Writing to the patient

Price, John; Asch, Rachel

doi:10.1192/pb.14.8.467

Psychiatr. bull.

1990

DOI: 10.1192/pb.14.8.467

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Writing to the patient

John Price

Rachel Asch

Abstract: In a recent study we compared writing to the patient with writing to the general practitioner after an initial psychiatric out-patient consultation. One of us (R.A.) interviewed the patients at home about two weeks after the consultation, and compared the two groups on satisfaction with the consultation, comprehension of information given by the psychiatrist, and compliance with advice. We felt that the comments of the patients might be of interest, particularly to those who might have considered (or done) som… Show more

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1993

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“…Although favourable empirical studies of psy chiatric patients given access (Stein et al, 1979: McFarlane et al, 1980Roth et al, 1980: Miller et al, 1987Parrot et al 1988;Essex et al, 1990: Price et al, 1990Bernadt et al, 1991;Kosky & Burns, 1995) far outnumber the unfavourable (Altaian et al, 1980, Sergeant, 1986 these uncontrolled studies do not compare psychiatric patients with other patient groups.…”

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confidence: 99%

Access to health records: psychiatric patients and patients with diabetes compared

Jha

Bernadt²,

Brown³

et al. 1998

Psychiatr. bull.

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Thisstudy was undertaken to assess whether psychiatric patients respond more adversely to reading their own records than non-psychiatric patients. Seventy-three psychiatric out-patients and 84 out-patients with diabetes were posted their main clinical summary with a questionnaire about it. For seven of the eight questions, more than 70% of both patient groups gave favourable ratings. However, the psychiatric patients gave significantly less favourable responses than the patients with diabetes on five of the eight questions. Fourteen of 73 (19%) psychiatric patients were upset by reading the clinical summary about themselves compared with four of 84 (5%) patients with diabetes.

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confidence: 99%

Access to health records: psychiatric patients and patients with diabetes compared

Jha

Bernadt²,

Brown³

et al. 1998

Psychiatr. bull.

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Teaching communication skills. Putting it on paper helps patient understanding.

Price¹

1993

BMJ

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EDITOR,-I C McManus and colleagues rightly emphasise the importance of teaching communication skills, but they do not mention written communication. Sometimes at the end of a consultation the patient is so exhausted and confused that, however good the doctor's communication skills, he or she has difficulty in comprehending the opinion given and the advice proffered. In a randomised trial in the Milton Keynes department of psychiatry, in association with the applied psychology unit of Cranfield College of Aeronautics, colleagues and I found that this problem could be overcome by writing to the patient after an outpatient consultation and summarising both the patient's and the doctor's contributions to the consultation.Patients who received letters were significantly more pleased with the consultation than patients whose general practitioners received letters in the traditional way.2 Patients reported that the receipt of a letter increased their self esteem and made them feel valued by the service.' They pointed out that to be written to (rather than about) was to be treated as a sane and responsible person; this was especially important to those attending the psychiatric outpatient clinic, in many cases for the first time in their lives. The letters were read many times; they were frequently shown to other family members and so formed the basis of family discussion about the illness and its treatment. The referring general practitioner was sent a copy of the letter and so knew what the patient had been told by the psychiatrist. The patients were asked to bring the letters to follow up consultations and to request correction and clarification when necessary.Several patients spontaneously remarked, "Why can't all doctors do this?" In fact, letters and other forms of written summary have been found useful in other specialties2 4; why not general practice too?We found that the prospect of writing to the patient rather than to the general practitioner made our consultations more patient centred. They were harder work but more fun. Why not make some experience of writing to the patient a regular part of the medical student curriculum or general professional training?

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Teaching communication skills. Funding required for teaching programmes.

Preston-Whyte¹,

McKinley²

1993

BMJ

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Writing to the patient

Cited by 5 publications

References 0 publications

Access to health records: psychiatric patients and patients with diabetes compared

Access to health records: psychiatric patients and patients with diabetes compared

Teaching communication skills. Putting it on paper helps patient understanding.

Teaching communication skills. Funding required for teaching programmes.

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