How Physicians View Caregivers: Simmel in the Examination Room

Abstract

The presence of caregivers in medical encounters changes the doctor-patient relationship. Although there is extensive literature on how caregivers affect medical encounters, there is little research on how physicians view such caregivers. We explore that issue by conducting structured, in-depth interviews with eighteen pediatricians and eighteen geriatricians. The interviews were recorded and transcribed, content analysis was performed, and conceptual codes were developed based on material in the interviews. Findings support Simmel's theory about the changes occurring when dyads become triads. Adding caregivers to medical encounters leads to a loss of intimacy between patients and physicians, decreased patient participation, and the formation of coalitions between physicians and caregivers. We conclude by urging medical schools to sensitize physicians to how caregivers affect medical encounters.