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Doctor-Patient Communication: Much Room For Improvement

In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82 percent) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted.

If that isn’t enough, when the researchers queried the physicians, 67 percent thought the patients knew their name and 77 percent of doctors thought the patients “understood their diagnoses at least somewhat well.” I would call that a pretty significant communication gap.

Ninety percent of the patients said they received a new medication and didn’t know the side effects. Although 98 percent of physicians thought they discussed their patients’ fears and anxieties with them, only 54 percent of patients thought they did.

The researchers from Yale University School of Medicine and Waterbury Hospital concluded that “significant differences exist between patients’ and physicians’ impressions about patient knowledge and inpatient care received.” Moreover, responses didn’t significantly differ by sex, age, race, language or payment source for the patients, or level and type of training for the doctors.

A great deal of evidence exists that shows patients who understand their condition, are educated about medication, and have good rapport with their physician have better outcomes. It’s just common sense. I know that medical schools teach interpersonal relationships, and the fact that so many physicians think they’re doing it right makes me wonder how they can be perceived so differently by the patients.

Some possible explanations are:

— Patients are stressed while hospitalized and do not remember what is said.

— Many patients are heavily medicated and that affects ability to learn and remember.

— Doctors are too rushed and deliver information too quickly to be understood.

— Hospitalized patients have too many consultants and no one is identified as the “responsible physician.”

— The trend to get patients out of the hospital quickly short changes communication time.

— Nurses, consultants, and hospitalists don’t communicate well together and the patient gets a different message from each visit.

There may be many other potential reasons. Everyone in medicine should take a pause to look at this study very carefully because it shows that there’s so much room for improvement.

*This blog post was originally published at ACP Internist*

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