Blog | Wednesday, August 18, 2010

Doctor/patient communication could use a boost


In a surprising report from the Archives of Internal Medicine, we learn that most hospitalized patients (82%) 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% thought the patients knew their name and 77% 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% of physicians thought they discussed their patient's fears and anxieties with them, only 54% of patients thought they did.

The researchers from Yale University School of Medicine and Waterbury Hospital concluded: "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 is just common sense. I know that medical schools teach interpersonal relationships and the fact that so many physicians think they are 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; and
--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 so much room for improvement.

This post originally appeared at Everything Health. Toni Brayer, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.