In today’s healthcare environment, providers are asked to do more with less resources and time. One area frequently cut by clinicians is the subjective examination or patient history, arguably the most important part of the patient encounter. Previous research has found over 80% of all diagnoses by physicians can be made utilizing the patient history alone. Utilizing open ended questions such as, “how can I help today?”, vs closed ended questions, “are you having any pain?”, provides the greatest amount of information from the patient. Unfortunately the medical research reports patients are interrupted by their physician only 18 seconds into their first answer to these questions. Interestingly, if patients are provided an uninterrupted environment to tell their story they complete their history in 2.5 minutes. A new study supports the evidence gathered from these 1970s and 1980s communication studies on physician interruption.
Patient and physician encounters from multiple clinics in the United States, including the Mayo clinic, were recorded and analyzed by researchers to determine the quality of this interaction (Ospina et al. J General Internal Medicine. 2018). Overall, the patient’s agenda or chief complaint was adequately addressed in only 36% of encounters, most frequently by primary care physicians (49%) and least frequently by specialists (20%). Consistent with prior research, when the physician prompted the patient’s agenda they were interrupted after 11 seconds. If left uninterrupted, patients completed their chief complaint by 108 seconds. These findings are striking when you consider the average patient’s appointment time was 30 minutes.
On of the main reasons we started MEND was to create a healthcare environment where patients have the opportunity to explain their story and symptoms. We find our one on one, uninterrupted, hour long appointments provide us an opportunity to thoroughly examine each patient. By removing time constraints we are able to accelerate a patient’s recovery in fewer visits.