I didn’t even examine him: Physician-patient communication

One doctor – call him Dr. M – says he has always been circumspect when he talked to patients. But one patient who came for a visit five years ago for a physical exam was skilled at furniture building, Dr. M's hobby. The patient spent 40 minutes with the doctor. When he left, Dr. M looked at his notes. "I realized I didn’t even examine him," Dr. M admitted.

The patient was gracious when Dr. M called to apologize, saying, "We’ll just wait for next time."

A recent study in the Archives of Internal Medicine concluded this happens often, though maybe not for such a long time. Researchers studied 113 surreptitious audio recordings of office visits of test patients. The researchers discovered that doctors talked about themselves in a third of the visits and that there was no evidence that any of the doctors’ disclosures about themselves helped patients or established rapport. Patients were not comforted, and conversations got off track, the authors of the study found, wasting patients' time. "What’s shocking about this article is how often they moved from the patient’s concerns to their own,”"commented one physician chairperson of family medicine at an academic medical center.

Advice: If this is a problem with your doctor, leave a copy of this blog post in the doctor’s office as a gentle reminder.


Read Gina Kolata’s article in the June 26 New York Times.