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To the Editor: In their article on soliciting the patient's agenda, Dr Marvel and colleagues¹ revisit the research of Beckman and Frankel² and urge adoption of the term "redirection" over "interruption." Even more important is their focus on full and complete agenda setting, establishing a positive and measurable communication objective that can be taught, practiced, and evaluated.

As part of workshops for teachers of patient-physician communication, we have been assessing baseline skills by asking physicians to identify segments from a taped interview around which they would provide instruction. The interview included, among other issues, a redirection by the physician. Only 14 (20%) of 72 participants identified the redirection.

Why has full agenda setting not become an essential part of communication instruction? One difficulty suggested by Marvel et al is that "interruption" is easily misinterpreted as breaking into the dialogue. Teachers also may fail to react to strategies that represent a . . . [Full Text of this Article]

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RELATED ARTICLE

Soliciting the Patient's Agenda: Have We Improved?
M. Kim Marvel, Ronald M. Epstein, Kristine Flowers, and Howard B. Beckman
JAMA. 1999;281(3):283-287.
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