Rogerian Letter

Emily Gathman

Louisiana State University

Authors 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.

224 Cottonwood Drive
Gretna, LA 70056

Phone: (504) 374-6837

Fax: (504) 678-5784

April 30, 2017

Gregory Jones, M.D.

Phsycian
Oschner Medical Center
2500 Belle Chasse Highway
Terrytown, LA 70056

Dear Dr. Jones,

Thank you for your help during our appointment. I really appreciate the time you took to see me.
However, Im still concerned about the back pain I am experiencing. I have been thinking about
the last appointment I had with you and if there was anything else I could tell you about my pain
to solve the issue. Ive thought of all the things I wanted to tell you about my back pain and
wondered why I hadnt mentioned it when I saw you. I then realized that I never got the chance
to tell you the rest of the information because you never asked. I was rushed in and out of the
appointment so quickly, I forgot all the information that might have helped you solve my case.
The communication during our appointment was problematic and left no room for me to fully
explain my symptoms before I was interrupted. I understand youre a busy man, but
communication is important to properly diagnose a patient. I feel this is a problem I need to
address due to the importance of communication in healthcare settings and the fact that it will
always be a required part of being a doctor.

I truly understand the time constraints that you are under. I know that you are a busy man with a
lot of patients to see every day. Being a doctor is a stressful job and pleasing all of your patients
is a complicated thing to do with only a few hours to meet with all of them. I recently read an
article about the hectic schedules doctors are placed on and what happens if this schedule is
thrown out of whack. In the article, Dr. Abigail Zugar describes the struggles of her busy day
when she says:

So when there is enough work to last till midnight, my agenda shifts, and not so subtly.
Everyone can tell when I begin to speed. Every visit is pared down to the essentials. All
optional and cosmetic issues are postponed, including most toenail problems and all
paperwork. Chatting is minimized. (2016).

I understand that like Dr. Zugar, you were probably very busy the day of my appointment and
could only get to the essentials of my back pain. However, perhaps the answer to my back pain
would have come out if you had given me the proper time needed to explain my pain fully.
Im not one to point fingers, so I can see my part in our communication barrier as well. While it
was difficult to keep up with the conversation while being interrupted, I should have stepped up
and mentioned the problems I was having with being interrupted. Patient-provider interactions
are interactive and reciprocal (DAgostino, Atkinson, Latella, Rodgers, Morrissey, DeRosa, &
Parker, 2017) which makes myself equally responsible for the ineffective communication during
the appointment. In the future, I will work on being more assertive when communicating with
healthcare providers in order to ensure I am receiving proper health care.

I would like to take some time explain why effective communication is so important for doctors
to practice when talking to patients and how it can affect the outcome of the appointment.
Doctor-patient communication is essential when diagnosing a patient. Without information from
the patient, it is difficult to know their symptoms and family history of health issues. By
interrupting the patient, you cut off the flow of information from the patient. The timing of
those interruptions potentially has a significant impact on the course and even outcomes of the
interview (Chegala, 2005, p.3). When I was interrupted during the appointment, it completely
changed my train of thought which affected the course of the interview. Because I was
interrupted, you missed out on information about my family history, the location of my pain, and
how the pain is affecting my life. All of this is important information that could have possibly led
to a better treatment plan for my back pain. Research has shown that majority of decisions that
are made when diagnosing a patient is based off of information that was communicated to the
doctor directly from the patient (Chegala, 2005, p.4). This statement is significant because
doctors who are communication poorly may miss the majority of information they need to make
a correct diagnosis. An incorrect diagnosis could be harmful and frustrating for patients who are
already in pain. The interruptions also effected me because I was unable to ask questions about
my situation. In fact, many patients have come across this same issue. In an article discussing
patient complaints, research was collected to study how poor communication from doctors
affects their patients. Patients were also not given a chance to ask questions, and when they
finally managed to do so, they were interrupted (Kee, Lim, & Koh, 2017). The interruptions by
doctors can may a patient feel unimportant and disrespected.

Another problem with the communication during the appointment is that you focused on the first
complaint that I brought up, and did not ask if I was experiencing any other problems. In a case
study that I read, research was done and it was found that the majority of interruptions occurred
on the patients first expressed complaint, and only a very small percentage (about 2%) ever
completed their agenda (Chegala, 2005, p.4). The fact that patients can not complete their
agenda is an issue because their most important concern may not be the first one they bring up. If
doctors only focus on the first complaint, patients may never have their problem addressed which
could be detrimental to their health.

The final issue I have with the communication during the appointment is the use of closed
questions. When doctors use close ended questions, it gives the patient limited options for
responses. In the article by Ha and Longnecker, it is stated that the use of open-ended questions
areexamples of skillful communication (2010). By using open ended questions, the doctor
leaves the question open to whatever information the patients feel is necessary for the doctor to
know. This method of communication provides doctors with a greater opportunity of getting vital
information from a patient about their health. In our appointment, you not only used close ended
question, but your questions were focused mainly on the biomedical aspect of my illness. While
biomedical information is important for diagnosis and treatment, it is vital to get other
information as well. Patientsoften have not only have a physical ailment but also have life
experiences associated with the disease (Chegala, 2005, p.5). If you had asked open ended
questions, you would have learned more about my pain that could have led you to a better
treatment plan.

While it may be hard to accept your downfalls in communication during patient interactions, it is
important that your communication skill improve to ensure the health of your patients. The
improvements are not only for the benefit of your patients, but for you as well. By having good
communication skills, you could greatly increase the probability of diagnosing and treating a
patient accurately. The correct diagnosis will not only be good for the patient, but for your
reputation as a doctor as well. Good communication skills will also help you to establish a
healthy relationship with your patients, which could help to prevent malpractice suits against
you. I hope this letter will get you to consider taking the necessary steps to improve your
communication skills to advance your patients care and your own success.

Sincerely,
John Smith
John Smith
jsmith@gmail.com

References
Chegela, D. J. (2005) The First Three Minutes. In Ray, E. B. (ed.), Health Communication in
Practice: A Case Study Approach (p. 3-10). Mahwah, NJ: Lawrence Erlbaum
Associates.

D'Agostino, T. A., Atkinson, T. M., Latella, L. E., Rogers, M., Morrissey, D., DeRosa, A. P., &
Parker, P. A. (2017). Promoting patient participation in healthcare interactions through
communication skills training: A systematic review. Patient Education And Counseling,
doi:10.1016/j.pec.2017.02.016z

Ha, J. F., & Longnecker, N. (2010). Doctor-Patient Communication: A Review. The Ochsner
Journal, 10(1), 3843.

Kee, J. W., H. S., Lim, I., & Koh, M. Y. (2017). Communication Skills in Patient-Doctor
Interactions: Learning from Patient Complaints. Health Professions Education,
doi:10.106/j.hpe.2017.03.006

Zuger, A. (2016). A Doctor on Schedule, Rarely on Time. The New York Times. p. D5.