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’Doorknob phenomenon’ cuts into physician productivity

Physician Practice Advisor, March 30, 2005

Doctors have been through the scenario dozens, even hundreds, of times: The patient has been seen for his or her initial complaint, examined, and given a recommended course of treatment. The exam is all but over, and on the way out the door, the patient casually, almost embarrassedly, mentions that he or she has had dizziness, shortness of breath, or a suspicious looking mole on his or her body. And just like that, the exam begins again and the doctor's schedule is in need of revamping.

According to a March 28 story by The Associated Press, the practice of patients saving a separate medical issue-sometimes minor, sometimes major-until they're walking out of a doctor's exam room has become so widespread in the medical industry that it's been given a name: "the doorknob phenomenon."

"Often it happens because doctors, including myself, don't do a good job of getting a sense at the beginning of the medical encounter what the needs of the patient are," William Harper, M.D., told the AP. Harper teaches communication skills to University of Chicago medical students, and recommends that they specifically ask patients if they have any other health concerns once they've dealt with the primary reason for the visit.

Other experts in the field similarly advise physicians to slow down a bit
during the exam, as rushed examinations can contribute to last-minute questions. Doctors are also encouraged to take the time to simply listen to their patients right from the get-go, so that patients-who know how their bodies feel-can steer the direction of the exam, rather than the doctor.

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