The Importance of Familismo

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.)

 

Excerpted from “Clinical Pediatrics in the Mexican Immigrant Commnity” www.contemporarypediatrics.com vol. 26, No. 2. See the complete article listed under special topics on this website.

4 Comments

  1. Hi and thanks for publishing this. This resolved plenty of doubts that I had.

    • Marcia Carteret, M. Ed.

      Hi – I would be really interested to know about the doubts you refer to. It is likely that others share similar doubts. If you’d like to write a little more about this, I’d be very interested.

  2. Tomas Romero,MD

    I liked Dr.Young’s article good intentions, but I am concerned about the lack of information about what today characterize Latinos in general, particularly those in USA. We don’t know the influence of acculturation and education level in those perceived values described as “familismo ” among USA Latinos. Indeed we don’t know how this “familismo” plays in the younger Latinos, or in those living in large urban centers, just to give some examples.

    I am sure that Dr. Young agrees that respect (“respeto” in Spanish) should be present in any patient-health care provider relation regardless of race/ethnicity, and is a universal principle not only in health care, but in any social interaction. To emphasize its importance with Latinos is like saying, “well, they deserve it too”, or indirectly suggesting that often it has not been the case.

    A diverse country like ours needs to have culturally competent systems, of critical significance in health care. This is a major challenge for our Academic Centers forming health care professionals.
    Today is clear that Latinos in USA are beyond the “me too” attitude of the past. The integration to the mainstream is a two way street, and it is happening right now. We need to adjust our perceptions of Latinos as this evolving process goes on or remain trapped to the stereotypes of the past.

  3. Anika Davis

    I would like to see an article specifically touching on the ways latinos cope with adversity and acculturation.

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