Perceptions: When Patients Have Their Say

By JOHN O'NEIL

re patients blabbermouths? Many doctors apparently think so.

Research has shown that doctors interrupt, on average, about 20 seconds after a patient begins to talk.

But a new Swedish study suggests that doctors actually have little to fear from letting patients have their full say.

In the study, which was published on Friday in BMJ, the journal of the British Medical Association, 14 doctors in the outpatient clinic of University Hospital in Basel agreed to time their patients surreptitiously while allowing them to talk without interruption at the beginning of a visit.

They shut their timers off whenever the patients indicated that their stories were complete with concluding lines like "That's all, doctor" or "What do you think?"

The doctors had expected that the average statement would go on for three and a half minutes.

In fact, the article said, the average patient finished in 92 seconds, and 78 percent were done within 2 minutes. Only 7 of the 335 patients hit the 5-minute mark, at which point the doctors were allowed to cut in. "In all cases," the article said, "doctors felt that the patients were giving important information and should not be interrupted."

The study's lead author, Dr. Wolf Langewitz, sent this advice in an e-mail message:

"To patients, I'd suggest: Be prepared! Don't start with your complaints right away. Start with the agenda. E.g.: `Dear Dr. Murphy, On my list for today are the following items.' Wait until the doctor pays attention! `First, what about the new pills you mentioned last time. Second: My daughter's in trouble, perhaps you could help us?'

"Physicians should get the message," Dr. Langewitz continued. "Listen — it won't take long."