Guest Blogger:
Meredith Masel, PhD, MSW
Oliver Center for Patient Safety Quality Healthcare

I remember, fondly, the game of “telephone.” We used to play it in school when our teachers were willing to let the class deteriorate into a pile of giggling elementary students. Somehow, no matter how hard we tried, “The quick brown fox jumps over the lazy dog,” would become “The foxy dad slept in the brown box.” Noteworthy is the concept that even bright, young, school-aged people forget details. Have you considered lately the details you may forget? What did you want during this grocery trip besides batteries? What have you been meaning to ask your sister? What was that other pill your doctor said might help if this one doesn’t work?

You may be surprised to read that studies show the average person may not remember more than 11-75% of the details of their conversation at a doctor’s appointment (Flocke & Stange). There are some implications to the problem of missing a few particulars. Patient satisfaction and sticking to your healthcare advice is highly dependent on remembering the details of that advice. So, how can you be sure that you are sending the message and the medicine home with your patients? Many groups use printed after visit summaries. These can be helpful if you have access to these tools. But there’s another way. Consider recording all or part of your encounter with your patients. Either in their own words repeated back to you (use the teach-back method we all learned in school), or while you are talking to your patient, recording can help them remember what they need to be successful with your treatment plan. They can then listen to the information from a medical appointment at any time, share with family/loved ones, take time to think about their choices, and have easy access during times out-of-town or during evacuation emergencies.  If you are confident in the care you are giving them, confident enough to take your own notes and make your own records, you can be confident enough to put yourself on tape (Kvedar).  If this makes you uncomfortable, have the patient do it in their own words.  If you notice they are getting something wrong, you’ll have made a breakthrough in your treatment.

How do you do it? Ask your patient if they are interested, tell them to bring a recorder or a cell phone to their appointment, or teach them about the web tool  During your appointment ask, “What are you going to tell your husband/wife about our conversation today?” Have them start a recording and talk in front of you. Or, you can ask your patient if he or she minds recording all or part of your appointment so they can listen to it later by themself or with another person. This may be especially helpful if one family member is in charge of an older parent’s care and siblings live in other states or counties. It can be a win-win situation if you can, for instance, tell someone that his sister has a recording about mom that can answer all of his questions.

“I wish I had a tape recorder on during that conversation.” How many times in your life have you said that? Try it with your patients.

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  1. Flocke, SA., & Stange, KC. Direct Observation and Patient Recall of Health Behavior Advice, Preventive Medicine, 2004, 38, 343-349.
  2. Kvedar, JC. Should Physicians Use Email to Communicate With Patients? Wall Street Journal, 1-23-2012.

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