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Gathering information
The Medical interview
The medical interview is used to gather information about a problem and also about patients beliefs, concerns, expectations and illness experience.[11] Research around the medical interview reveals some interesting facts!
Did you know that...
Only 1/4 of patients completed their opening statement[1][2]
Doctors frequently interrupt patients, this often prevents patients from disclosing all of their health problems. Residents have been found to interrupt patients every 12 seconds[3]
Patient-centred consultations were only one minute longer than physician-centred consultations [4]
Without specific questions from physicians, the patient’s perspective on the illness (concerns, etc.) surfaces spontaneously in only about 1/4 of medical interviews[5]
Female residents interrupted their patients less often than did male physicians [3]
Residents interrupted female patients more than male patients[3]
Better non-verbal communication skills are associated with significantly greater patient satisfaction[6]
Female physicians participated in more psycho-social discussion, emotionally focused talk and positive talk[7][8]
Nine out of 10 patients do not receive good explanations on proposed treatments or tests[9]
86 % of interview closures are initiated by the physician[10]
In 21% of closures, new problems arise that were not mentioned earlier in the visit[10]
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1. Beckman and Frankel, 1984. Beckman HB, Frankel RM: The effect of physician behaviour on the collection of data. Ann Intern Med. 1984;101:692.
2. Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient’s agenda: have we improved? JAMA, 1999; 282(10):942-3.
3. Rhoades DR et al. “Speaking and interruptions during primary care office visits.” AO.Fam Med. 2001;33(7):528-32.
4. Abdel-Tawab, N, Roter D. "The relevance of client-centered communication to family planning settings in developing countries: lessons from the Egyptian experience." Soc.Sci.Med. 2002;54(9):1357-68.
5. Lang, F et al. "Sequenced questioning to elicit the patient's perspective on illness: effects on information disclosure, patient satisfaction, and time expenditure." Fam.Med. 2002;34(5):325-30.
6. Griffith C, Wilson J, Langer S et al. House staff non-verbal communication skills in standardized patient satisfaction. J of Internal General Medicine. 2003;18:170-4.
7. Roter D, Hall J, Aoki Y. Physician gender effects in medical communication: A meta-analytic review. J of Am Med Assn. 2002;288:756-840.
8. Bylund C, Makoul G. Empathic communication and gender in the physician- patient encounter. Patient Educ & Counselling. 2002;48:207-216.
9. Braddock CH, Edwards KA, Hasenber NM, Laidley TL, Levinson W. Informed decision-making in outpatient practice. JAMA. 2000;282(24):2313-20.
10. White J, Levinson W, Roter D. ‘Oh, by the way’: The closing moments of the medical interview. J Gen Intern Med. 1994;9:24-8.
11. The facts below are from a document produced by Dalhousie medical school "Five Basic Tasks of the Medical interview" csp.medicine.dal.ca/docs/CCG_evidence.pdf Accessed May 11, 2010