On Being a Doctor: "Please Stop Interrupting"

Here's an interesting piece by Juliet Mavromatis who is a general internist based in Atlanta, Georgia in the Health Care Blog. It's titled “Why Doctors Interrupt”.

The article describes an interaction between Dr. Mavromatis and a neurosurgeon about a patient’s headaches. Only a few sentences into her opening description about the patient the neurosurgeon interrupts. Dr. Mavromatis persists tenaciously despite the neurosurgeon’s interruption with her story but describes the interaction leaving her with unease. She writes:

“Interruption is a pervasive communication style with doctors.  In a well known study by Beckman and Frankel patients were allowed to complete their opening statement expressing their agenda in its entirety in only 23% of physician interviews.  The average time to interruption was 18 seconds.  This study’s findings have been replicated by several others.  In a more recent study of primary care residents, patients were allowed to speak for only 12 seconds on average before they were interrupted.  Female patients experience interruption more frequently than males. In contrast, studies have suggested higher rates of patient satisfaction with physician visits during which patients and doctors interrupt at similar frequency and also with visits in which there is more “reflective” silent time during the conversation.  Perhaps the tendency to interrupt extends to all physician derived professional communications, as in my case with the neurosurgeon on the phone.

Why do physicians interrupt?  In practical terms, throughout the course of a given day a physician may be tasked with listening to twenty to thirty patient derived histories and with solving difficult problems for each of these patients in a matter of ten to fifteen minutes. This is a tough, if not impossible job.  Consequently, once a physician believes that the meat of the story is out there, he or she may respond and interrupt before hearing details that the patient (or colleague) feels are important.  In more abstract terms interruption is a communication strategy that reinforces physician dominance in the hierarchy of the patient-physician relationship.

The most frequent complaint that I hear from patients about other physicians is that a physician did not “listen,” or did not “seem to care” about their problem.  My advice to physicians and medical trainees: sit down, bite your tongue and wait. If you do interrupt, do so with brief questions allowing your patient to return to his or her agenda.  You might be surprised and learn something, and no doubt you’ll certainly have happier patients (and colleagues).”

The article by Juliet Mavromatis resonates with me because, as I reflect on my own clinical practice, I agree it’s quite easy to interrupt a patient just to keep to the designated time for a follow-up versus new patient visit. After reading this article I am going to try in stop interrupting a patient.