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Shelby: A healthcare provider's perspective on adoption and medical history

Guixi, Jiangxi, China --> Kentucky, United States

When people ask, "Do you wish you knew your real parents?" It irritates me. My real parents are the parents that have raised me since I was 11 months old. I replied, "I never knew my biological parents, so I can't miss what I did not know." Throughout my life, I have given little thought to the people I share genetics with. My adoptive parents provided me with unconditional love, and that is enough for me.


However, recently, the idea of my biological parents has been brought to my attention. I am in my first year of medical school, and we have learned how to take a family history from a patient. At first, I struggled with this skill because I had never thought about the importance of a family history to a patient's care. Every time I sit in a doctor's office and they ask about it, I always reply, "I'm adopted," and that ends the conversation. 

"When I conduct a patient interview, I have to always remind myself that most people have knowledge of their familial health history."

Now, I have switched from the patient to the provider. When I conduct a patient interview, I have to always remind myself that most people have knowledge of their familial health history. Gathering a thorough family history is important in developing differential diagnoses and determining appropriate screenings that could be life-saving.


After learning about the importance of family history, I began to wonder about my biological parents. Are there any diseases that run in my biological family? Am I at risk for life-altering pathologies? Would my providers have diagnosed my asthma and ADHD sooner? I doubt I will find answers to these questions. Genetic health screens exist, but they will not always be accessible to patients.


To my fellow adoptees: I understand how frustrating it is when a provider asks for your family history. Sometimes, it feels like you are missing a piece of a puzzle. It can be a painful reminder of all the unknowns about your past. My advice is to continue to advocate for yourself and your health. You know your body best, and it may require your healthcare team to get creative to help you find answers.


To my fellow healthcare providers and students: Remember that not everyone will know who their biological parents are. I have reminded several of my classmates of this fact, and I caution that they cannot rely on family history alone. Sometimes, we have to think more creatively to best provide care to our patients. When you have a patient who has an unknown family history, do not press further. For some patients, it may be a sore subject. You may find yourself in a position where family history would be critical in narrowing the diagnoses, but you will have to find alternative methods to best determine a diagnosis and the best care.

 

Accessibility

[Description: Light beige background with two photos on the left side. The top photo is of Shelby in a white coat against a background that says "University of Louisville." The bottom photo is of Shelby with her parents in her graduation cap and gown. Large text at the top says "Shelby." Smaller text under that says "A healthcare provider's perspective on adoption and medical history." In a purple box with a quotation mark, text says "I have switched from the patient to the provider. When I conduct a patient interview, I have to always remind myself that most people have knowledge of their familial health history." Small text at the bottom of the image says "Guixi, Jiangxi, China to Kentucky, United States."]

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