title: A critical appraisal of the out-patient fracture clinic: is communication really the key?
abstract: The most common factor in an adversarial doctor-patient relationship is failed communication. We audited our communication skills, patient satisfaction and assessed patients' capacity for retaining information. 120 consecutive first time patients with one of 5 fracture types were assessed. Patients scored (a) the doctor's communication skills and (b) their overall fracture clinic experience. Patient satisfaction was high, mean 8.2 (range 2-10, SD 1.76) points. There was a statistically significant difference in a patient's knowledge pre and post consultation. Forty-three patients (36%) could recall a specific consequence of the fracture (p<0.005). Forty (31%) and twenty six (22%) patients could recall the name of the Registrar and Consultant respectively. Doctors scored 9.2 (range 7-10, SD 1.23) points for communication skills. Patients are concerned with a fracture's impact on daily activities, often failing to register who treats them and any serious consequences. With doctors being scored so highly, the dilemma remains of how better to deliver the message.
authors.affiliation: Our Lady's Hospital, Navan, Co. Meath, Ireland.
authors.forename: G C
authors.initials: GC
authors.lastname: O'Toole
authors.forename: P
authors.initials: P
authors.lastname: O'Grady
authors.forename: P
authors.initials: P
authors.lastname: Beddy
authors.forename: J P
authors.initials: JP
authors.lastname: McElwain
mesh_terms: D000553:Ambulatory Care / Q000592:standards* / Q000639:trends; D003142:Communication; D005260:Female; D005592:Fracture Fixation / Q000592:standards* / Q000639:trends; D050723:Fractures, Bone / Q000175:diagnosis / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D007494:Ireland; D008297:Male; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011446:Prospective Studies