Physicians Ask Patients to Explain Reason for Visit, Then Interrupt
Scientists have found that physicians only spend, on average, 11 seconds listening to their patients describe the reason for their visit before interrupting them, according to a study that was recently published in the Journal of General Internal Medicine. The scientific researchers discovered the lack of attention greatly hinders the doctor-client relationship and limits trust in the long-run. “Our results suggest that we are far from achieving patient-centered care,” Naykky Singh Ospina, one of the authors.
For their study, the team analyzed 112 recorded meetings between doctors and patients at primary care facilities in the states of Minnesota and Wisconsin, including those at the prestigious Mayo Clinic and its affiliated clinics. The scientists counted how long it took a doctor to interrupt if he or she first said something like “What can I do for you today?” or “Tell me what brings you in today.” These openers are specifically designed to allow the patient to steer the conversation. Yet, it was found that the doctors were not looking for lengthy responses.
“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,” Ospina said. “Yet, it seems rather unlikely that an interruption, even to clarify or focus, could be beneficial at the early stage in the encounter.”
67 percent of patients were interrupted after responding when asked and only 36 percent of doctors even asked questions that allowed patients to direct the focus of the conversation. In the remainder of the visits analyzed, the doctors themselves guided the conversation right from the onset of care.
Specialists allowed even less time for patients to offer a response than primary care doctors. It is believed this to be due to the fact that specialists are often debriefed by referring physicians or other staff members on the reason for care prior to entering the room.
In primary care visits, 49 percent of patients were able to explain their agenda, while in specialty visits, only 20 percent of patients at specialists were allowed to explain. For specialty care visits, eight out of ten patients were interrupted even when they were given a chance to offer their viewpoint. The average appointment length was thirty minutes, but appointments were longer when patients were allowed to explain their reason than when they were not given the opportunity.
In a high-volume practice, the medical staff has limited time to spend with each patient. Physicians are also incentivized for spending less time with each individual because they are essentially paid per patient by billing each client’s insurance carrier. Other reasons a doctor may not allow a patient to respond could be a lack of communication training or personal burnout, according to industry researchers.
The purpose of the study was to determine just how patient-centric general practice really is, and the scientists hope that future studies might reveal that allowing a patient to speak longer ultimately leads to a more positive outcome. This could also persuade patients to return to one place time and again rather than opting to visit an urgent care or choose a new provider.