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What patients actually say to their physicians is largely unknown

David B. Nash, MD, MBA
Patient
October 22, 2011
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Every once in a while, I come across a new concept or technology application that really captures my imagination.

This was the case when I became aware of an enterprise whose core business is patient-physician communication.

What patients actually say to their physicians — and what physicians actually say to their patients — is largely unknown.

A company called Verilogue ventured into this previously uncharted territory and began to audio record patient-physician interactions.

To date, they have captured more than 60,000 unique patient-physician conversations across more than 70 therapeutic categories!

These recordings of real-time conversations between patients and physicians are made at the point of care with scrupulous attention to maintaining complete patient and physician confidentiality.

Advanced linguistic and statistical analyses of the recorded conversations yield insights that enable “end users” to gain a deeper understanding of patient and physician perspectives.

One obvious “end user” would be the health products and services info-marketing sector. In fact, more than 40 pharmaceutical companies have partnered with the company to better understand doctor-patient communication as part of their sales training.

But, from a health policy perspective, I couldn’t help thinking of the other potential “end users” who might benefit from this type of information.

It is well established in the literature that physician-patient communication is extremely complicated, very susceptible to break down, and fraught with problems.

There are lots of reasons why this is the case:

  • Stressed by the symptoms or the condition that led to their visits, patients may have difficulty concentrating and remembering the details of conversations with their doctors.
  • The information that doctors must share is often complicated and difficult for many patients to comprehend.
  • Perhaps most important, physicians and patients often approach an interaction from vastly different perspectives, making it difficult to find common ground.

Studies have found that when patients understand the information being communicated by their healthcare providers, there are substantial increases in patient satisfaction, compliance, and positive outcomes.

Not surprisingly, studies have also found decreases in patient anxiety, treatment time, and cost.

So, how might the information gained from analyzing patient-physician conversations be leveraged to help optimize communications?

One is to help patients learn to become more active and engaged in their health care.

For example, Verilogue recently launched a program that focuses on improving the dialogue between patients, their caregivers, and their physicians.

The program consists of a suite of online and mobile dialogue coaching tools aimed at improving patient confidence, shared decision-making, and care coordination.

After listening to and learning from actual examination room conversations between physicians and people with concerns and experiences like their own, patients are likely to be better prepared for visits with their healthcare providers.

I can also envision a potential role for this type of information in medical education.

By studying communications, we become more effective communicators.

The insights drawn from analyses of physician-patient conversations might help medical educators determine the elements that constitute “good” clinical communication.

Conversations with a set of “standardized patients” with certain diagnoses might help medical students and seasoned practitioners become more effective communicators.

David B. Nash is Founding Dean of the Jefferson School of Population Health at Thomas Jefferson University and blogs at Nash on Health Policy.

Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.

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