title: Do patients wish to 'listen in' when doctors dictate letters to colleagues?
abstract: OBJECTIVE
  To evaluate the effects on clinical outcome of dictating correspondence in front of patients and sending them copies of letters.
  
  
  METHODS
  Observational study of the practices of two consultants, one of whom (RDS) routinely dictated letters in front of his patients and almost always sent them a copy while the other (AM) did neither. Questionnaires were completed anonymously by patients at the end of their consultation.
  
  
  METHODS
  Neurology department of a teaching hospital.
  
  
  METHODS
  Patients attending neurology outpatient clinics.
  
  
  RESULTS
  Seventy-two percent and 62% of the two consultants' patients were audited, and the demographic features of the two groups were similar. Eighty-six percent and 25% of RDS's and AM's patients, respectively, said that they wished to be present during dictation (p < 0.001). Within AM's group, those who had had some experience of the practice (with other consultants) were more likely to express a desire to be present during dictation (p = 0.023). Ninety-two percent and 77% of RDS's and AM's patients, respectively, felt that having a copy of their letter would be 'very useful' or 'useful' (p < 0.001). The perceived usefulness of receiving a copy letter and the desire to be present during dictation were associated for the total group and for RDS's patients. The two groups of patients were asked to express their degree of understanding at the end of the consultation, and 81% and 93% of RDS's and AM's patients, respectively, thought that their understanding was 'excellent' or 'good'. No trends emerged with regard to patients' preferences (to be present or absent during dictation and to receive or not receive a copy of their letter) and their level of understanding.
  
  
  CONCLUSIONS
  Patients appear to like being present when their letters are dictated, and appreciate receiving copies of these, but their overall understanding is seemingly independent of these variables. The success of the clinical consultation is probably influenced by numerous factors, and the elevation of patients' presence during dictation of correspondence and receipt of copy letters above all others seems unjustified.
authors.affiliation: Department of Neurology, Essex Centre for Neurological Sciences, Queen's Hospital , Romford , UK.
authors.forename: Rajith
authors.initials: R
authors.lastname: de Silva
authors.forename: Anjum
authors.initials: A
authors.lastname: Misbahuddin
authors.forename: Salwa
authors.initials: S
authors.lastname: Mikhail
authors.forename: Kate
authors.initials: K
authors.lastname: Grayson