doctor-patient communication | Acta Medica Marisiensis

Introduction: The subject of this research is to investigate communication between general physicians and patients by focusing on the mechanism of turn-taking. The study is meant to identify some characteristics of successful doctor-patient communication and will also attempt to analyze a history taking event with regard to its turn-taking structure.
Material and method: The subject of this research is doctor patient dialogues. The transcribed versions of the recordings contain important information about the content and the process of the conversation as well as special signs for interruptions, breaks and intonation. A history taking encounter of a general physicians and a heart patient was analyzed. Doctor-patient communication was studied from the aspect of trustful relationship. The methods, number, and places of turn-taking were explored.
Results: Based on the results, the patient’s turns were allocated by self-selection 12 times and there were 10 instances of current – the doctor-selecting next speaker. Table II shows the number and different types of indicating turn allocation in the dialogue. According to the results, turn allocation was indicated by the patient’s questions and the doctor’s imperative sentences.
Conclusions: The present research is to be extended with further investigations concerning the mechanisms of problem-solving and turn-taking. For the purposes of widening the focus of the present research further doctor-patient encounters will be recorded, and analyzed using the method of conversation analysis.

Particularities of Doctor-Patient Communication, Assessed in 6 Romanian Ambulatory Practices

Gáspárik Andrea Ildikó¹, Ábrám Z², Albert-Lőrincz Enikő³, Török Kinga¹

1 University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Hygiene, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
3 Social Work Department, Babeș-Bolyai University, Cluj Napoca, Romania

Introduction: The way doctors collect data, explore patient concerns, discuss and explain the diagnosis will influence the patients’ comfort, satisfaction, attitude and adherence to medical treatment and even their health outcomes. Our aim is to assess structure and patterns of doctor-patient communication in Romanian ambulatory practices.
Materials and methods: We included in our analysis 69 doctor-patient meetings in 6 outpatient clinics (five different specialities, state and private practice), taking place in 3 Romanian cities. Data collection was carried out by non-participatory observation of the time-structure of visits (anamnesis, examination, explanation of diagnosis, treatment-, and lifestyle recommendation, administrative works), proportion of talks and reports belonging to the parts, number of questions asked by each part, and non-verbal behaviour, helping the patient feel comfortable during the visit.
Results: The average length of the meetings was 7.41 minutes. Discussions are less representative in Romanian medical practice. Patients were let to speak about their problems 7 seconds, without interruptions. Administrative duties (registering, writing) took 27% of the time, 42% was represented by examination (physical and instrumental). Explaining diagnosis and treatment accounted for 5% and 9% respectively. There were two doctors (of six) showing different gestures to help the patient feel comfortable during the consultation. Doctors talked 3 times more than patients and had in average 6 questions compared to less than one question, formulated by the patients. Lifestyle recommendations were observed in 2 cases (of the 69).
Conclusions: Although the international literature describes a shift in the doctor’s and patient’s attitude from the traditional paternalistic model towards a partnership, where patients assume a more active role in their healing process, our data suggest a doctor-patient relationship strongly dominated by doctors, a passive behaviour of patients, actually a free-will subordination to the doctor’s high-status (no or few questions, no willingness to participate in decision making).