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When face to face with the doctor, patients may
not voice many of the concerns that prompted them to make an appointment
in the first place. Only 4 out of 35 patients were able to voice all their
concerns to their physicians. The most common unvoiced concerns included
worries about a possible diagnosis, fears about the side effects of medication,
and concern about being given an unwanted prescription. Past studies have
suggested that emotional and social concerns are the least likely to be
broached during appointments.
Doctors are in a powerful position in the relationship
with patients and need to work to share information and decision-making
with the patient and to encourage patients to talk. The reason behind
the unvoiced concerns is that patients are behaving as they are expected
to -- not as they would like. They need to feel that they can voice the
concerns about their illness, including their reluctance to take prescribed
drugs. The authors of the study note the shrinking amount of time available
for communication between doctor and patient.
British Medical Journal
May 6 2000;320:1246-1250
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