Viewpoint: A little more conversation

Are you an 18-second doctor? Your patients certainly hope not.

Eighteen seconds is the amount of time, on average, that patients are permitted to talk before the physician-that's you, quite possibly-interrupts them, according to a study by the Albert Einstein College of Medicine in New York. Is 18 seconds enough time to fully understand your patient's concern?

Consider it in another way: Could you, in 18 seconds or less, sufficiently describe how your broken car is not getting you where you need to go? It takes that long just to properly replicate the thwunk-thwunk-thwunk sound that's taunting you from under the hood.

In this issue, we examine the differences a few years can make between older and younger physicians. But it's also a good time to ponder the difference a few seconds can make between an engaged doctor and a rushed one. Younger doctors, perhaps not surprisingly, tend to interrupt their patients more quickly than their older peers, according to the Albert Einstein research.

"When I see a patient for the first time, when I knock on that door, I think How can I change this person's life?" says Stephen Beeson, MD, a family practitioner and medical adviser for the Studer Group, a healthcare consulting firm. "If you don't make that change in your thinking, you're just doing a series of tasks."

One key way to accomplish this, says Beeson, is to make time for non-medical conversation. Show you care about the person, not merely the valuable time she's consuming.

Speaking in a session at the American Academy of Family Physicians' Scientific Assembly in his hometown of San Diego, Beeson recounted the tale of a female patient who had mentioned her beloved dog named Muffin to a member of the office staff. That person passed the information on to Beeson, who made a point of asking about Muffin during his consult. What followed was an extended dog discourse-and an indelible new bond between patient and physician.

"I wondered what had happened to my career that I'm spending 15 minutes talking about a dog named Muffin," Beeson recalls, "but it was a fundamental step in establishing that relationship."

Beeson recommends allowing the patient's agenda and concerns to drive the visit-not for 18 seconds, but for as long as it takes to get her thoughts conveyed clearly. Let her know you understand by repeating what she says back to her. It shows that you're listening and that you care. "One thing you never want to do is question the authority of a patient complaint," says Beeson.

Likewise, Beeson advocates making follow-up calls to check on patients you've recently seen; his 400-physician medical group makes 10,000 such calls each month. Every call expresses an unmistakable sense of commitment to his patients-and has earned him the business of entire neighborhoods through word-of-mouth.

You can make an even greater difference in the lives of your patients by encouraging your staff to value these same traits. Don't allow them to shout out a patient's name at the door, as though she's the next contestant on The Price Is Right. As Beeson puts it: "I want you taking her arm under your arm and talking about her dog named Muffin."

It may cost you a few minutes of conversation, but could reward you with a lifelong relationship. And that, says Beeson, is the beauty of practicing medicine. "Our ability to make a difference in the lives of our patients-nobody can take that away from you."

Erich Burnett
Editor-in-Chief