Connecting With Patients-The Missing Links

These are trying times for the patient-physician relationship.1,2 Patients frequently report that their physician is not listening or, at least, that they do not feel heard.3 Some research suggests they are right—sometimes their physicians are not listening.4,5 Appointment times, although short, are longer than in the past and have increased from just over 15 minutes in 1995 to more than 20 minutes in 2015.6 However, too much of that time is directed not at the patient but at the patient’s virtual self, at what Verghese7 has called the “iPatient” via the now omnipresent electronic medical record (EMR). In their enterprising Special Communication in this issue of JAMA, Zulman and colleagues8 point out that care has become more impersonal, creating an environment in which understanding patients and their symptoms and concerns is made even more difficult.