Dynamic Chiropractic – March 22, 1999, Vol. 17, Issue 07

The Difference

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher
Finally, it's your big chance. You've got the ball and the "24-second clock" is ticking away. So much is riding on these 24 seconds. In many ways, the quality of your future will be determined.
Can you do it?

No, I'm not talking about the final seconds of the NBA championships. What I'm referring to is a typical visit with a medical provider. According to a recent study,1 patients have less than 24 seconds to communicate their health concerns before the medical doctor interrupts them to narrow down the problem!

It gets worse:

  • Almost 25% of the time, the MDs never asked their patients what their concerns were!

  • Patients were allowed to communicate all of their concerns only 28% of the time.

  • If the MDs had allowed their patients to speak just six seconds longer (on average), the patients would have completed their list of concerns.

Don't blame managed care. A study conducted in 1984 found that MDs were interrupting the patients after only 18 seconds!2

Why do MDs only let their patients speak for 24 seconds before they interrupt? Are they just rude by nature? Is it to save time and get to the next patient? Do the MDs just figure the patients don't have the sense to describe their chief complaints?

I don't think so. When MDs look at patients and hear their complaints, they have a tendency to focus just on the complaints.

Once MDs focus in on specific complaints, the likelihood that they'll then listen to a complete list of patient concerns was only eight percent.

So when Ms. Jones, who has been the doctor's patient for 18 years, comes in and tells her MD that she has a leg pain, she becomes Ms. Legpain. Forget about what's attached to the leg, let's examine the leg. Might there be other relevant complaints? No time for extraneous matters. The transformation is complete. Ms. Jones is Ms. Legpain, at least until she returns with arm pain and becomes Ms. Armpain.

This is the difference philosophy makes. It changes how you look at a patient. As a chiropractor, you don't just see a leg, an arm, a stomach or a spine. You see a person. You aren't trying to treat the disease. Your goal is to restore health and vitality.

You know that a low-back problem could be caused by a host of lower extremity conditions, and relief for a pain in the arm could come with a spinal adjustment.

You also know that you can learn a great deal and gain insight by listening carefully and completely to your patients. That is why in every study I've ever seen, doctors of chiropractic have consistently received the highest scores in patient communication.

The good news is that the medical profession is learning. In the last 15 years, they have added an average of almost six seconds in listening to their patients. At this rate, 15 years from now, medical patients can look forward to a half minute of uninterrupted explanation.


  1. Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient's agenda. JAMA 1999;281:283-287.
  2. Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med 1984;101:692-696.

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