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Interruption in the medical interaction
T Realini1, A Kalet, J Sparling
1Department of Ophthalmology, University of North Carolina at Chapel Hill, USA.
Objectives:
To describe patterns of interruption in the physician-patient interaction; specifically, to determine who interrupts, to determine if a shift in control occurs as a result of interruption, and to characterize the information gained when patients interrupt physicians.
Design:
Observational.
Setting:
Community-based primary care practices in North Carolina.
Subjects:
Internists and family physicians in private practice in North Carolina (six men and two women) and their patients (13 men and 27 women).
Interventions:
None.
Main Outcome Measure:
The obtainment of control of the interaction, at least momentarily, as a result of interruption.
Results:
Analysis of 40 audiotaped interactions revealed 833 interruptions (mean +/- SD, 20.8 +/- 12.2 per interaction): Patients initiated 55% of all interruptions. Physicians and patients each gained control of the conversation after 50% of interruptions. Patients gained control after 74% of patient-initiated interruptions, and physicians gained control after 79% of physician-initiated interruptions. Patients were more likely to gain control by interrupting late in the interaction, and 75% of patient-initiated interruptions resulted in new information (solicited and unsolicited) being contributed to the interaction.
Conclusion:
Interruption by patients can be an informative event.