Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Loved Ones: Seize The Opportunity


Ask for loved ones’ input during clinic visits. Different perspectives may shed new light on patient concerns.

While looking at a painting together, my wife said with excitement, “Wow, the artist made her subject resemble herself!”


I was stunned, because I hadn’t seen that at all. My wife’s observation broadened my perspective and helped me appreciate the painting much more.


I recalled this experience recently when I saw my patient, an 81-year-old woman with degenerative arthritis, who had fatigue and loss of strength and stamina over the last six months. She was cognitively intact, had no neurologic complaints, felt emotionally well, and had a good appetite and sleep habits. When I asked if anything was different in her life or routine in recent months, she couldn’t recall anything new or unusual. Then I turned to her son who accompanied her to the visit. I asked my patient for permission to question him, and she agreed.


“How does your mom seem to you? Have you noticed any change in her abilities or routine?” I asked.


“Yes,” he answered without hesitation. “Ever since my dad died, she’s been doing a lot more work around the house.” This insight was vital to fully understand my patient’s health in context.


For many years, I didn’t take full advantage of the perspective of the people who joined my patients in the exam room. I introduced myself and acknowledged any input that was offered, but I didn’t seek their input. People who the patient chooses to have with them at a visit, whether family, caregiver, or friend, may have information to complement a patient story and aid in diagnosis. They may share insight into which treatments a patient is more or less likely to adhere to. Patients have many reasons for bringing someone along with them. We may never know how they can help improve care unless we ask.


Here are 3 tips for engaging guests in the exam room:


1. Always ask who a guest is and how they’re  connected to the patient.


2. Ask the patient’s permission before questioning a guest.


3. Actively seek guest input. Different perspectives can shed new light on patient concerns.




This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.