The Downfall of Patient–Physician Communication in the ER

Article

Some of the biggest patient–physician communication breakdowns occur when a patient visits an ER.

Physicians must have excellent communication skills in order to provide safe and effective care to their patients. Some of the biggest patient—physician communication breakdowns occur when a patient visits an ER, which can be chaotic and limit a physician’s ability to provide proper instruction as they move from one patient to the next.

To evaluate this problem, researchers from various health institutions in Michigan and Illinois conducted an interview-based study examining patients’ understanding of their diagnosis, emergency department (ED) care, post-ED care, and return instructions. Of the 140 adult patients and caregivers interviewed, “almost [80%] of patients didn’t understand one of these four ‘areas.’ Half didn’t understand two or more.” These discouraging results suggest that patients visiting an ER leave with “an incomplete understanding of what exactly has just happened to them,” whereby “many take medication incorrectly or make other mistakes that land them back in the very same emergency room.”

There are certainly ways to fix the problem; among them is the use, by physicians, of the “teach back” method, in which patients repeat their instructions or become more involved in their care by asking questions if they do not understand what is being explained. Some experts have even “recommended reducing funding to emergency rooms with high re-admission rates, as a means of motivating physicians to address the problem.”

Do you spend the necessary time with an ER patient to make sure they understand what’s been discussed? Besides the recommendations mentioned in here, what are your suggestions for verifying patients’ understanding?

Related Resources

Physician-patient Communication

Effective Physician-patient Communication and Health Outcomes: A Review

Emergency Excellence Raises the Bar for Emergency Care

Physician-patient Communication about Prescription Medication Nonadherence: A 50-state Study of America’s Seniors

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