地域医療と健康教育

抽象的な

The Companion of the Patient in the Family Doctor's Office: Making Visible The "Guardian Angel"

Turabian JL and Perez-Franco B

The companion of the patient is his "guardian angel". She or he may seem to play a secondary role, but sometimes is the main actor. Each person has his "guardian angel" and so there is a high prevalence/frequency of occurrence of companion in the family medicine office, which is about 25% of patients seen, and what is most striking, the companion is in the office, without patient, in 40% of the visits. In this situation it is important that the family doctor is careful and be aware of the "guardian angel" of each patient, in order to "make the invisible, visible". This "angel" –companion- can have different shapes, and his presence can be felt more or less clearly, but is constantly giving messages in the interview, which becomes a triad, and his presence can be an aid to the diagnosis and treatment. Some cases about the presence of a companion in the primary care consultation are presented: the partner companion, the companion who comes in place of the patient (absent), the intrusive, the observer companion, and the sick one. The family members are the most frequent companions of patient in the office, and therefore we have to create a model of practice, for all patients, family oriented. A second adult, usually the husband or wife or parents who accompany the patient in the office, is always important and deserves the attention of the doctor. The presence of family members in the office visit creates opportunities to the family doctor who can talk to them about their family history and context, and this knowledge can be important for decision-making and for therapeutic measures.