A continuous flow of information during the interview and examination is important for effective dialogue to occur. Interruptions in this process can distract the physician and inhibit open communication on the part of the patient.


• Pagers going off


• Consider having a triage nurse hold your pager while you are in the office. Pages can be answered promptly without interrupting the patient-physician communication. Urgent requests can be brought to your attention after the appointment has concluded, or the visit can be interrupted for emergencies. A bonus is that any additional information you may need, such as a chart or a laboratory report, can be brought to you at the time of the page information.

• Have a strict policy regarding phone interruptions. Most messages can be screened by staff, and if necessary, a brief message can be forwarded to you.

• Consider having several set times for answering messages. The staff can inform the caller of a time to avoid unnecessary callbacks.

• Knocks on the door disrupt the flow of the conversation, and they may alarm a patient if they occur during the more intimate parts of an examination. Limit door knocks to an absolute minimum.

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