AT PALLONC 2017

Patients with cancer perceived physicians who did not use a computer as more compassionate, more professional, and better at communication, according to results of a randomized, video-based study presented at the Palliative and Supportive Care in Oncology Symposium.

In addition, the majority of patients said they would prefer having a doctor who communicated face to face (in other words, without aid of a computer) to be their provider, said Ali Haider, MD , of the University of Texas MD Anderson Cancer Center, Houston.

“This study gives us a message that patients would prefer their doctors to give them undivided attention,” Dr. Haider said in a press conference. “Better communication can enhance patient trust and satisfaction.”

This is one of the few, if not only, studies to evaluate how the presence of a computer affects exam room interactions between physicians and patients, Dr. Haider said in a press conference held during the meeting.

To test the impact of the computer in the exam room, Dr. Haider and his colleagues created four different 3-minute video vignettes featuring two different actors playing physicians in an encounter with a patient. Each actor created one video in which he used a computer and one in which he did not. To minimize potential bias, the videos had identical scripts, and actors were careful to use the same gestures, expressions, and nonverbal communication in each video.

A total of 120 cancer patients were randomized to view two of the videos and fill out validated questionnaires rating their perception of the physician’s compassion, communication skills, and professionalism.

The face-to-face clinical encounter videos were associated with a median compassion score of 9 on a scale of 0-50 where 0 is best and 50 is worst; by comparison, the encounters with computers scored worse, at a median of 20 out of 50 (P = .0003). Likewise, the patients rated the face-to-face encounter videos significantly higher on communication skills (P = .0001) and professionalism (P = .013).

After watching both videos, the patients were asked which encounter they would personally prefer, and 86 (72%) said they liked the face-to-face communication video better.

Actors and patients were all blinded to the purpose of the study, according to the researchers.

Further research is required to confirm these findings in other clinical settings and populations, according to Dr. Haider.

“We believe these results may be different if we choose a younger population, or patients with high computer literacy,” he explained.

While more research may be needed, “face-to-face communication seems quite possibly the preferred route, despite the pressures clinicians have to search and document in the medical record,” said medical oncologist Andrew S. Epstein, MD , of Memorial Sloan Kettering Cancer Center, New York, who was not involved with the study.

“In an age of ubiquitous technology, this study is an important reminder of the need to address the potential for technology to interfere with the patient-physician interface,” said Dr. Epstein, who moderated the press conference from the palliative care symposium, which was cosponsored by AAHPM, ASCO, ASTRO, and MASCC.

op@frontlinemedcom.com

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