Doctors give patients just 11 seconds to explain reason for visit before interrupting!

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GAINESVILLE, Fla. — Ever feel like your doctor is in a rush to get you out the door when you come in for a visit? You’re not just imagining things. One study finds physicians give a patient an average of just 11 seconds to describe their issue before cutting them off.

Researchers from the University of Florida determined that for all the waiting we do after we arrive at a medical practitioner’s office, its the doctors who seem to have the least amount of patience. The study shows that just a third of physicians give patients adequate time to explain why they’re there.

“Our results suggest that we are far from achieving patient-centered care,” says study co-author Naykky Singh Ospina in a release, adding that medicals specialists proved to be in the biggest hurry, compared to primary care physicians.

Singh Ospina, who led the research team, sought to examine the flow of conversation between clinicians and patients. More importantly, researchers wanted to see how viable it was for the most important person in the room — the patient, of course — to lead the discussion. Her researchers secured videos of consultations that were filmed in clinics across the U.S. as training sessions for the physicians between 2008 and 2015.

Examining doctor-patient conversations

The team specifically analyzed the first few minutes of the 112 consultations, looking to find out how frequently doctors let the patients dictate the conversation. This was done through inquiries such as, “Tell me what brings you in today,” or “What can I do for you today?” If patients were given the opportunity to set the agenda, the researchers then timed the responses to see how long they could speak before the doctor interrupted them.

The results show that just 36% of doctors ask questions that allowed patients to set the agenda, but two-thirds (67%) of those patients were interrupted after responding. Researchers calculated the doctors cut patients off 11 seconds on average into a response, while those who were able to describe their issue in full needed only six seconds to do so.

“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,” says Singh Ospina. “Yet, it seems rather unlikely that an interruption, even to clarify or focus, could be beneficial at the early stage in the encounter.”

Burnout to blame?

Researchers also found that only 20% of specialists give patients the opportunity to describe their issue at the onset of a consultation. Of course, it’s certainly possible it may be because they’ve already been briefed on a patient’s problem through a referral or a nurse’s inquiry. Conversely, half of primary care physicians reviewed in the study inquired about a patient’s agenda off the bat.

Still, Singh Ospina notes the importance of physicians — even if they’d previously been alerted to a patient’s reason for visiting — to allow people to discuss their concerns right away.

“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 says.

As for reasons behind being in such a hurry, the authors suggest burnout that many doctors experience could prevent them from adequately serving their patients needs. Other factors include time constraints or simply not receiving strong enough training on how to communicate properly with patients.

The study is published in the Journal of General Internal Medicine.

This post was originally published on July 20, 2018.

Comments

  1. I have a 70 y.o. BiL Doc-in-a-box. He sees 85 pts every 10-12 hour day, the vast majority with acute trivial complaints that have waited until the last possible instance to seek help. God bless the docs.

  2. Most people are dolts who can barely complete a sentence.
    How about come prepared?
    Doctors willingly listen when you have something relevant to say.

  3. As someone is is very ill, they shut down the second they say hello. It is an average of one second at the VA hospital

  4. ER Doctor ( PA ) didn’t listen and after a slue of people the young Head Nurse sat down and talk and listened , paid attention to Sciatica, Something popped, Can’t Sit , Numbness in Foot and then touched and asked here, here, here , She got and immediately called for an MRI, Second ER Doctor ( PA ) said yea, ” of course ” numbness of the back of Calf and Toes, First Doc should be eaten by a pack of wolves , which in her case will be Lawyers eventually

    1. Doctors treat disease processes. Nurses treat people. I am quite fortunate that my PCP is a former RN/ARNP who also got her MD.

      Ordinarily I won’t go into an office where their nursing staff is awful (the doc will be lousy too).

    2. The ER doc is not there to just listen to complaints. And ER’s should not be used as a doctors office. If its is NOT an emergency you shouldn’t be there.

  5. I am a surgeon and the hypothesis they are stating is not true….come on now….well..Medicare demands 30 seconds….this study is incorrect

  6. Most people research their used car purchases far, far more than their physicians’ qualifications. And doctors know it. Where did YOUR doctor go to med school? Do his residency? What board certifies him/her?

    1. Do you think if you know the name of his medical school it will somehow make him/her a better doctor? Board certifications are far more important.

  7. Went to meet a new internist the other day – one of the first time I have encountered this. Previously I would have said have not seen this before.

    he had his game plan for all these visits etc. he didn’t ask and didn’t seem interested in my specialists (he was a referral from same practice no less) and recent lab results (3 weeks old). He wanted to order up lots of stuff included infrequent tests that had all been completed within the last year and are needed every 3 to 5 years. When I pushed back he snarked and asked, “you have insurance right? – what do you care?”.

    i said, “I care 2 ways…first I don’t have time to get extra unneeded tests performed, and second I am a partner in a private firm so a few dozen of us cover insurance for hundreds of employees and their families. I don’t want to see insurance abused. If we have high usage then I do pay for it. I pay for all of my insurance and kick in my share for half of the insurance of 3,000 employees.

    Looking back on it, it think its because the internist was a new yorker and probably thinks everyone in DC is a country bumpkin compared to him.

    I have a follow-up and then I won’t be returning.

  8. Doctors make their big bucks based on how many patients that they can cram into a day; certainly not how well or even if they listen at all to those that may be literally dying before their eyes. More tests, more drugs, etc, etc…. No one really cares anymore. The assembly line of life. In one end and out the other. just pray that you don’t break-down somewhere in the middle cause the doctor ain’t home.

  9. 3 basic questions all doctors should ask but don’t.
    What is your diet?
    Do you sufficiently hydrate?
    Do you get 8 hrs of sleep per night?

  10. I see a doctor only to get an advice. I always make the determinations on meds myself. I presently take no prescription med. My alternate health care person is the one I listen to, for she helped me in the past.

  11. Take solace in the fact that when doctors go to other doctors for treatment, they have to face
    the same situation as civilians…

    1. Your anger at doctors should really be reserved for insurance companies, HMO’s and medicare/medical.

  12. My Dr. and I have frequently discussed the current pressure they are under to get through as many patients as possible in a given time period. Recently my Dr. has had to enter all his notes and comments into the computer rather than give a transcriptionist a recording of the session. He told me the insurance companies and Medicare have reduced the fees they will pay to the point he has had to lay off staff. And now we see that the care a patient receives suffers. I do not know what the answer is or where the balance should be, but I do think we need to have honest conversations between the providers, the insurance companies and, God forbid, the regulators to make sure we do not destroy what is left of the system of care we have.

  13. 10 minute scheduled visits by greedy HMO’s who employ physicians? Electronic medical records that take several minutes to complete. Huge co-pays, patients thus come in with a long list of problems. Unrealistic expectations, I want a cure!. Constant fights with insurers for payment. Incompetent staff. Eventually, burn out inevitable. Doctors are humans too, not robots. They burn out and just don’t care anymore. Just trying to survive and maintain any sanity. Try it for a while and you might understand. Idealists like this author are mostly clueless. Just writing papers to advance their careers and not have to actually see patients.

    1. Can’t take the heat get out of the kitchen. You are caring for people’s lives, and taking their money….

  14. 200 years ago they were bleeding people with leeches. Mercury skin ointments. Trepanning and lobotomies. Today we’re all a chemistry experiment. Wanna get your doctor to listen? I’m 66. In fairly good health. Until recently I was taking ZERO medications. None! Every doctor I told that to almost fell off their chair. “Oh! We can fix that.” 😉

    One drug I am taking will “cure” hep-c in 12 weeks. Ok. What the heck. I’ll give it a try. Doctors have been annoying me with that diagnosis for 20 years. Other drug I’m taking is for high blood pressure. Just spitballing. If I loose 40 pounds and get back to the weight I was at 20 years ago… blood pressure will drop. No more drugs.

    Mark my words. Someday folk will look back at todays pharma culture and laugh, ‘what the heck were they thinking???’.

    1. So drop the forty pounds and the doctor will have no need to prescribe you anything for your high blood pressure.

  15. So I was wrong. I’ve told people that I’ve tried to describe my symptoms and after about thirty seconds I can see the doctors eyes glaze over and they’re (in their minds) on the back nine or at the Mercedes dealership.

  16. I believe this, but it may be even worse. Doctors use time as a control mechanism which is arrogant and disrespectful to those who show up on time and are kept waiting, because the doctor wants to ply his game. More than once when my appointment with my cardiologist was his first in the morning, the nurse would come in and do all the stuff the doctors used to do. Then you wait some more, when you know for a fact that you are the only patient in his office. After a while the saunter in as if they sooo busy with another patient or some such line of BS. AND IT GOES ON……….

    1. And what makes you so sure he was not busy with another patient? Also no doctor does what the nurses do, why would they? I can see you have a real animosity with those who have gone to medical school, but very little real understanding of what doctors actually do. Also, seeing. doctor in a hospital setting is not the same thing as seeing a doctor in a private practice. Seeing a primary care or family doctor are not the same thing as seeing a specialist or needing a surgeon. Lumping all forms of physicians together or all forms of medical care together makes not a shred of sense.

      1. Ms20, you seemed to have not understood the tenor of my argument. But more than that, you come off like a medical student or a young intern. I have had more operations and procedures than you can shake a stick at my friend, so don’t tell me I don’t know what the heck is going on.

        Also, you missed the part where I wrote that I was the very first person in the waiting room and the first person being seen on multiple mornings. I know exactly what I am talking about.

        1. I am neither. But I do know many. And understand this from a very different perspective.
          Also, having the first appointment of the day for a specialist of some kind does NOT mean you are the first patient that doctor is actually seeing that day. Many have to see patients at whatever hospital they are afflicted with before they start office hours. Having had so many surgeries and procedures should give you a more clear and varied understanding of the profession. Of course the type of insurance you have may also be part of the reason for your poor views of those who are trained to take care of you.

          1. Boy, have you drunk their cool-aid. Are you seriously serious? Wait until you get a little older my friend, then talk to me about what you experienced at their hands.

  17. In most cases, “Doctor” knows all. He/She is omnipotent, all knowing, possessing a great mind, with great “healing” hands…and you and I are only drones, not worthy of the “Great Doctor” and his/her marvelous knowledge! And…Doctor is in a hurry to get to the golf club or to his Cessna 310. Doctors have little compassion for the people who make and keep them wealthy! They are as LAWYERS for the most part. greedy, snooty and uncaring.

  18. You may benefit by being prepared when you go in. If the Dr. sees you have notes, they are more likely to make sure you’ve covered everything. Be articulate, not a rambling time waster. If you’re a hypochondriac, make a PowerPoint presentation.

  19. I just sit and listen. Older studies show that a patient who really wants to talk will talk for an average of 1 minute. If you interrupt they will talk longer. So just listen for one minute. Older studies also indicate that if you sit down, the patients perceives you have spent 4 TIMES as much time with them compared to if your were standing. All this, and I think I am actually going pretty fast through my day

  20. My recent experience with young(er) doctors showed they are far more interested in hearing me out.

  21. At 78 years old I am fortunate to have a doctor that does listen. However, I do try to make is as easy for him as possible by making the list prior to my visit – as to my concerns. I am in unusually good heath for my age so the list is short – however, he addresses each one. I changed to him from a doctor such as described in the article – that one didn’t even give you the 11 seconds! Doctors are busy but they are in the business of serving patients – they put a lot of schooling, residency, etc. into that business and we need to be the beneficiaries. I have one grandson who is now in his residency, another just starting the process. I hope they are able to set an example such as my current doctor is doing – I’m sure they will.

  22. What do you expect when the government requires the doctors to do the massive data entry on a PDA using slow networks that are trying to keep up with demands. This displaced the jobs for medical transcription, this makes a much sense as having Tom Brady clean the uniforms after the game. Keep doctors in front of patients not found mindless data entry.

  23. That’s simply not true…I was talking to my doctor for FIFTEEN minutes when he said, “I’m sorry, I wasn’t listening!?”

  24. most of the doctors are asian or Indian(not Native) they scarcely speak intelligible english and have
    little idea of American cultural nuance

  25. Could that have anything to do with the fact that over 200,000 people died of malpractice last year ?

  26. Having listened to patients for over 40 years, I came to realize the virtually all of them came to the office without organizing their thoughts. On the other hand, a famous doctor once said, “Listen to your patients. They are telling you the diagnosis.” Saying that, patients often focus on medically irrelevant information, which, due to the constraints of time, requires the doc to refocus the conversation. Especially today, with a Google-informed public, patients come to the visit armed by research that might not be valid. Doctors have to sort that out, while under pressure from the “payers” to see a certain number of patients within a certain period of time, not a good scenario for the best communication. Generalizing the entire medical profession with this conclusion is unfair, but my prior comments might help explain why the claim might occur in some offices.

    1. Under pressure of GREED is more like it . Dr.’s offices are like mass production factories , more so than ever since the ‘ miracle ‘ of Hobama care .

    1. Thank Obamacare for that. Computers help some but they are crushing the physician patient relationship.

  27. Bad doctors galore with a few good ones. Been mistreated by many doctors, many are bored, hate their jobs, don’t listen and when you get your records, they call you CRAZY if they can’t find what’s wrong with you. Get you records from another doctor in another state and the doctor will be appalled and mad as hell at what he/she reads from your hometown doctor. It’s an old saying, “if they don’t know what’s wrong with you, they call you CRAZY!”

  28. I trust a Veterinarian with my life more than I trust most doctors. Veterinarians love animals. Doctors go into medicine for the love of Money. Give me a VET any day.

  29. On average 11 seconds. If the patient is intelligent and gets to the point, I’m sure the doctor gets more useful information and keeps listening.

  30. When I call for an appointment, my Doctors assistant ask me why I want to see the Doctor, I tell her and she makes a written note….the Doc. has it in front of him when I walk into his office, very little conversation, my Doctors Great, I tell him it hurts to hold my arm up like this and he sez; “Don’t do that”!!!!…..I’m in and out in 20 min. not counting waiting room time.

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