10 Jan 2010

Better medicine through better listening

Posted by paulandrew

Ipodular Monkey  My good friend Elka Vera told me about this fascinating interview on NPR with Dr. Lisa Sanders, who has written a book about the challenges of medical diagnosis.

The problem seems to be that many physicians, feeling pressed for time, interrupt, to move things along. But the result is that they often don’t come to understand what the real problem is, resulting in more follow-up visits, and even more time. Granted, doctors are balancing many factors–it isn’t easy. Nonetheless for some, the idea of “slow down and listen, in order to speed up” could be in order.

On a related note, a few months ago when I went in to see a specialist at Kaiser, I was astounded when he listened extremely attentively for 5 minutes as I explained exactly what I’d observed. He interjected a few small questions, but really left it up to me to guide. The result was that he heard all I had to say, we got on the same page with the situation, and I was able to really take in his point of view. It was great.

“Having the patient tell the story is thought to be the most efficient way of getting all of this data out. And yet we don’t do it.”

You can read the full transcript of the interview or hear it online.

I’ve put an excerpt of theinterview below:

DAVIES: Wasn’t there a study which actually recorded interviews by physicians and gave us a sense of what the interaction was like?

Dr. SANDERS: Absolutely. There’s actually been two that were a few years apart, and they showed the same thing, which is basically, doctors let patients talk for an average of 20 seconds before they interrupt – sometimes even less. In the most recent study, some doctors let a patient talk for only three seconds before they interrupted. And they interrupted with a very specific question, usually. But the chance that the patient would go back and finish that story is almost zero. I mean, it almost never happens.

They get distracted. New information prompts new questions, and people go on to, you know, describe other symptoms. But having the patient tell the story is thought to be the most efficient way of getting all this data out, and yet we don’t do it.

DAVIES: And do the studies also indicate that when doctors do interrupt, that they get an inaccurate picture of what’s going on with the patient?

Continued on the NPR website.

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