RT Journal Article
SR Electronic
T1 Physicians’ and Patients’ Interruptions in Clinical Practice: A Quantitative Analysis
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 423
OP 429
DO 10.1370/afm.2846
VO 20
IS 5
A1 Plug, Ilona
A1 van Dulmen, Sandra
A1 Stommel, Wyke
A1 olde Hartman, Tim C.
A1 Das, Enny
YR 2022
UL http://www.annfammed.org/content/20/5/423.abstract
AB PURPOSE Physicians’ interruptions have long been considered intrusive, masculine actions that inhibit patient participation, but a systematic analysis of interruptions in clinical interaction is lacking. This study aimed to examine when and how primary care physicians and patients interrupt each other during consultations.METHODS We coded and quantitatively analyzed interruption type (cooperative vs intrusive) in 84 natural interactions between 17 primary care physicians and 84 patients with common somatic symptoms. Data were analyzed using a mixed-effects logistic regression model, with role, gender, and consultation phase as predictors.RESULTS Of the 2,405 interruptions observed, 82.9% were cooperative. Among physicians, men were more likely to make an intrusive interruption than women (β = 0.43; SE, 0.21; odds ratio [OR] = 1.54; 95% CI, 1.03-2.31), whereas among patients, men were less likely to make an intrusive interruption than women (β = −0.35; SE, 0.17; OR = 0.70; 95% CI, 0.50-0.98). Patients’ interruptions were more likely to be intrusive than physicians’ interruptions in the phase of problem presentation (β = 0.71; SE, 0.23; OR = 2.03; 95% CI, 1.30-3.20), but not in the phase of diagnosis and/or treatment plan discussion (β = −0.17; SE, 0.15; OR = 0.85; 95% CI, 0.63-1.15).CONCLUSIONS Most interruptions in clinical interaction are cooperative and may enhance the interaction. The nature of physicians’ and patients’ interruptions is the result of an interplay between role, gender, and consultation phase.