With all the emphasis on the technological side of medicine – blood work etc., I am pleased that there seems to be some recent interest in research into the art of medicine and particularly that of taking a history. The National Institutes of Health have been looking at research involving family history.
As far as a working physician is concerned this is important from the point of view of the health of the patient from both a positive and negative point of view. For example a positive family history of a close relative in terms of heart trouble or cancer might be important in terms of looking out for that particular disease, getting additional or earlier screening, having a higher suspicion for similar illnesses. For example a family of thyroid disease makes a thyroid disease a more likely diagnosis in a relative, it also makes other autoimmune diseases such as vitamin B12 deficiency more likely. On the other hand knowing that both parents lived to over 90 can be somewhat reassuring, but can also mean that sometimes illnesses are not seen as serious by the patient.
The other side of the family history which is very important is the emotional side of a family history. If a son or daughter has seen one of their parents with a particular illness or disease, sometimes have been ill for months or years, then it is important that is known about. A couple of pounds of weight loss might seem like a trifle to one person, but not to someone who has seen a close relative loose weight before a serious disease was identified. On the other hand knowing that someone would naturally be thinking about the illness of a relative can want the doctor to be in the position where they can reasonably reassure that ‘well you definitely have not got that’. Sometimes knowing that there is a risk and discussing what that risk might mean to a particular patient and seriously advising any reasonable and balanced step to avoid or detect early is very important.
Knowing about what illnesses are in the family can be straightforward but can also allow the physician to advise and treat more appropriately.