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Interruption in the Medical Interaction
Tony Realini, MD;
Adina Kalet, MD, MPH;
Joyce Sparling, PhD, PT, OT
Arch Fam Med. 1995;4(12):1028-1033.
Abstract
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Objectives
To describe patterns of interruption in the physician-patient interaction; specifically, to determine who interrupts, to determine if a shift in control occurs as a result of interruption, and to characterize the information gained when patients interrupt physicians.
Design
Observational.
Setting
Community-based primary care practices in North Carolina.
Subjects
Internists and family physicians in private practice in North Carolina (six men and two women) and their patients (13 men and 27 women).
Interventions
None.
Main Outcome Measure
The obtainment of control of the interaction, at least momentarily, as a result of interruption.
Results
Analysis of 40 audiotaped interactions revealed 833 interruptions (mean±SD, 20.8±12.2 per interaction). Patients initiated 55% of all interruptions. Physicians and patients each gained control of the conversation after 50% of interruptions. Patients gained control after 74% of patient-initiated interruptions, and physicians gained control after 79% of physician-initiated interruptions. Patients were more likely to gain control by interrupting late in the interaction, and 75% of patient-initiated interruptions resulted in new information (solicited and unsolicited) being contributed to the interaction.
Conclusion
Interruption by patients can be an informative event.
Author Affiliations
From the Department of Ophthalmology (Dr Realini), Division of Physical Therapy (Dr Sparling), University of North Carolina at Chapel Hill; and the Division of Primary Care, Department of Medicine, Gouverneur Diagnostic and Treatment Center, New York (NY) University School of Medicine (Dr Kalet).
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ABSTRACT
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