holistic internal medicine doctor :: Article Creator11 Seconds: How Long Your Doctor Listens Before Interrupting You
A doctor may interrupt you because he or she is on the clock. (Photo: Shutterstock)
Apparently it takes mammals on average 21 seconds to pee regardless of their size, based on Georgia Tech researchers watching different animals urinate. Therefore, you may have much more uninterrupted time to empty your bladder than you do to tell your doctor why you are seeing him or her on a visit.
A study published in the Journal of General Internal Medicine showed how soon doctors interrupt their patients during appointment and how many don't even give their patients a chance to first explain the reason for the visit. Before you say anything and ask any questions, let me continue.
For the study, a team recorded and analyzed 272 randomly selected patient-doctor encounters at the Mayo Clinic and affiliated clinics in Minnesota and Wisconsin. The majority of the time the doctor did not even ask the patient the purpose of the visit: 64% of primary care visits and 80% of specialist visits.
Even when doctors gave patients the opportunity to explain the purpose of the visit, most of the time doctors interrupted the patient: 19 (63%) of the 30 primary care encounters and 8 (80%) of the 10 specialty care encounters.
These interruptions came pretty quickly: a median of 11 seconds with a range of 3 seconds to 234 seconds. (3 seconds?!?) And most of the time (59%), the interruption wasn't something like "I see, tell me more" or "that must be hard for you" or "I really have to go pee" but instead a closed-ended question, that is, a question just seeking a "yes" or "no" response.
How then can a doctor really tell why you are there and provide proper care? Even the best medical record systems can't always provide enough information on a patient before a visit. Last I checked mind reading is not part of any medical record system, although who knows what Google is working on these days.
After all, you may want to wait until you actually see your doctor before fully revealing and explaining the purpose of your visit. Think about it. Would you tell the appointment scheduler that you have intense and uncontrollable farting? Would you tell the receptionist at the clinic with others in the waiting room that you have intense and uncontrollable farting, unless, of course, they have already noticed? Moreover, telling someone about intense and uncontrollable farting in 11 seconds or less can be like releasing one in a room and then immediately leaving. Without the opportunity to offer more accompanying details, brief statements can lead to lots of misunderstanding and misinterpretation.
A doctor's visit shouldn't feel like a Shark Tank pitch. In fact, guests on that television show typically get more time to talk uninterrupted than 11 seconds.
Something is wrong when entrepreneurs have much more time to make pitches uninterrupted on the... [+] television show Shark Tank than a patient has to describe his or her complex medical issues to a doctor. (Photo by GP Images/Getty Images)
Does this mean that many doctors are just naturally uninterested in listening to you? Not necessarily. Sure some doctors may not care to listen to patients. Every profession has its bad apples. Also, there are doctors who will make assumptions about you without bothering to even listen to you. They may stereotype and judge you based on your appearance or other superficial characteristics. But when a majority of doctors aren't taking the time to listen, it is a systems problem and not just an individual doctor problem.
Fifteen minutes is just not enough time to see a patient. As I have written for Forbes previously, this is less time than it takes to go to the bathroom, even when you don't have the runs. With so little time to complete a patient interview, a physical exam, and associated documentation and so many patients to see each day, it would be no surprise if doctors were to eye the clock nervously when a patient begins to speak. A doctor mindful of how little time there is may be consciously or unconsciously trying to fast-forward the visit.
Moreover, doctor fatigue, stress, and disgruntlement being such major problems, as I also described previously for Forbes, it should be no surprise that many may be less inclined to listen. After all, think about the last time you were very stressed and someone wanted to tell you about their problems. Was your response, either openly or in your head, "you think you've got problems, let me tell you about my problems"?
Ultimately, this rush-rush situation is driven by insurance reimbursement and administrators who don't actually see patients but are trying to increase revenue. Ironically, such rush-rush ends up costing everyone a lot more money.
Imagine if a restaurant were to handle customers in the following manner. Instead of giving you time to read the menu and discuss the options, the restaurant said, "you look like a duck confit person, our records show that you ate duck confit before, therefore you will eat duck confit." Except the consequences of a missing key medical information and providing the wrong diagnoses and care are much greater than getting duck confit when you really wanted string beans, unless you are severely allergic to duck.
Medical costs, productivity losses, suffering, and deaths go up when patients don't receive the right diagnoses, preventive care, or treatments. When you feel unheard, you may seek alternative providers, who at least will take time to listen to you (or at least pretend to listen to you) regardless of whether they provide legitimate evidence-based care. This results in hospitals and clinics losing revenue and more people with jade eggs in their vaginas.
The system needs to change to instead provide financial incentives for longer and more meaningful patient visits. Improving doctor well-being should be at the front of fixes for the health care system. As a friend often says, you can't save someone else from drowning when you yourself are drowning.
When you have more time to pee uninterrupted than explain your problems to your doctor, something is really, really wrong with health care systems. It's going to result in higher costs and greater health problems. And it will leave a lot of patients pissed off.
Medical Director Of The University Of Kentucky Integrative Medicine And Health Program
Connie Jennings, M.D., practices internal medicine with a patient population ranging from young adults to geriatrics at the University of Kentucky and is the medical director of the University of Kentucky Integrative Medicine and Health Program. Dr. Jennings also practices acupuncture, provides integrative medicine consults, and teaches meditative skills. Her integrative medicine team promotes healthy lifestyles, disease prevention, and holistic healing, and in addition to her clinical work, she teaches undergraduates and professional students. Her approach to medicine focuses on the relationship between the patient and the provider as the healing force.
Integrative Medicine
Mind-Body Medicine Alongside Mainstream Care
A multi-disciplinary integrative healthcare team often includes physicians, nutritionists, massage therapists, acupuncturists, yoga instructors, and meditation instructors, among others. Integrative health practitioners partner with the patient to provide individualized treatment and prevention of disease and disorders; the patient is part of the decision-making process. Whenever feasible, less invasive, more natural interventions are used for healing and health promotion. Many alternative treatments have been researched and can be effective.
How does nutrition factor into integrative medicine?
The food you eat affects your health and the development of illness and disease including cancer, diabetes, heart disease, and many other conditions. If your diet contains too much fat and cholesterol, you may end up with atherosclerosis; too much sugar can lead to diabetes; add fish to your meal plan and your risk of heart disease decreases. And people who eat a lot of fruit, vegetables, and whole grains normally live longer and healthier lives. Nutrition is a foundation of integrative care.
Are supplements and herbs part of complementary care?
While it is best to eat your nutrients in the form of food, supplements are indeed part of complementary care. Here is a short list of helpful supplements.
• Omega-3 fatty acids, high in cold-water fish, help prevent heart disease, arthritis, and cancer. It also reduces inflammation, which is important for immune response.
• Folate, high in leafy greens and other vegetables and fruits, also reduces the risk of heart disease and stroke.
• Flavonoids, high in blueberries and cruciferous vegetables like broccoli, may help fight cancer.
• Calcium and Vitamin D, high in eggs and fish and dairy, regulates the calcium in your body, which is good for bones and muscles.
• Lutein, high in leafy greens like kale and spinach, may also reduce the risk of cancer as well as cataracts.
Are mindfulness and meditation useful in integrative care?
Some people regard mindfulness and meditation as mind-cleansing practices, and that mindfulness and meditation are important for overall well-being. These practices reduce stress, anxiety, inflammation, and pain; plus, they can boost mood and immunity. These practices also increase compassion, emotion-regulation, focus, productivity, and even perspective. People might think they have to sit lotus style and chant, but it's more about being present with oneself and just breathing.
What mind-body practices can I use with integrative care?
While any physical activity is good for your well-being, yoga, qigong, tai chi, or similar practices use the body and movement with mindful intent. When practicing these or other methods, the individual empties the chatter inside the head and focuses on the way the body moves and breathes. These practices help reduce stress, anxiety, and pain; they also boost mood and overall health.
Why is physical therapy important in integrative care?
Physical therapy is often used in recovery after an injury. Muscles, for example, need to be strengthened after a broken bone has healed. Patients see physical therapists after surgery, stroke, paralysis, among other reasons, and it can help recover range of motion, overall strength, and balance. Physical therapy is also used in pain management and age-related changes and problems.
Is acupuncture effective?
This is a technique used in traditional Chinese medicine. Practitioners insert thin sterile needles into specific points through the skin and into the body. According to the National Center for Complementary and Integrative Health of the National Institute of Health, research shows that the practice can help patients manage pain in the back, neck, and knee. There is also evidence of effectiveness for migraines and general headache pain. And in one review of research, acupuncture may also help with certain symptoms in cancer patients.
Is chiropractic care effective?
There is research on the effectiveness of chiropractic care, also known as spinal manipulation. One review published in the Annals of Internal Medicine, for example, found that spinal manipulation helped reduce chronic lower back pain; such manipulation has also been found to increase overall movement and function. More and more chiropractors are found in mainstream health delivery systems.
Is massage therapy used in integrative care?
Is animal-assisted therapy effective?
This type of therapy can be effective for animal lovers; treatment can include cats, dogs, horses, birds, or any number of animals. Research suggested positive results of this therapy for those with autism, medical conditions, depression, anxiety, addiction, and other problems. Trained therapy pets are also popular in hospitals, rehab centers, nursing homes, and other facilities. Animal-assisted therapy is used alongside the treatment with a psychotherapist, social worker, counselor, or other providers.
Are creative therapies like music, dance, and art effective?
These creative therapies have been used in the treatment of many conditions such as Alzheimer's disease, Parkinson's, dementia, and brain damage due to stroke or traumatic brain injury, mood disorders, eating disorders, and many others. Research on the use of music in Alzheimer's patients has proven effective, with patients able to make cognitive connections that appear to be totally lost. Talent is not required. These creative outlets are used to put patients in touch with their bodies, emotions, and memories.
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