When is it helpful to convene the family?

There are three factors supporting current efforts to bring the family into the mainstream of American medicine: (1) research capabilities of the discipline of epidemiology, (2) the intervention skills developed by family therapy, and (3) pressures to provide cost-effective care as economic resources diminish. The fundamental question addressed in this paper is, when can it be helpful for the family physician to convene the family in the consultation room? Physicians in the field and residents in training are often reluctant to take this step because of time constraints, awkwardness in talking to two or more members of the family, and unfamiliarity with what to do with the information that is gathered. From currently available research data, a list of 14 medical conditions is presented in which it can be predicted that family functioning or nonfunctioning is contributing to the cause of disease, or that the family will experience a major reaction to the illness. These medical conditions offer an ideal opportunity to begin working with families. A specific case history illustrating this approach is presented to demonstrate that convening the family can be an important dimension of family medicine.