Department of Family Medicine, Moreshouse School of Medicine, Atlanta, GA, USA.
Am Fam Physician. 2011 Oct 1;84(7):780-4.
The physician-patient relationship is part of the patient's larger social system and is influenced by the patient's family. A patient's family member can be a valuable source of health information and can collaborate in making an accurate diagnosis and planning a treatment strategy during the office visit. However, it is important for the physician to keep an appropriate balance when addressing concerns to maintain the alliance formed among physician, patient, and family member. The patient-centered medical home, a patient care concept that helps address this dynamic, often involves a robust partnership among the physician, the patient, and the patient's family. During the office visit, this partnership may be influenced by the ethnicity, cultural values, beliefs about illness, and religion of the patient and his or her family. Physicians should recognize abnormal family dynamics during the office visit and attempt to stay neutral by avoiding triangulation. The only time neutrality should be disrupted is if the physician suspects abuse or neglect. It is important that the patient has time to communicate privately with the physician at some point during the visit.
医患关系是患者更大的社会系统的一部分，受到患者家庭的影响。患者的家庭成员可以成为健康信息的有价值来源，并可以在就诊期间合作做出准确的诊断和制定治疗策略。然而，医生在解决问题时保持适当的平衡以维持医生、患者和家庭成员之间形成的联盟非常重要。以患者为中心的医疗之家是一种帮助解决这一动态问题的患者护理理念，它通常涉及医生、患者和患者家属之间的强大伙伴关系。在就诊期间，这种伙伴关系可能会受到患者及其家人的种族、文化价值观、疾病观念和宗教信仰的影响。医生应该在就诊期间识别异常的家庭动态，并通过避免三角关系来保持中立。只有在医生怀疑有虐待或忽视的情况下，中立才应该被打破。重要的是，患者在就诊期间的某个时刻有时间与医生私下交流。
