McLafferty Robert B, Williams Reed G, Lambert Andrew D, Dunnington Gary L
Department of Surgery, Southern Illinois University, School of Medicine, Springfield, Ill, USA.
Surgery. 2006 Oct;140(4):616-22; discussion 622-4. doi: 10.1016/j.surg.2006.06.021. Epub 2006 Aug 30.
This study analyzes specific elements of physician communication that lead patients to not recommend surgeons to family members or friends (FMoFs).
Patients completed questionnaires after surgery clinic encounters. Questionnaires addressed whether surgeons used optimal communication behaviors and whether patients would recommend the surgeon.
A total of 1,514 questionnaires were completed for 39 surgeons. Patients reported the following communication lapses: failure to ask whether the patient had questions (6.9% of occasions), failure to sit down (6.5%), use of words patients could not understand (5%), failure to educate patients about their condition (4.3%), failure to introduce themselves (4%), lack of interest in patients as persons (2.4%), and inadequacies in answering questions (2%). Surgeons omitted at least one of these optimal behaviors in 16.3% of encounters. Surgeons were not recommended in 1.7% of encounters. Twelve surgeons (31%) were not recommended on at least 1 occasion. Behaviors omitted most commonly in encounters where patients wouldn't recommend surgeons included failure to show interest in the patient (52%), explain their medical condition (52%), invite questions (40%), and answer questions (36%).
Extrapolating these results to 1,618 patient visits/surgeon/year, results in the following number of patients annually who do not recommend their surgeons: 15 for failure to adequately explain their medical condition, 15 for failure to show interest in them, 11 for failure to ask if the patient had questions, and 10 for failure to answer questions. Considering the ripple effect due to the number of a patient's FMoFs, surgeons should be aware of the significant impact of even occasional lapses in optimal communication behaviors.
本研究分析了导致患者不向家人或朋友推荐外科医生的医生沟通的具体因素。
患者在外科门诊就诊后完成问卷调查。问卷涉及外科医生是否采用了最佳沟通行为以及患者是否会推荐该外科医生。
共为39位外科医生完成了1514份问卷。患者报告了以下沟通失误：未询问患者是否有问题（6.9%的情况）、未坐下（6.5%）、使用患者听不懂的词汇（5%）、未向患者说明病情（4.3%）、未自我介绍（4%）、对患者缺乏个人关注（2.4%）以及回答问题不充分（2%）。外科医生在16.3%的就诊中至少遗漏了其中一种最佳行为。在1.7%的就诊中，患者没有推荐外科医生。12位外科医生（31%）至少有1次未被推荐。在患者不推荐外科医生的就诊中，最常被遗漏的行为包括对患者缺乏关注（52%）、解释病情（52%）、询问问题（40%）和回答问题（36%）。
将这些结果推算至每年每位外科医生的1618次患者就诊，得出每年因以下原因不推荐外科医生的患者数量：因未充分解释病情为15例，因缺乏关注为15例，因未询问患者是否有问题为11例，因未回答问题为10例。考虑到患者家人或朋友数量带来的连锁反应，外科医生应意识到即使偶尔出现最佳沟通行为失误也会产生重大影响。
