Beyond the labs: Talking about your patients' relationships

By Anastasia Climan, RDN, CD-N | Fact-checked by MDLinx staff
Published February 9, 2023

Key Takeaways

  • Social support matters, so checking in with patients about their personal relationships is a vital part of their comprehensive care.

  • Unsupportive loved ones may sabotage patients’ health goals, but asking questions and offering resources can prompt them to initiate changes. Implementing a few general best practices can help domestic violence victims who come into the office.

  • Opening discussions and building trust with patients are key elements of gaining insight into their personal situations and helping to protect their health and well-being.

As patients’ relationships may significantly impact their habits, adherence to treatment, and health outcomes, addressing suspected red flags in their personal lives without making assumptions or overstepping boundaries can feel like a balancing act.

As Valentine’s Day places society’s focus on relationships, here are some practical tips to support your patients’ journeys to better health, either alongside (or apart from, if necessary) their partners.

Unhealthy relationship dynamics

Negative relationship traits can range from unsupportive comments to physical harm. Whatever the situation, relationships can affect a patient’s self-esteem and their likelihood of following through with medical recommendations.

Research published by The Journal of Rural Health found that social groups strongly influence health behaviors.[] For example, smoking cessation is dramatically hindered when the individual is surrounded by others who smoke.

Additionally, barriers to healthy eating or physical activity often include family obligations and social pressure, including the food preferences and demands of others in the household.

How you can help

Clinicians should express curiosity about their patients’ lives beyond their latest lab results.

Posing questions to patients about what may be slowing their progress may help them consider factors that need to change. Pulling in key players (like a spouse) can help elicit better communication.

Although there’s not always time for these important conversations during a primary care visit, offering referrals to individual therapy, relationship counseling, and group classes can help improve your patient’s relationship dynamics and social support network.

While you probably wouldn’t go as far as advising a patient to leave their marriage, you could connect them with local organizations, such as a diabetes group or exercise class, that could help to make up for some of the support lacking at home and encourage them to prioritize their health.

Related: How physicians can help manage sexual trauma in patients

Domestic violence situations

Aside from the common challenges seen in a “normal” relationship, many clinicians eventually encounter patients living in dangerous partnerships and environments.

According to National Coalition Against Domestic Violence statistics, 33% of women and 25% of men have experienced some form of physical violence from an intimate partner.[] For many, domestic violence takes a widespread toll and raises the risk of:

  • Alcohol or drug use

  • Chronic pain and chronic disease

  • Gastrointestinal problems

  • Neurological disorders

  • Nutritional deficiencies

  • Post-traumatic stress disorder

  • Sexually transmitted diseases

  • Stillbirth and miscarriage

As matters escalate, victims may also be at risk of losing their jobs or their lives. Depending on the circumstances, some of these individuals may not realize how unhealthy their relationship is, or in extreme cases, may knowingly or unknowingly become victims of human trafficking.

According to research published by the Annals of Health Law, 88% of human trafficking victims had experienced a medical encounter with a healthcare professional without being identified or assisted.[] That’s because human traffickers commonly go to great lengths to threaten and manipulate their victims to hide the abuse.

How you can help

People who are in abusive situations can be of any age, ethnicity, or economic background.

While there’s no easy way to know your patient’s full story, you can enable pathways to receive help.

Implementing a clear policy that every patient must be seen individually for at least a portion of their visit can create separation from an abuser and provide an opportunity for them to speak up.

Providing patients with non-judgmental access to social services helps establish patient-provider trust. For those who come in frequently for sexually transmitted diseases or suspicious injuries, a coordinated effort to reach out and make the office a safe place to be vulnerable might make all the difference and even lead to a life-saving breakthrough.

What this means for you

A clinician’s job is to treat the whole patient. Your patients’ romantic relationships may seem like none of your business, but they can significantly impact your patient’s care, safety, and long-term well-being. Opening discussions, building trust, and putting systems in place to protect and guide your patients will improve their chances of living healthier lives.

Read Next: 'But what if I'm wrong?'—Reporting cases of patient abuse
Share with emailShare to FacebookShare to LinkedInShare to Twitter