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Primary Care

Length of patient's monologue, rate of completion, and relation to other components of the clinical encounter: observational intervention study in primary care

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7438.501 (Published 26 February 2004) Cite this as: BMJ 2004;328:501

This article has a correction. Please see:

  1. Israel Rabinowitz, family physician1,
  2. Rachel Luzzati, family physician1,
  3. Ada Tamir, statistician2,
  4. Shmuel Reis, family physician (reis@tx.technion.ac.il)1
  1. 1Clalit Health Services and Department of Family Medicine, B Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
  2. 2Department of Community Health and Epidemiology, B Rappaport Faculty of Medicine
  1. Correspondence to: S Reis, Departments of Medical Education and Family Medicine, B Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, POB 9649, Bat-Galim, 31096 Haifa, Israel
  • Accepted 13 October 2003

Introduction

The patient's opening statement in a consultation (the patient's monologue) is an important part of history taking, and doctors are encouraged not to interrupt the patient—but they often do,1 2 probably because they think that the patient's monologue is time consuming. When uninterrupted, patients conclude their monologue in less than 30 seconds in primary care and about 90 seconds in consultant settings.15

We assessed encounters in primary care that included a new clinical problem, recording the length and rate of completion of patients' monologues before and after instructing doctors not to interrupt.

Methods and results

We recorded consecutive encounters between eight family physicians and their patients on two days in six family clinics in northern Israel. All doctors were videotaped on both days. They had been told that the study focused on the doctor-patient interaction. Patients were …

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