by Janine Young, MD—
The importance of immediate and extended family ties are very important to the Latino community—otherwise known as familismo. The mother, father, grandparents, aunts and uncles may come to their children’s doctor visits, and all may have some say in how the child will be cared for. Grandmothers (la abuela), in particular, often play a strong role in how their grandchildren are cared for, both in what they are fed as well what remedies are used.
The importance of the extended family in decision making, particularly when discussing serious medical conditions, must be kept in mind when caring for many Mexican-American families. Allowing for family meetings to include important extended-family members when discussing serious medical conditions is of utmost importance to ensure that medical decisions, treatments, and plans will be followed.
In many Latin American countries, the degree of respect (respeto) paid to a physician may translate into the desire to not offend that physician. Some families may not want to question the doctor, even if they do not believe or do not understand some aspects of the diagnosis or plan. They may be used to a more paternalistic doctor-patient relationship.
It is important to be aware of this potential dynamic, and to attempt to provide a non-threatening open environment where families are encouraged and supported to ask questions. Latino families also expect to be shown respect by their physicians, in the form of a handshake both at the beginning and end of a visit, a greeting (e.g., buenos dias [good morning], buenas tardes [good afternoon]) as well as being addressed in the more formal “you” (usted) as well as Señor (Mr.) or Señora (Mrs.)
