Physicians’ and Patients’ Interruptions in Clinical Practice: A Quantitative Analysis

This study aimed to analyze interruptions from both a physician and patient standpoint to determine circumstances under which they occurred. Interestingly, the authors expand their study to include connotations of interactions to classify them as positive or negative. The study analyzed interactions that occurred during the problem presentation, diagnosis and treatment phases of consultations. Overall, the study recorded 2,405 interruptions among 17 physicians, with 82.9% defined as cooperative. The study also identified that male physicians and female patients were more likely to make interruptions.

Our team had many thoughts on the strengths of this study and how it could be expanded upon in the future. The study successfully fulfilled its objective of identifying predictors of interruptions. The authors also expanded on this objective to include how study phases and positive and negative interruptions factored in as well. However, we felt that there were other areas that could be investigated as well. We noticed that the study identified how long physicians had been practicing and whether patients had seen the physicians before but did not provide further data on what effect these variables had. Does continuity of care lead to less interruptions, or potentially more positive interruptions? We were also curious about the statistical analysis performed. The authors clearly did significant work to analyze larger correlations but did not provide much data on individual physicians. Were there potential outliers, such as physicians who had extremely high or low numbers of interruptions? If so, were these physicians factored into the results? The study strictly controlled interruptions it interpreted, only focusing on patients and physicians during the phases. Could interruptions by family members of patients have equal bearing? Likewise, could interruptions before or after the consultation and diagnosis also have an impact on patient experience? In general, there are many additional factors around interruptions that could be studied.

One of our other questions for the research team is how they think their study can be generalized. Data collected were from 7 years ago in the Netherlands. Since then, the COVID-19 pandemic has caused significant changes in how patients view their healthcare providers and clinical settings in general. What changes in the physician-patient dynamic may have occurred due to the pandemic? Also pertaining to the pandemic, more providers have engaged in telehealth delivery of medicine. Are the same trends likely to carry over to online formats of healthcare as well? Might interruptions be perceived as more negative without social contexts? On another note, how do population demographics of the Netherlands compare to other countries? In 2021, 92.57% of the population of the Netherlands lived in urban areas. How then might study results be different in more rural countries? In future studies, it might be a consideration to study physicians across multiple platforms and countries.

Based on study conclusions, how can healthcare be improved? The authors ultimately labeled most interactions as positive. Should interruptions then be encouraged? Would educating patients on the phases described in the study and when they should feel comfortable interrupting be an effective tool for communication? Many factors, such as gender, may have societal determinants behind them. If that is the case, can training to reduce negative interruptions be effective, or is it simply a reality that not all interruptions can be alleviated? Finally, how did interruptions truly affect patients? When interrupted more often, did patients feel they were mistreated or just given more attention? What were patient outcomes when correlated with interruptions? In conclusion, this study has opened the door into studying patient-physician interactions, creating as many new questions to explore as it has answered.