A team of researchers from the University of Florida, Gainesville, recently carried out a study that investigated the clinical encounters between physicians and patients. They assessed consultations between 112 patients and their doctors at appointments that took place between 2008 and 2015. The visits were videotaped in different clinics throughout the country.
The researchers were looking out for whether doctors gave patients a chance to set the agenda for the visit – for example, by asking questions like, “What can I do for you?” or “Tell me what brings you in today.” They also noted that when patients were interrupted while speaking.
Doctors let just a little over a third (36 percent) of patients set the agenda. Unfortunately, two thirds of these patients were interrupted pretty quickly – just 11 seconds after they started speaking, on average. Those who weren’t interrupted, however, finished speaking after around six seconds, so it’s reasonable to expect that they may have been interrupted as well had they continued speaking for much longer.
This lack of patience on the part of doctors is generally unwelcome by patients, who often wait upwards of an hour for face time with their physician, and it is just one of many reasons the people are growing increasingly fed up with health care in this country.
Whatever happened to patient-centered care?
Study co-author Naykky Sigh Ospina said that these results show just how far we are from attaining patient-centered care. She said that while respectful interruptions can help doctors gain clarity on a person’s problems and therefore help patients, interrupting people at such an early stage in the appointment does not seem likely to be beneficial.
The researchers noted that past studies have shown that when patients are allowed to describe their concerns fully, they need a mean of 92 seconds. This is significantly greater than the amount of time most physicians are willing to let their patients speak, but is it really so long that patients deserve to be cut off?
As if that weren’t bad enough, specialists tend to allow even less time for patients to describe the reason for their visit. Just 20 percent of specialists give patients a chance to describe their problem at the beginning of their consultation. Although specialists are often informed in advance of a person’s reason for visiting through their referral or questions from a nurse ahead of the consultation, the researchers stress that it remains important for physicians to let people discuss their concerns right away.
Many doctors try to work their way through their patient list as quickly as possible
The researchers believe that many doctors are simply overworked and burned out – working as many as 120 hours per week – and some are dealing with time constraints. There’s also the fact many doctors simply don’t receive enough training on properly communicating with their patients.
This ties into a 2013 New York Times report that internists spend just eight minutes with each patient on average. Moreover, they were found to be relying on electronic information more than ever to minimize patient interaction. Doctors are using a host of strategies to get through their list of patients more quickly, including skipping introductions, avoiding sitting down as it can encourage longer conversations, and avoiding touching the patient because it can be too time-consuming.
Is it any surprise that more people are trying to educate themselves on health matters and take responsibility for their own well-being?
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