Interruption in the medical interaction
T. Realini, A. Kalet and J. Sparling
Department of Ophthalmology, University of North Carolina at Chapel Hill, USA.
OBJECTIVES: To describe patterns of interruption in the physician-patient
interaction; specifically, to determine who interrupts, to determine if a
shift in control occurs as a result of interruption, and to characterize
the information gained when patients interrupt physicians. DESIGN:
Observational. SETTING: Community-based primary care practices in North
Carolina. SUBJECTS: Internists and family physicians in private practice in
North Carolina (six men and two women) and their patients (13 men and 27
women). INTERVENTIONS: None. MAIN OUTCOME MEASURE: The obtainment of
control of the interaction, at least momentarily, as a result of
interruption. RESULTS: Analysis of 40 audiotaped interactions revealed 833
interruptions (mean +/- SD, 20.8 +/- 12.2 per interaction): Patients
initiated 55% of all interruptions. Physicians and patients each gained
control of the conversation after 50% of interruptions. Patients gained
control after 74% of patient-initiated interruptions, and physicians gained
control after 79% of physician-initiated interruptions. Patients were more
likely to gain control by interrupting late in the interaction, and 75% of
patient-initiated interruptions resulted in new information (solicited and
unsolicited) being contributed to the interaction. CONCLUSION: Interruption
by patients can be an informative event.
