Yes, if you keep it under 11 seconds
Springer Nature
EDITOR'S NOTE: According to the National Institutes of Health, it used to be 18 seconds. Question - how did we lose the seven seconds? - W. ColletteOn 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.
The pressure to rush consultations affects specialists more than primary care doctors says Naykky Singh Ospina of the University of Florida, Gainesville and the Mayo Clinic in the US.
She led research that investigated the clinical encounters between doctors and their patients, how the conversation between them starts, and whether patients are able to set the agenda.
The study is in the Journal of General Internal Medicine which is the official journal of the Society of General Internal Medicine and is published by Springer.
The
researchers analyzed the initial few minutes of consultations between 112
patients and their doctors. These encounters were videotaped in various US
clinics during training sessions for doctors.
In their analyses, Singh Ospina and her colleagues noted whether, for instance, 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 their analyses, Singh Ospina and her colleagues noted whether, for instance, 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 per cent), 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 ten 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.
In this study, patients who were not interrupted completed their opening statements within about six seconds.
Primary
care doctors allowed more time than specialists and tended to interrupt less.
According to Singh Ospina, specialists might often 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,” adds Singh
Ospina.
She
acknowledges 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 agrees. “Yet, it seems rather unlikely that an
interruption, even to clarify or focus, could be beneficial at the early stage
in the encounter.”
Time
constraints, not enough training on how to communicate with patients, and
burnout experienced by physicians may stand in the way of a more
patient-centred approach. Singh Ospina would like to see further studies
exploring a possible link between a patient being given a chance to set his or
her agenda, and the ultimate experience and outcomes of their visit to their
doctor.
“Our
results suggest that we are far from achieving patient-centred care,” she says.
Reference: Singh
Ospina, N. et al (2018). Eliciting the Patient’s Agenda-
Secondary Analysis of Recorded Clinical Encounters, Journal of
General Internal Medicine DOI: 10.1007/s11606-018-4540-5
