Physician Perm September 10, 2018

Doctors Give Patients Just 11 Seconds Before Interrupting

How well do physicians really listen during a patient encounter?

A new study in the Journal of General Internal Medicine found that, on average, patients get about 11 seconds to explain the reasons for their visit before they are interrupted by their doctors. Also, only one in three doctors provides their patients with adequate opportunity to describe their situation.

There could be a number of things standing in the way of a more patient-centered approach, including time constraints, not enough training on how to communicate with patients, and physician burnout, the researchers noted. Nonetheless, they definitely see room for improvement.

"Our results suggest that we are far from achieving patient-centered care," said lead researcher Naykky Singh Ospina of the University of Florida, Gainesville and the Mayo Clinic.

The researchers investigated the clinical encounters between doctors and their patients, how the conversation between them starts, and whether patients are able to set the agenda. They noted that the pressure to rush consultations affects physician specialists more than primary care doctors.

Singh Ospina and her team analyzed the initial few minutes of consultations between 112 patients and their doctors at various U.S. clinics. They noted whether doctors invited patients to set the agenda through opening questions such as "How are you?" or "What can I do for you?" The researchers also recorded whether patients were interrupted when answering such questions, and in what manner.

In just over one third of the time (36 percent), patients were able to put their agendas first. But patients who did get the chance to list their ailments were still interrupted seven out of every 10 times, on average within 11 seconds of them starting to speak. In this study, patients who were not interrupted completed their opening statements within about six seconds.

Primary care doctors allowed patients more time than specialists and tended to interrupt less. According to Singh Ospina, specialists might skip the introductory step of agenda setting because they already know why a patient has been referred.

"However, even in a specialty visit concerning a specific matter, it is invaluable to understand why the patients think they are at the appointment and what specific concerns they have related to the condition or its management," she said.

Singh Ospina acknowledged that the frequency of interruptions not only depends on the type of practice being visited, but also relates to the complexity of each patient.

"If done respectfully and with the patient's best interest in mind, interruptions to the patient's discourse may clarify or focus the conversation, and thus benefit patients," she said. "Yet, it seems rather unlikely that an interruption, even to clarify or focus, could be beneficial at the early stage in the encounter.”

Reference: Eliciting the Patient’s Agenda, Journal of General Internal Medicine.

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