Concise Review for CliniciansTwo Words to Improve Physician-Patient Communication: What Else?
Section snippets
WHY SHOULD PHYSICIANS BE CONCERNED WITH PHYSICIAN-PATIENT COMMUNICATION?
Learning about the true chief complaint at the conclusion of a patient visit is not only inefficient but also impedes proper diagnosis and treatment. Poor communication also negatively affects patient compliance and outcomes. Patients complain that physicians do not listen, are hurried, and do not allow them to participate in their care. In this managed-care era, physicians complain that they are hurried and hassled and have insufficient time with their patients. Obtaining the patient's medical
FUNCTIONS OF THE MEDICAL INTERVIEW
The American Academy on Physician and Patient (AAPP) adopted a functional framework for the medical interview.2 Within this framework, the 3 functions of the medical interview are information gathering, relationship building, and patient education.
In the Kalamazoo consensus statement, the elements of physician-patient communication are expanded to 7 essentials.3 The key element is establishing a relationship by opening the discussion, gathering information, understanding the patient's
DOES THE PATIENT-CENTERED APPROACH MAKE A DIFFERENCE?
There is evidence that physician-patient communication can affect patient satisfaction, outcomes, compliance, and malpractice claims. Levinson et al8 identified differences in communication between primary care physicians with and without malpractice claims. They found that primary care physicians who had no malpractice claims provided more information about the visit, allowed patients to express all concerns and tell their story, checked their understanding of patients’ concerns, asked
SUMMARY
The medical interview is the most common and critical procedure that physicians perform. The ability to perform the 3 functions of the medical interview—information gathering, relationship building, and informing and educating patients—is enhanced by using a patient-centered approach. This begins at the start of the interview with the physician using language (eg, “What else?”) that allows patients to express all their concerns rather than interrupting patients after their first statement. When
Acknowledgments
We thank our colleagues from the Mayo Clinic Department of Internal Medicine for their insightful contributions: Drs Timothy G. Call, Daniel L. Hurley, Adamarie Multari, Paul S. Mueller, and Jeffrey T. Rabatin. We also thank Drs Anthony L. Suchman and Peter F. Weissman of the AAPP for their assistance and intensive work in this important area of medical care.
Questions About Physician-Patient Communication
- 1.
Which one of the following is true about a patientcentered interview?
- a.
It takes more time than a physician-centered interview
- b.
It elicits only psychosocial information about the patient
- c.
It uses continuers to allow patients to express all their concerns
- d.
It is applicable only to an extended visit, such as a general medical examination
- e.
It means only the patient determines the agenda
- a.
- 2.
Which one of the following best describes why the physician interrupts the patient during a physician-centered
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A question-and-answer section appears at the end of this article.