Dear Dr. Roach: My husband and I have been going together to the same primary care physician for many years, every six months for routine checkups and sometimes in between when needed. In the past we always were examined in the same room, with each other present during the exams. At our last visit our doctor told us he has to see us separately and gave us the excuse that he finds it more efficient to do it this way. I’m not confrontational, nor is my husband, but I’m not comfortable about this and said so, but he still kept us separated. We are both in our late 70s, and I think it’s important for us to be together during our exams for many reasons. Can you help us with what we can say to our doc to change his mind? It may be in his best interests for this new policy, but I do not think it’s in our best interests.
M.H.
There are several reasons to be cautious about seeing couples together, from a physician’s perspective. One is that sometimes, a disproportionate amount of time is spent on one person, and while that may be good for the person getting all the attention, the other person’s medical needs might suffer. Another is that a person might feel uncomfortable sharing certain medical information in front of their partner. This isn’t always the case, of course, but is a potential problem.
I have had cases where one partner admits infidelity (outside a visit) but tells me I may not discuss it with the partner. I have also had cases where there is partner abuse: This is so common that asking about it is recommended, but of course this cannot be done in front of the potentially abusive partner. Abuse can take many forms, including physical, psychological, financial and sexual. Both men and women can be abused, although it is much more common and more dangerous physically to women.
There are potential benefits to seeing a couple together as well. Often, the partner is able to provide critical information that helps the doctor make a diagnosis. This is particularly important if one person is a bit forgetful. Many couples just feel more comfortable together, as it sounds like you and your husband are.
There is often a way to compromise. The visit can start with the couple together, then each is examined separately — and any questions can be asked that seem uncomfortable — then brought back together to go over the plan. The first time I see a couple who want to be seen together, I do insist on separate examinations, if only to screen for intimate partner violence and solicit any questions one person wants to ask separately from their partner. If there are no concerns after the visit, and both still want to be examined together, then it’s reasonable to do so in future visits. If one person needs extra time, they can always come for an individual visit.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
