'Some' difference in bedside manner reduces patients' unmet needs

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Meg Sullivan
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UCLA RESEARCH ALERT

FINDINGS:
A new study suggests that a single word can go a long way toward ensuring that patients discuss their medical concerns during a doctor visit. UCLA sociologist and conversation analyst John Heritage led a team that followed 224 patients as they sought medical treatment from doctors for a host of ailments they described in advance. After addressing each patient's initial complaint, half the study's doctors asked whether "anything" else was troubling the patient; the other half asked whether there was "something" else. According to the study, framing the question using "something" reduced the incidence of unmet medical concerns by 75 percent. Past research has shown that at least 40 percent of U.S. patients bring more than one concern to a doctor's visit -- and possibly as many as three or more -- suggesting that patients often have more than one reason to seek medical care.

IMPACT: With visit times constrained to an average of 11 minutes, physicians face difficulties in addressing the full array of patient concerns. This study for the first time quantifies the value of a slight adjustment in bedside manner. Researchers theorize that the impact stems from linguistic differences between the words "any" and "some." "Any" tends to be used in negative contexts, predisposing patients to respond negatively to questions that use the word. The word "some" does not carry the same connotation.

AUTHORS:
John Heritage, a UCLA professor of sociology; Jeffrey D. Robinson, associate professor of communications at Rutgers University; Marc N. Elliot and Megan Beckett of the Rand Corp.; and Michael Wilkes, professor of medicine and vice dean for medical education at the University of California, Davis.

JOURNAL:
The research appears in the October 2007 issue of the peer-reviewed Journal of General Internal Medicine. The paper can be viewed at www.sscnet.ucla.edu/soc/faculty/heritage/publications/Unmet_Concerns.pdf.

Media Contact:
Meg Sullivan
310-825-1046
[email protected]