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Why Patients Change Doctors

Guest SuziQ2

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Patients Change Doctors Because of Poor Physician Communication


NEW YORK (Reuters Health) Jan 15 - Patients who feel that their doctors do not spend enough time listening or answering questions report that this promotes a lack of trust. This is also the primary reason that patients in the US consider changing doctors, researchers report.


Writing in the January issue of the Journal of General Internal Medicine, Dr. Nancy L. Keating from Harvard Medical School, Boston, and colleagues looked at the relationship between patients' experiences and their trust in their physician. The participants were 2052 patients who responded to a telephone survey in 1997.


The researchers classified patients' complaints into one of the following six categories: not allowing patients enough time to explain the reason for the visit; not providing understandable answers to questions; not taking enough time to answer questions; not asking about how family or living arrangements affect their health; not giving enough medical information; and not involving patients in decisions to the extent they wanted.


Seventy-eight percent of the patients reported having at least one of the six communication problems. Multivariable analysis revealed that each problem was independently linked with a lower perception of trust (p < 0.001). Having five to six of these problems was associated with an lower overall physician rating (p <0.001), the investigators found.


Three of the problems, not providing understandable answers (odds ratio 2.0), not taking enough time to answer questions (odds ratio 3.3), and not giving enough medical information (odds ratio 4.0), were independently related to patients' considering changing physicians, Dr. Keating's group notes.


"Although most patients' experiences with their physicians are good, those that are not may have important consequences, including lower trust, lower ratings of physicians and greater likelihood of changing physicians."


The investigators suggest that "more physician training in communication skills, particularly focused on answering questions in ways that patients can understand, taking enough time to answer questions, providing adequate amounts of information and discussing differences in opinion about whether tests, procedures, or referrals are needed, may strengthen patient-physician relationships."


J Gen Intern Med 2002;17:1-11.

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Guest Nancy Cornish

Well, I've had all six communication problems.  It would be nice to think the doctors would LISTEN to what this article is trying to get across, but I kind of doubt it.  They are too busy writing scrips for Prozac so they will get a free trip from the drug company.  Can you tell I've lost all respect for them?

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