Soliciting the Patient's Agenda

January 22, 1999

If you’ve ever felt like your doctor doesn’t really listen to you, you’re probably right. In a report published in this week’s JAMA, Ronald M. Epstein, M.D., and Howard B. Beckman, M.D., of the University of Rochester found that the average family physician listens for only 23 seconds before interrupting a patient, letting only about a quarter of patients fully explain their concerns.

In the 1980s, Beckman conducted a study showing that doctors tended to "redirect" conversations in an average of 18 seconds, frequently choosing a problem to explore before learning all of a patient’s health concerns. Although the new study shows an improvement of five seconds in doctor listening time, it suggests that doctors are still making important decisions well before the patient has explained the purpose of the visit.

Medical schools are the key to training doctors that listen. In an intensive course at the University, Epstein teaches doctors-to-be how to better relate to patients so that the patient’s concerns are properly addressed and acted upon. The study findings show that physicians specially trained in patient relationships were 44% more likely to allow a patient to finish explaining his concerns.

Dr. Epstein is available for interviews. M. Kim Marvel, Ph.D., Director of Behavioral Medicine of the Fort Collins Family Practice Residency Program was the principal investigator of this study.

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