Tuesday, November 17, 2009

Jennifer Frank, MD: How much to share with patients?

In a recent clinic session, I was faced with a familiar dilemma about how much of my own experiences as a wife, mother, and human being to share with my patients.

My first patient of the afternoon was a 2-week-old little girl. Things were going great at home, but her parents had some questions about H1N1 vaccination. Since the little girl’s mom was a patient at our clinic, we vaccinated her to protect her daughter. However, the little girl’s dad was not our patient, so I explained that he would need to contact his own doctor to receive an H1N1 vaccination. My little patient’s father looked at me with an expression like “hey, c’mon.”
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I told him that my own husband (the primary caregiver for our 4-month-old son) had not been vaccinated either since his family physician did not have a supply of H1N1 vaccine yet. I don’t know if my patient’s father felt any better about leaving the clinic unimmunized, but hopefully he respected that I was following the rules for my own family.

A second patient also had an H1N1 concern. She has a 3-month-old daughter at home and was coming in to start contraception. The medical assistant offered her H1N1 vaccination but my patient refused, citing the recent appearance of an H1N1 expert on Good Morning America who stated that he would not get the vaccine himself or give it to his kids.

While I was performing her exam, I gently re-introduced the idea of H1N1 vaccination. “I haven’t heard about any experts opposing the vaccine,” I started, “but I can give it my strongest endorsement by telling you that I received my vaccine and will get my kids vaccinated as soon as it is available to them.” We went on to discuss live versus inactivated vaccine, and she elected to receive the same vaccine I received, as she knew that I was also a mom who is breastfeeding a young baby.

My final patient of the afternoon struggles with multiple medical problems. He and his wife are considering starting a family. After congratulating me on the recent addition to my family, he asked, “Can I ask you a personal question?”

“Sure”, I replied.

“How old are you?”

“Thirty-six,” I responded. He was reassured that I was close to his age and still able to get pregnant. He went on to ask me how I was able to lose my baby weight. I shared my secret answer: “Genetics,” I said. “Both my parents are pretty thin and I was lucky to inherit the right genes.”

I struggle at times with how much of my personal information to share with patients. While I often look for scientifically rigorous answers, I recognize that personal stories or experiences often carry more weight with my patients. I also assume – rightly or wrongly – that I have added credibility when I am able to give both the “doctor” answer and the “mom” answer.

Jennifer Frank, MD, FAAFP, is an assistant professor in the University of Wisconsin Department of Family Medicine and a faculty family physician at the Fox Valley Family Medicine Residency Program in Appleton, Wis. She is a mother of four, whose husband, also a physician, is a stay-at-home dad.

1 comment:

  1. Sharing some of yourself builds a connection with your patients. They see you as a little more human. I think you demonstrated a nice 'balance' in these stories.