title: The influence of physician communication style on overweight patients' perceptions of length of encounter and physician being rushed.
abstract: OBJECTIVE
  Little is known about how patients and physicians perceive time and the extent to which they perceive the physician being rushed during encounters. One aim of this paper is to examine whether patient and physician characteristics and physician communication influence patient perception of the duration of the encounter and their perception of physicians being rushed. Another aim is to examine the relationship between patient and physician perceptions of physicians feeling rushed.
  
  
  METHODS
  We audiorecorded 461 encounters of overweight or obese patients with 40 primary care physicians and included 320 encounters in which weight was discussed. We calculated time spent with physician and coded all communication about weight using the Motivational Interview Treatment Integrity scale (MITI). Patients completed post-visit questionnaires in which they reported the estimated duration of the encounter and how rushed they thought the physician was during the encounter. Physicians reported how rushed they felt.
  
  
  RESULTS
  Patients estimated encounters to be longer than they actually were by an average of 2.6 minutes (SD=11.0). When physicians used reflective statements when discussing weight, patients estimated the encounter to be shorter than when physicians did not use reflective statements (1.17 versus 4.56 minutes more than actual duration). Whites perceived the encounter as shorter than African Americans (1.45 versus 4.28 minutes more than actual duration). Physicians felt rushed in 66% of visits; however, most patients did not perceive this. Internists were perceived to be more rushed than family physicians.
  
  
  CONCLUSIONS
  There is wide variation in patients' ability to estimate the length of time they spend with their physician. Some physician and patient characteristics were related to patient perceptions of the length of the encounter. Reflective statements might lead patients to perceive encounters as shorter. Physicians, especially family physicians, appear able to conceal that they are feeling rushed.
authors.affiliation: HØH, Research Centre, Akershus University Hospital, Løkog, Norway, and Institute of Clinical Medicine, University of Oslo. Pal.gulbrandsen@ahus.no
authors.forename: Pål
authors.initials: P
authors.lastname: Gulbrandsen
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.forename: Pauline
authors.initials: P
authors.lastname: Lyna
authors.forename: Rowena J
authors.initials: RJ
authors.lastname: Dolor
authors.forename: James A
authors.initials: JA
authors.lastname: Tulsky
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control / Q000628:therapy*; D009819:Office Visits / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D011320:Primary Health Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013637:Tape Recording; D015431:Weight Loss