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May 14 2000
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Patients Do Not Tell Doctors Their Concerns, Fears

 

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



Dr. Mercola Dr. Mercola's Comments:
There are many valuable lessons in this report for those of use who take care of patients. I believe it is very important to provide enough flexibility in one's schedule that provides the time to "catch up" should one or more patients require extra time to communicate an important concern that could not be done otherwise in a rushed environment. I am not always successful at doing this, but I see patients in four hour blocks and usually have thirty minutes structured in those four hours that is specifically planned for catching up. This is non-billed time that is given to patients who may need the extra time to communicate some fears or concerns.

The article did have an interesting element in that many of the physicians were actually envious of their colleagues who are alternative practitioners and get longer sessions with their patients. In the UK, doctors spend on average 7 minutes with each patient. To my understanding it is virtually impossible to treat a patient in 7 minutes. I do not know how they do that without seriously compromising the quality of care rendered to the patient.

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