Communication between surgeons and patients in routine office visits

Background. Research conducted in primary care settings has demonstrated th at effective communication enhances patient recall of information, complian ce, satisfaction, psychologic well-being, and biomedical outcomes. However, surgeons face communication challenges that are unique to the surgical sit uation. This study provides the first description of routine communication Between community-practicing surgeons ann their patients. Methods. Audiotapes of 676 routine office visits with 29 general surgeons a nd 37 orthopedic surgeons were coded for structure and content. Descriptive analysis of quantitative data is supplemented by illustrative examples of dialog selected to represent typical patterns of communication. Results. The mean visit length was 13 minutes. Surgeons talked more than pa tients, with typical surgical cal consultations containing relatively high amounts of patient education and counseling. Consultations had a narrow bio medical focus with little discussion of the psychologic aspects of patient problems. The affective tone of visits was generally positive, with few ins tances of overt criticism or disagreement by either party. However, surgeon s infrequently expressed empathy toward patients, and social conversation w as brief. Conclusions. The study underscores the differences in Both the content and process of routine surgical visits compared with primary care visits. On th e basis of this work, it seems particularly important for surgeons to devel op skills that enhance patient education and counseling. Further research i s needed to understand the influences of surgeons' communication on patient behavioral, psychologic, and biomedical outcomes.