
How to build bridges—not barriers—with patient families
ChenMed was founded by a family to provide for families — so it’s essential that our care team members involve our patients’ loved ones in their care. Family members are crucial partners for health care providers who work with older patients, as cognitive or physical challenges may affect their ability to understand or follow a care plan. Loved ones can also help physicians better understand the patient’s living situation and any social determinants of health—such as safe housing, healthy food access, or transportation—with which they may be struggling but feel ashamed to admit.
Although involving family members and loved ones in patient care has tremendous benefits, it can present its own challenges. Here are some important things to remember to ensure you build a collaborative, not combative, relationship with the most important people in your patients’ lives.
Ask your patient’s permission to speak with their family members.
Early in a ChenMed primary care provider’s relationship with a patient, we have a conversation with them about advance care planning. A key component of that discussion is identifying the patient's family members or other loved ones who want to be informed about important health care matters. We also ask them to determine who should act as their health care surrogate should the need for one arise. Because relationships may change over time, we revisit this conversation with patients periodically to ensure we always have an up-to-date list of their approved contacts.
Plan for appointments when you know families will be involved.
Inviting more people to take part in a patient encounter by necessity increases the length of time the appointment will last. Family members may need more than one explanation of a patient’s health situation, or they may have many follow-up questions. Addressing all these questions and concerns is essential to securing their buy-in and that of your patient—so cutting things short isn’t a good idea. Scheduling additional time for this appointment beyond a typical visit allows you to engage deeply in these conversations, increasing your chances of building a strong relationship with family members and achieving the health outcomes you want for your patient.
Approach potential disagreements with humility and understanding.
Many patients and their families come to an appointment having already consumed information about the patient’s condition. However, not all that information may be accurate. Regardless, it’s important to begin by acknowledging, rather than dismissing, patients’ opinions and concerns based on the information they’ve seen. Sometimes, patients and loved ones will come to me with questions about over-the-counter supplements, herbal treatments, and other subjects that I honestly do not have expertise in. I start by admitting that, then explaining that my training in evidence-based preventive care suggests a different care plan. This is an excellent way to turn the conversation away from potential medical misinformation and toward a workable path forward without antagonizing or alienating the patient or their family.
Enlist family members to help understand and account for the social determinants of health.
Many older patients, be it because of pride or shame, are not forthcoming about challenges they face regarding the social determinants of health. A productive relationship with a patient’s family members can give primary care providers the invaluable information they need to help address factors like access to transportation, healthy food, and safe housing that their patient may be facing. In many cases, your partnership in overcoming these challenges may relieve loved ones concerned about the patient’s welfare. In this way, we can make burdens easier for these family members to bear while at the same time improving health outcomes for our patients.
How value-based care can facilitate stronger doctor-family relationships
Any primary care provider in any care model can adopt this approach to working with patients’ families—but it’s a lot easier to do when you work in a full-risk, value-based care setting like ChenMed’s. Here, our primary care physicians carry far smaller patient panels than our fee-for-service peers, and we see our patients at least once a month. This enables the personal attention and time needed to form strong doctor-patient relationships and doctor-family relationships.
Want to learn more about our approach to value-based care? Get our guide, which reveals a deeper understanding of this care model, including:
- Patient-centered medical home
- Accountable care organizations
- Payment models
- and more
Get “Changing U.S. Healthcare: Value-Based Care Explained” now.

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