We often see husband direct the course of care and obstruct any meaningful progress for the injured wife. Equally as often, we see the wife over nurturing this big and robust husband whose injury is modest but who loves all the attention.
I strictly enforce the policy that the spouse is not permitted in the room while I am examining the injured worker. It is very, very common for the patient then to reveal the role that the husband (or wife) is playing in the injury.
For a psychological exam, it can be revealing as to whether:
the patient comes alone or
the spouse sits for six+ hours in the waiting room and/or
the spouse keeps asking staff questions
the spouse makes unrealistic demands
on breaks the spouse interrogates the patient
the spouse wants to offer data about doctors, insurers, case managers, etc
the spouse dispenses medication
the spouse potentiates ill will toward the doctors involved
And, likely, you can think of other spousal behaviors that suggest more problems than solutions are coming from the marriage.
However, there are times when husband/wife involvement can be very helpful. Patients often cannot _hear_ what they are told, and a husband or wife can serve as a note-taker and case-summary communicator. Not infrequently, there are educational and/or intellectual differences between husband and wife, and the brighter or more educated of the two may retain more of the data.
From a psychological standpoint, knowing the role of the spouse is a key element in determining whether this patient will recover from injury or even comply with care.
