Getting interrupted while in the doctor’s office can be annoying, both for the patient and physician.
In an essay in The New York Times, pediatrician Rahul Parikh notes that, in an average primary care office visit, doctors were interrupted twice. And in the ER, “emergency room doctors experienced an average of 10 interruptions an hour, compared with 4 an hour for primary care doctors.”
Having a computer in the room, and entering data in the electronic medical record, was the most frequent cause. And indeed, that’s only going to get worse as more practices go digital.
Not only does patient satisfaction suffer from interruptions, Dr. Parikh extrapolates data from airline pilots, writing, “dire consequences may occur when the train of thought is broken during crucial tasks.”
As primary care doctors have more bureaucratic responsibilities thrust upon them, alongside transitioning to computer-based systems, it’s important to find ways to minimize the number of disruptions during the patient encounter. Yes, some urgent interruptions can’t wait, but the majority can be addressed in between office visits.
Patients will not only be thankful, but better care will be provided.
Related posts:
- JCAHO and why doctors are spending less time with patients
- Primary care doctors face burnout, and how that affects health reform
- Some reasons why patients have so many doctors
- What do patients want from their doctors?
- How the primary care shortage affects rural Idaho
- Are patients who enter hospice care really abandoned by their primary care doctors?
- Can patients and doctors handle the truth?
{ 4 comments }
This is not purely a medical phenomenon. Interruptions are now part of the fabric of daily life. Public Enemy #1 is the cell phone, which is an omnipresent and potent mood shatterer. It intrudes on family dinners, romantic restaurant dinners, car rides with the kids, lectures and in the work place. In our exam rooms, it’s often the patients’ phones that are ringing. It’s tougher than ever to find a quiet sanctuary, but I try.
The pager is the absolute worst interrupter of all…and this is especially obvious for medical trainees. When I was an intern, I remember 2 things clearly:
1. The residents and attendings seemed to have godlike memories and intellects.
2. My co-interns breaking down when paged to death (one liked to shout “can I please finish just one F***ing thought?”).
…and then I became a resident and all of a sudden, the page volume decreased. It became even better as an attending. Suddenly I realized why residents and attendings seemed so smart: it was the lack of pages. Sure, experience plays a big role, but just being able to complete a thought or a task before the next interruption adds dozens of effective IQ points.
Kurt Vonnegut once wrote a story about a society that made everybody equal: pretty people had to wear ugly masks, strong people had to carry around heavy weights, etc…
Guess what this society gave smart people to make them dumber. They had devices installed in their ears that would ring every so often (the smarter, the more often the interruption). Nice parable for the pager!
Re: annoying cell phones, in spite of sign-off requests
You would think someone would come out with a cell-phone-signal scrambler for use in medical offices, classrooms, and the like. Maybe someone has…
As I entered middle age, I found that controlling the flow of flow of information was key to doing quality work. Whether it was wisdom of experience or the the beginning of cognitive decline remains to be seen. Strictly controlling interruptions in and out of the workplace is critical for me to maintain the quality of my work and of my life. That naturally means not being instantly available to everyone all the time. Finishing this patient, this file, this conversation, this meal, this nap, before entertaining the next demand on my time is essential to maintaining focus and equanimity.
Comments on this entry are closed.