One of the hardest things for most people to do is listen—I mean really listen—when another person is speaking. When psychologists train people on this important skill, they often describe it as “active listening.” I like that phrase because it emphasizes that listening is not a passive task but takes attention and work.
For physicians the challenge is no different, but the stakes are much higher. From medical school forward, doctors are trained on how to conduct a “history” when seeing patients.
When patients go to see a doctor, they know their symptoms and what they are feeling, but do not typically know the cause of their problems. When taking a patient history, doctors must obtain important information from patients, including why they came to see the doctor (chief complaint), past medical problems and treatments, and what medications they are taking.
Unless the patient has an ongoing relationship with the physician taking the history, the only sources of this critical information for the patient history would be conversations with the patient and family members.
Have you ever heard the saying, “Junk in, junk out?” In my experience as a Houston, Texas medical malpractice attorney, that is exactly what happens for some doctors who rush through a patient’s history.
New research published in the Journal of Internal Medicine shows that my experience is accurate. The study found that the average doctor only gives patients 11 seconds to speak and describe their reason for visiting before interrupting. In the physician-patient encounters studied, 67% of patients were interrupted, and only 36% of doctors asked questions to try to focus patients on the reason for their visit.
Poor listening skills are even worse for specialists, like neurologists, cardiologists, and surgeons. While 49% of primary care physicians allowed the patient to explain the purpose of their visit, only 20% of specialists took the time to listen.
When doctors do not actively listen to their patients, they miss important information that guides their physical examination, diagnostic testing, diagnosis, and treatment decisions.
When doctors do not actively listen to their patients, they jump to false conclusions and diagnoses that are not based on all the available facts and information.
When doctors do not actively listen to their patients, they needlessly endanger their patients.
These disturbing findings remind me of two different lawsuits I handled for patients who were misdiagnosed in hospital emergency rooms. Both patients were experiencing strokes. Both were discharged from the hospitals without proper treatment, only to return later to be treated for massive strokes. One patient was diagnosed with migraine headaches and the other with a psychogenic reaction (meaning “it’s in your mind”).
In both cases, the emergency room physicians and neurologists did not listen to the patients and their spouses. According to my clients, they kept complaining of stroke symptoms over and over, but the doctors’ attention was already diverted elsewhere, and it was too late to influence them.
What you can do
Take a moment and think about this. For any doctor’s appointment other than a general checkup, do you think you could explain the reason for your visit in 11 seconds or less? What if you felt something was seriously wrong?
Before going to see a physician, I recommend that you make a game plan in your mind about what you want to say. Do not waste time on small talk. Get to the point. While your doctor may ask some helpful questions to help focus the conversation and information that you are providing, do not allow yourself to get cut-off before you have shared what is important.
Once the doctor makes a diagnosis or shares the treatment that he or she has in mind, be armed and ready with questions. “What about this?” “What about that?” “I didn’t get to tell you about this, does that make a difference?”
If you are in an emergency room or hospitalized, I recommend going through this process with every physician who sees you.
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Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
