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Study Shows Doctors Listen for 11 Seconds Before Interrupting

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If you’ve ever gone to the doctor and felt as though your concerns weren’t met, you’re not alone. Sometimes you have to pick which concern needs the most attention, and a new study shows why you may want to prioritize. On average, doctors listened to their patients for 11 seconds before interrupting.

Out of 112 recorded interactions between doctors and patients, 40 doctors asked patients their reason for making an appointment. Primary care physicians were more likely to ask patients about their concerns. Of those that allowed the patient to set the agenda, doctors interrupted after an average of 11 seconds.

This study is small, but other studies have shown similar results. Though this study showed the quickest interruption time, a previous study in JAMA showed that physicians interrupted patients between 18 and 23 seconds after asking about the patient’s concerns. Another study showed that the average time before an interruption was 16.5 seconds.

The researchers classified interruptions as doctor-led interjections that caused incomplete patient statements. This includes closed-ended questions (which require the patient reply yes or no), asking the patient to elaborate, restating what the patient said or a statement that halted or changed the course of the patient’s narrative.

“Our results suggest that we are far from achieving patient-centered care,” lead researcher Naykky Singh Ospina said in a statement.

The researchers looked at patients who were seeking treatment for Grave’s disease, depression, osteoporosis, diabetes and cardiovascular disease prevention. On average, doctors saw patients for 30 minutes.

Researchers found that patients are interrupted frequently, but how much a doctor interrupts varies depending on the physician’s practice and the complexity of the patient. The researchers said interruptions can be beneficial to the patient by providing clarity or refocusing the conversation. The researchers speculated, however, that an interruption so early into an appointment would likely not be beneficial, even if it were to clarify or focus the conversation.

Dr. Jennifer Caudle, a family physician and associate professor at Rowan University School of Osteopathic Medicine, told The Mighty that interrupting is sometimes used to facilitate further dialogue. If a patient brings up a symptom, a doctor might want to ask questions about that symptom such as “when did it start” or “are there any other accompanying symptoms.” It’s a way to encourage more dialogue to make sure the doctor’s on the right track, Caudle said.

“Sometimes it’s hard to describe things, and that’s OK,” she said. “This is not a doctor show. This is a shared conversation and a shared collaboration to figure out what’s going on and what needs to happen.”

Caudle said doctors have to be good listeners, but sometimes listening can be affected by a number of factors. She added:

Sometimes when we feel like we understand or have a sense without hearing more, which is maybe right or maybe wrong. Something else that plays a role is time constraints that we have with a patient. We have 15 minutes and if the description of the issue takes seven, it may be problematic. Those are not circumstances that justify physicians not listening. It doesn’t do that, but those are sometimes playing a role in the office visit dynamic.

Caudle said there are things you can do to help make your appointment a productive one. You should come in organized and with an idea of what your goals for the visit are. You should also make note of any new symptoms or worsening symptoms since your last visit.

It’s not unusual to forget what you wanted to talk about and then remember after you’ve left the office. Writing down “action items,” or items you need to discuss, is one of the best ways to approach an office visit, Caudle explained.

Caudle also recommended keeping a running list of questions in weeks or months before your next visit. You can keep them on your smartphone if you have one.

“Have a list of [concerns], so that when you get to the doctor, you can be prepared to say, ‘There are a number of things I have concerns about,’” she said. “Then, you and the doctor can decide which ones to deal with first and second, etc.”

It’s also important to let your doctor know about any concerns or troubling symptoms you may have, she added. Don’t wait until the end of your appointment to address something important.

If you’re struggling to communicate effectively, let your doctor know so the issue can be addressed. If you feel unheard by your doctor after addressing the issue, it may be time to find a new provider.

Photo via Getty Images/Rawpixel

Originally published: July 24, 2018
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