Every Patient's Advocate

Yackety Yak: It’s all about the doctors

… so said the doctors in a study conducted in Rochester, NY and reported in the Archives of Internal Medicine ….

It seems that 100 doctors were studied over the span of a year to see how they communicated with patients. Mystery patients made appointments, visited the doctors, then recorded their conversations. Even though the doctors had given permission for that to happen, they didn’t know for sure which patients were the fake patients.

In one-third of the conversations, the doctors talked about themselves, likely in an effort to create a rapport with the patient.

But when that happened, 80% of the time the conversation never returned to where it began — meaning — the conversation never turned back to whatever the patient was saying or asking. Meaning — patients didn’t get their full service, nor did they have the opportunity to get answers to all their questions.

Here’s a link to the study:
http://archinte.ama-assn.org/cgi/content/abstract/167/12/1321

Read about it in the New York Times:

http://www.nytimes.com/2007/06/26/health/26doctors.html?_r=1&ref=health&oref=slogin

The interesting commentary shows that the doctors who did the research were, in a word, appalled at themselves. I give credit to Dr. Susan H. McDaniel and Dr. Howard Beckman, who led the research, for owning up to their own befuddlement at the results.

Hey — at least give them a pat on the back for trying! But, give them a swat for being clueless, too.

I see a few different aspects here for sharp patienting:

First — doctors hear that their patients want to establish a rapport, or that patients want a doctor with good “bedside” manner… BUT…. nobody teaches those doctors just how to accomplish that. So what happens? Because they don’t know any better, they talk about themselves.

Hey medical schools — do you hear that? There’s been a cry to teach doctors some bedside manner for years… do you hear this? What good is a doctor’s diagnosing and treatment ability if it can’t be well communicated?

Second — if doctors talk about themselves and still try to stick to their 6 or 7 insurance-alloted minutes? Well then — that’s definitely wrong! If they want to spend the patient’s precious time talking about themselves, so be it, but either discount the visit, or make sure the patient gets what s/he is paying for.

Third — we are empowered patients. We are free, intelligent and have questions. The tenets of smart patienting tell us to get the conversation back on track ourselves! We don’t have to converse at the doctor’s direction — we can direct the conversation ourselves, can’t we? Ask those questions. Don’t allow yourself to be derailed!

Kudos to the primary care doctors who were willing to be studied. Kudos to those doctors who analyzed and published the results. Kudos to the doctors who “get” the results and wish to move their patient interaction into a more positive direction.

And mega-kudos to those patients who can establish a rapport with their doctors, without allowing it to detract from their care.

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