Running head: ROGERIAN L: CH.

1 TFTM 1

Rogerian Letter:
The First Three Minutes
Gabby Sperber
Louisiana State University

Author Note
The following Rogerian letter was written for English 2001, taught by Jean Coco, and

addresses issues raised in the case study The First Three Minutes, published in Health
Communication in Practice: A Case Study Approach.
298 Cypress Lakes Drive
Slidell, LA 70458

Phone: (985) 445-9487

Fax: (985) 707-5799
Gsperb1@lsu.edu

April 30, 2017

Hospital Administrators
(Oschner Hospital)
1514 Jefferson Hwy
New Orleans, LA 70121

Dear Hospital Administrators,

In the fast-paced world we live in today, effective communication is necessary to keep life
running smoothly in most cases. I think everyone can agree that clear communication between
doctors and patients is especially essential. Doctors have an extremely demanding job which can
make it easy to distort hasty communication versus efficient communication. Since everyone has
been a patient at one point in their lives, it is applicable to everyone to want doctors to receive
the best training in communication in order to keep patients happy and healthy. As a patient and
also working adult, I want to encourage the hospital administration to initiate classes to inform
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doctors of more effective ways to communicate with patients, especially in the first three minutes
of an appointment, in order to determine accurate diagnoses and be proactive to prevent future
health problems.

As a Hospital Administration, you stress that a major part of running a hospital is not only
making sure suitable treatment is given and patients leave satisfied, but also costs. It is clear that
money drives the medical field and keeps hospitals functioning with the newest technologies and
most qualified doctors. The Hospital Administration has an extremely difficult task to make
budgets for hospital spending, and of course it is important to try to keep healthcare costs as low
as possible to benefit everyone. In many cases, sometimes healthcare costs are the reason some
areas of the medical field stop being funded or new programs cannot be created. The Oschner
Hospital Administration is hesitant to create new programs to teach a better doctor-patient
communication style, such as the patient-centered interviewing style, since some programs
already do not have enough money to continue being funded. The Administration stresses that
time is money in the medical field, so it is important to budget wisely and be as efficient as
possible in the least amount of time as possible.

Being a working adult myself, I can completely understand and agree with the importance of
having a budget and prioritizing which programs are important enough to be funded and that
some may need to be cut. Working in the Hospital Administration is a lofty job and I respect that
not every decision is an easy one to make, especially when it comes to peoples lives. I also
realize the importance of all the programs funded by the hospitals, and that each one is distinctly
made for the betterment of treatment and healthcare for patients. I understand some programs
take priority over others, and some Hospital Administrations believe teaching communication
skills does not necessarily seem as important as other medical skills. I also recognize that when it
comes to teaching doctor-patient communication, there are some aspects that cannot be taught. It
is clear that two people need to participate in order to have an effective conversation. This means
that patients and doctors must both put in effort to benefit their health; therefore, the doctors
cannot be held completely responsible when a patient will not work with them.

While I agree that budgeting, time management, and other medical skills are important, I wonder
if doctor and patient communication is suffering from this fast-paced system of medical care.
Doctors may be so focused on seeing the most amount of patients possible, that they are not fully
hearing the patients concerns. A research study of 74 office visits was recorded, and it was found
that in only 17 of the visits the patient was allowed to complete their opening sentence of
concerns. In 51 of the visits the physician interrupted and directed questions toward a specific
concern, and in only 1 of these 51 visits was the patient allowed to complete their opening
statement (Beckman & Frankel, 1984). These statistics clearly show that the current interviewing
style being taught is not effective, and the Hospital Administrations and medical schools should
shift to a new form known as the patient-centered interviewing style. This interview style is a
step-by-step process that focuses on asking more open-ended questions and taking into account
the patients story behind their visit. Another significant aspect of this style is that it focuses
mainly on the first three minutes of an appointment. The first three minutes of an appointment
may seem like insignificant small talk; however, the first three minutes are actually critical
because it sets the tone for the rest of the appointment (Smith, 2002). When doctors are not
correctly trained in effective communication it can lead to a wrong diagnosis, or an unsatisfied
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patient which could consequentially affect the hospital as a whole. Although doctors may be
trained extensively in medical care, I think teaching communication is often overlooked in
medical school and hospitals. People often forget that a diagnosis is often concluded mainly from
what the patient says is wrong, and then tests are taken to determine for sure. If a doctor has a
poor communication style and cuts the patient off, such as in the case study with Mr. Smith, the
real problem behind the patients pain can be overlooked or not even heard at all. It is important
for hospital administrations to remember the real purpose behind medical care: the patients
health. While keeping costs low is important, it should not be at the expense of a grieving family
because their family members death could have been prevented if communication with their
doctor could have been better. Classes should be installed in medical schools and hospitals that
teach the correct style of communication, such as the patient-centered interviewing style.

Some people argue that this new style of patient interviewing is lengthier and could lead to
increased health care costs; however, this style of communication is only for the first three
minutes of an appointment. An abundance of research shows that if the doctor allows the patient
to speak more and focuses on listening, a diagnosis can be reached faster and actually speed up
the appointment (Nussbaum, Parrott & Thompson, 2011). This will actually allow the doctor to
see more patients in a day, which ultimately benefits the Hospital Administration in every way.
While forming new classes and programs to teach will cost money, it is nothing compared to the
costs that occur from lawsuits when there is malpractice due to poor communication between
doctor and patient. Not only can better communication skills lead to better patient care, it can
also benefit the hospitals financially and give the hospitals a larger budget to fund other
beneficial programs.

After thinking about your concerns, I have a better understanding of why the Oschner Hospital
Administration is hesitant to install new classes and teach new criteria to students. Although the
cost saving and timely effects of the patient-centered interviewing style might not be
immediately evident, the effects will be evident in the long run when there are less lawsuits and
doctors have time for more appointments. This style of interviewing has already had successful
results at numerous other hospitals, and I hope the Oschner Hospital Administration will be
willing to consider these statistics and research that support the patient-centered interviewing
style over the paternalistic biomedical model style being taught now. I am hopeful that with our
common concern for patients health that we can take a step in the right direction towards
teaching a more effective style of communication to doctors at every hospital.

Sincerely,

Gabrielle Sperber
Oschner Hospital Patient
Gsperb1@lsu.edu
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References
Beckman, H., & Frankel, R. (1984). The Effect of Physician Behavior on the Collection of Data.

Retrieved April 19, 2017, from http://annals.org/aim/article/699136/effect-physician-

behavior-collection-data
Cegala, D.J. (2005). The First Three Minutes. In Ray, E. B. Editor, Health communication in

practice. [electronic resource]: a case study approach. pp 28-738793. Mahwah, NJ:

Lawrence Erlbaum Associates, Publishers.

Nussbaum, J. F., Parrott, R., & Thompson, T. L. (2011). The Routledge handbook of health

communication. New York: Routledge.

Smith, R.C. (2002). Patient-centered interviewing: An evidence-based method (Tape 1). East

Lansing, MI: Instructional Media Center, Michigan State University, from

http://patcom.jcomm.ohio-state.edu