuss a certain issue, it is also their right.
Of course, there are situations where it is better for family members to have different doctors. For example, if a patient, who presents themselves to the family doctor as a loving and caring father, is seen by other family members as someone who abuses psychoactive substances and is repeatedly caught being unfaithful, the help of a family doctor alone may not be sufficient. In such cases, involving a psychologist at the very least would be necessary.
All patients are equal to the doctor
Certainly, not all families are equally harmonious, and not all families will want to discuss the problems of other family members together. This is not necessary; what is more important is that the doctor knows the history of each family member and takes it into account when working with each of them individually.
What is the more appropriate term for such a doctor: family doctor or group doctor?
In our society, the concept of family has become so blurred that I would rather refer to a group than a family. Even if a group of people lives under one roof and they are not even relatives, they still have common issues. Nowadays, people may live under one roof simply because it is more affordable, and they are not necessarily members of the same family. They will still have common problems related to their environment and common infections.
Why is this approach beneficial?
If all members of a family or a group of people living under the same roof want to work with a doctor individually, it can still save time and help identify each member’s areas of concern more quickly, even if there is no group therapy involved and the confidentiality of each family/group member is maintained. This approach helps the doctor identify problems more efficiently and allows them to use effective therapies and recommendations for all family/group members, which also reduces the time spent with the specialist.
Conclusion
It is very important for you to have one primary care physician who coordinates the care for your entire family. Except for newborns and young children, who are usually cared for by a pediatrician, although after the age of 12, these family members can be patients of the same family doctor.
Of course, it is necessary to respect the right to personal space of both patients and doctors. It should be noted that not every doctor will agree to such an arrangement, and patients should understand this as well. It may happen that the doctor advises family members to have different doctors. In short, for this approach to work, you need the consent of all family members, as well as the doctor’s agreement to work with all members of the family.