Don't disregard patients' contextual concerns

Inattention to patients’ socioeconomic issues can lead to errors in treatment plans. A study conducted by Saul J. Wiener, MD suggests that doctors are taught to notice medical issues and tend to disregard contextual concerns of patients’ life circumstances.

Actors portrayed as patients made 399 unannounced visits to 111 internists at practices in Chicago and Milwaukee. The actors followed scripts that contained hints to clinically significant biomedical issues and contextual information such as environment and behavior that are essential to providing care. All interactions were recorded on audiotape. Researchers analyzed doctors’ notes and audio recordings to calculated how often physicians identified cues of possible complications and whether they adjusted their care plan. The results indicated that physicians noticed more biomedical red flags (63%) than contextual red flags (51%).

“Overlooking contextual aspects of patients’ life circumstances is just as important as overlooking biomedical situation and [both] can lead to inappropriate care,” said Dr. Weiner. He recommends that medical schools provide more training to identify social and economic issues.

According to Dr. Weiner, it is important to listen to the patient and pay attention to the information that is provided during an office visit and ask the right follow-up questions. For example, if a patient mentions, “It’s been tough since Iost my job,” physicians would often respond with “I am sorry to hear that.” Along with the empathy, physicians should ask “How has it been tough?”  Physicians should be aware of patients’ social and economic situations along with biomedical issues to provide proper health care for each individual patient.

For more information on this study, visit amednews.