Techniques for terminating patient-physician encounters in primary care settings.

BACKGROUND Physicians in the community work on a tight and often pressured schedule; verbal and non-verbal techniques to terminate the patient-physician encounter are therefore necessary. OBJECTIVES To characterize ways of terminating the encounter. METHODS Using a structured questionnaire we observed seven family physicians and nine consultants and recorded patient-physician encounters to assess techniques for terminating the encounter. RESULTS In all, 320 encounters were recorded, 179 (55.9%) by consultants and 141 (44.1%) by family physicians. The mean duration of the encounters was 9.02 +/- 5.34 minutes. The mean duration of encounters with family physicians was longer than with consultants (10.39 vs. 7.93 minutes, P< 0.001). In most cases the encounter ended with the patient receiving printed documentation from the physician (no difference between family physicians and with consultants). Consultants were more likely to end the encounter with a positive concluding remark such as "feel good" or "be well" (P < 0.01). There was no single occasion where termination of the encounter was initiated by the patient. CONCLUSIONS Giving a printed document to the patient appears to be perceived by both patients and physicians as an accepted way to end an encounter. Another good way to end the encounter is a positive comment such as "feel good" or "be well."