Interruptions to the physician-patient encounter: an intervention program.
BACKGROUND
Israeli physicians are very familiar with the problem of interruptions during encounters with patients. However, a thorough search of the medical literature revealed only one report of this problem from Israel, and none from other countries.


OBJECTIVE
To characterize the phenomenon of interruptions to the patient-physician encounter in a clinic in Dimona and to assess the effect of an intervention program designed to reduce the magnitude of this problem.


METHODS
During an 8 day work period in March 1997 all patient-physician encounters were recorded and characterized. An intervention program was then designed and implemented to reduce the number of interruptions. Data were again collected a year after the initial data collection.


RESULTS
During the 8 day study period prior to the intervention program there were 528 interruptions to 379 encounters (mean of 1.39 per encounter). The main causes of interruptions were entrance of uninvited patients to the examination room (31%) and telephone calls (27%). Most of the interruptions occurred during the morning hours between 8 and 10 a.m. (45%) and at the beginning of the week (Sunday 30%). After the intervention program there were 402 interruptions to 355 encounters (mean of 1.13 per appointment, P = 0.21).


CONCLUSIONS
There was no statistically significant improvement in the number of interruptions following the intervention program. This finding is either the result of a local cultural phenomenon, or it indicates a national primary care health system problem that may require a long-term educational program to resolve it. Further research is needed on the magnitude, causes and consequences of interruptions in family practice and, if warranted, methods will have to devised to cope with this serious problem.
Peleg
R
R
Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel. ayapeleg@bgumail.bgu.ac.il
Froimovici
M
M
Peleg
A
A
Milrad
V
V
Ohana
G
G
Fitoussi
S
S
Dryfuss
E
E
Sharf
M
M
Shvartzman
P
P
D006801:Humans; D007557:Israel; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration; D011787:Quality of Health Care; D013689:Telephone