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The Companion of the Patient in Family Medicine: The Fable of the Painting and the Frame

Jose Luis Turabian, Luis Enoc Minier-Rodriguez, Francis Eliant Rodriguez-Almonte, Raul Cucho-Jove and Sandra Moreno-Ruiz and Alejandro Villarin- Castro

Physician training focuses on an encounter between two people: the patient and the physician. In practice, a third person (companion) frequently accompanies a patient during medical encounter, but nevertheless reviews about the presence of a companion of the patient in consultation are rather scarce in our environment. The subjective experience of disease is built by patient in the family context and is expressed in the medical consultation, often, with the presence of a companion of the patient. The presence of the companion of the patient in consultation is a metaphor from the patient. We show a very brief update, through a short fable, about the subject of companion of the patient in the consulting room. There is a high prevalence of the presence of companion (25% of the interviews are with companions), predominating a middle-aged adult, usually the couple and is a worker, housewife or retired. The patients with companion are older women, with more chronic diseases, with poly-pharmacy, they generate hospital referrals, and they have lower levels of social class. The presence of a companion is an indicator of potential problems in the context of the patient (in 45% of the cases the patients with companion vs. 30% in unaccompanied patient). The 55% of companions are "non-collaborators", that are they predominantly housewives and unemployed persons. There is a high frequency of the companions who attended the family medicine consultation without the presence of the patient (9% of all consultations), which has ethical and legal implications. The companion shapes the experience obtained by the patient's physician. A second adult accompanying the patient in the consultation is always significant and deserves the attention of the doctor. It is needed achieve communication skills during the interview with the different companions of the patients in family medicine consultation.