Interactions Between Oncologists and Patients During Rounds

Abstract

Physician behavior during inpatient rounds was observed and quantified for 394 interactions between patients with cancer and physicians. Most patients had solid tumors (90%) and a limited prognosis despite treatment (61%). The physicians spent 1.45 .+-. 0.58 h on morning rounds seeing an average of 9.3 .+-. 3.39 patients. For each patient an average of 3.61 .+-. 2.83 min was spent in the room. The rest of the time was involved in reviewing the results of diagnostic tests, discussing treatment plans, and updating patients'' charts. Time spent in the room was significantly related to the patient''s sex and diagnosis. Physicians spent more time with patients having the poorest prognosis (P = 0.009). Specific behaviors were analyzed using a Physician Behavior Check List that allows accurate recording of behavior during a brief patient-physician encounter. Factor analysis of responses to the check list resulted in 4 factors that explained 58.7% of the variance. The physician behavior factor scores failed to correlate with factor scores from the responses of the same physicians to the Cancer Attitude Survey. The physicians were unable to accurately estimate the time they actually spent with patients or the frequency of specific behaviors that occurred during these interactions.