[Interruptions during consultations--harmful to both patients and physicians]

The physician-patient consultation is a confidential meeting that necessitates uninterrupted privacy. During consultations, physicians are asked to give their undivided attention to the patient. The purpose of this study was to document interrupted consultations and to address the related opinion of both physicians and patients.

The study was divided into two parts: 1. A record was kept of all interruptions that occurred during one working day in the offices of four family physicians and four pediatricians in a large urban clinic in Israel. 2. Documentation from interviews and questionnaires that were submitted to both physicians and patients from the clinic and neighboring clinics regarding interruptions during consultations with patients.

There were 218 interruptions recorded during 110 pediatric consultations. Four hundred and twenty-six interruptions were recorded during 116 consultations with family physicians. A total of 83% of the pediatrics consultations and 95% of the family physician consultations were interrupted. The most common reasons for interruption were: 1) disturbance by other patients (23% pediatric visits and 44% family medicine visits) and 2) telephone calls, 22% for all physicians. Eighteen percent of the pediatricians time and 31% of the family physicians time was involved with dealing with problems other than those of the patient. Fifty-one physicians from the study clinic and neighboring clinics completed a questionnaire. Eighty-four percent of the physicians expressed the opinion that interruptions during consultations are harmful and disruptive and 92% felt that this had a negative influence on patient-doctor relationships. Sixty patients were interviewed and asked to express their opinion about interruptions during consultations. Only 40% of the patients felt that their physician had given them undivided attention. Seventy percent of the patients were aware of the interruptions during their consultations and subconsciously annoyed.

Interruptions during consultations are frequent and harmful to both patients and physicians. Consultation interruption should be regarding as a major threat to the quality of the patient-physician relationship. The nursing and clerical staff of the clinics should be briefed and cautioned to limit interruptions during consultation hours to a minimum.