Soliciting the patient's agenda: have we improved?

Area of Science:

• Medical Communication
• Family Medicine
• Health Services Research

Background:

• Physicians often prioritize a single patient issue before understanding the full scope of concerns.
• Effective communication is crucial for comprehensive patient care.

Purpose of the Study:

• To assess how experienced family physicians elicit patient concerns in different practice settings.
• To analyze the impact of physician communication strategies on patient disclosure.

Main Methods:

• Cross-sectional survey utilizing linguistic analysis of 264 patient-physician interviews.
• Data collected on physician solicitations, patient response completion, and timing of concerns.

Main Results:

• Physicians solicited concerns in 75.4% of interviews; patients completed initial statements in only 28.0%.
• Redirecting patients after a brief period (mean 23.1s) did not significantly increase interview time but reduced concern completion.
• Late-arising concerns were more frequent when physicians did not solicit patient agendas (34.9% vs 14.9%).

Conclusions:

• Physicians frequently interrupt patients, hindering the complete articulation of concerns.
• Soliciting patient agendas is time-efficient and enhances data yield, improving interview efficiency.
• Improved communication practices can lead to better patient data collection and potentially better health outcomes.