The skeptical cardiologist was trained to listen carefully to patients who are relating their “history” as we term it and to minimize interruptions. However, there are only a limited number of minutes in the day and some patients are capable of monologues that rival a Shakespeare soliloquy.
If a physician doesn’t learn methods for getting the patient back on point he will spend his days stressed and running behind schedule.
A recent JAMA editorial describes the three E’s that physicians should employ when interrupting a patient.
The first “E” element is to excuse yourself. The second is to empathize with the topic being interrupted and the third is to explain the reason for the interruption.
For the patient who is repetitive, disorganized or circumcloquacious:
(circumloquacious (adjective): Using excessive language to evade a question, obscure truth or change the subject [comb. of ‘circumlocution’ and ‘loquacious’]
Always circumloquacious, she evaded defining the word and instead started a discourse on etymology and metalinguistics.
the writer suggests this typical “topic tracking” interruption:
Forgive me. You are sharing a lot and I can see you are really bothered about… your headache, fatigue, allergy, stomach pain… and this is frustrating and scary for you. I would like to switch gears and ask several specific questions, then do an exam to make sure we develop a plan that works best for you.
Excessively circumloquacious patients can be their own worse enemies as the office visit is spent on issues peripheral to their major problems.
Hopefully your doctor has learned some variation on the three E’s to deal with circumloquacity (I just invented that word!), otherwise he/she will continually be late and stressed.