Doctor who?

Doctors thought they explained carefully. Patients thought so, too. Then came the pop quiz—and a big red F. Why are you in the hospital? (More than 40 percent of patients surveyed didn't know.) Did your doctors tell you about possible drug side effects? (Never, said 90 percent.) Who is your main physician? (More than 80 percent couldn't say.)

In the same survey, more than three-fourths of the physicians thought patients understood their diagnoses. Most said they explain drug side effects sometimes, if not always. Two-thirds believed their patients knew them by name. And patients gave the doctors high marks for communication.

Previous studies found similarly low levels of patient knowledge. The Yale paper, published in the Archives of Internal Medicine, adds a new twist by comparing physicians' and patients' perceptions.

"We are pretty thorough in our own discussions with patients," says Douglas Olson, a chief resident at Waterbury Hospital—one of the Yale School of Medicine's teaching sites—and author of the paper with School of Medicine assistant professor Donna Windish. "So we have to come up with a better way of doing it."

"Small interventions can be effective," comments Amgad Makaryus, a cardiologist at North Shore University Hospital on Long Island, New York, who has tested ways to improve physician-patient communication. He learned one effective method from his mentor, an "old-time attending physician"—who gave his business card to all new patients, telling them he'd quiz them on his name.

"You could be a Nobel laureate," says Makaryus, "but if your patient doesn't follow what's going on, they're not going to do well." All three researchers suggest additional studies to prove the link between knowledge and health. 


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