Understanding the Doorknob Phenomenon: Enhancing Patient Communication in Virtual Healthcare Settings

In recent years, especially after the COVID-19 pandemic, telemedicine has gained significant importance in healthcare. Clinicians and patients have had to adjust to virtual visits, a key element in maintaining healthcare access while reducing health risks. This change has introduced unique communication challenges in these virtual settings. One key issue is known as the “doorknob phenomenon.” Recognizing and addressing this issue is important for medical practice administrators, owners, and IT managers in the United States, considering its effects on patient outcomes and care quality.

The Doorknob Phenomenon Explained

The term “doorknob phenomenon” describes a situation that often happens at the end of a patient visit. As the clinician is about to end the conversation, the patient may suddenly raise important concerns or questions. This can lead to missed opportunities for discussing critical health issues and may result in patient dissatisfaction. The doorknob phenomenon is particularly noticeable in telemedicine, where nonverbal cues are harder to see, and the urge to finish the meeting might overshadow the patient’s remaining concerns.

Research shows that patients often bring up additional questions or worries at the last moment, just as the clinician is about to conclude the visit. This timing can disrupt the consultation and prevent a complete discussion of vital topics affecting the patient’s health. Often, this results in consultations that do not fully meet the patient’s needs or expectations.

Communication Challenges in Virtual Healthcare

While telemedicine has expanded healthcare delivery, it brings specific challenges that are not usually present in in-person visits. A major challenge is the loss of nonverbal communication cues, which are important in interactions. In traditional medical consultations, face-to-face conversations allow clinicians to notice subtle body language, facial expressions, and other signals indicating patient anxiety, confusion, or urgency. These insights are often reduced or absent during virtual visits, making it easier for clinicians to overlook underlying issues that may not be verbally expressed.

Furthermore, patients may face difficulties with health literacy, affecting their understanding of medical information. About 36% of U.S. adults have limited health literacy skills. This understanding gap can worsen in telehealth settings where time limits and technology issues lead to hurried interactions and increased potential for miscommunication.

Studies indicate that during telemedicine appointments, patients might forget nearly 50% of what is discussed, and many may remember incorrect information. The speed at which a clinician concludes a session can result in patients leaving with unresolved questions. To manage the complexities of virtual care, providers need to implement strategies to prevent misunderstandings and ensure patients finish the session feeling informed and supported.

Best Practices for Effective Communication

To improve patient interactions during virtual visits, clinicians should adopt best practices that tackle the communication challenges in telehealth settings. Here are several effective strategies:

• 1. Start with Clear Agenda Setting
  Setting an agenda at the beginning of the visit helps to create clear expectations. By outlining the topics to be discussed, patients can prioritize their concerns and questions, reducing the likelihood of holding back critical information until the end.
• 2. Employ Plain Language
  Using simple language is essential for patients to understand complex medical terms. Explaining jargon in straightforward terms aids patient understanding and retention of information. Regularly checking for understanding can help identify parts of the conversation that may be confusing for patients.
• 3. Utilize the Teach-Back Method
  The Teach-Back method encourages patients to explain what they have understood from the consultation. This technique allows providers to clarify any misunderstandings and ensures that important information is conveyed and comprehended.
• 4. Practice Active Listening
  Active listening means being genuinely engaged in the conversation and responding thoughtfully to what patients say. Using verbal affirmations and paraphrasing their concerns reinforces their importance and ensures that their issues are taken seriously.
• 5. Allow Time for Closing Questions
  Thinking ahead about final questions at the end of each visit can help reduce the doorknob phenomenon. Clinicians should invite patients to express any additional concerns before finishing the meeting, allowing for a pause that ensures patients feel heard and valued.
• 6. Ensure a Comfortable Environment for Patients
  Encouraging patients to choose a private, quiet space for their virtual visits can greatly improve communication. This environment allows patients to feel at ease and promotes open dialogue without interruptions.
• 7. Provide Visual Aids
  Using visual aids, such as diagrams or written instructions, can be very helpful, especially for patients with low health literacy. These tools make complex information more understandable during virtual interactions.

Technological Solutions and Workflow Automation

As telehealth has become a primary model for many practices, incorporating technology is important for improving patient communication. Medical practice administrators and IT managers can consider various tools to automate workflows that enhance patient interaction and care continuity.

The Role of AI in Enhancing Communication

Artificial Intelligence (AI) can be significant in streamlining patient interactions and addressing communication issues in virtual healthcare settings. For example, natural language processing (NLP) tools can analyze patient inquiries and documentation, allowing healthcare providers to better understand patients’ concerns before consultations begin. Additionally, AI-powered chatbots can assess patient questions and provide instant replies to common queries, enabling clinicians to focus on more complex interactions during live sessions.

Appointment Reminders and Follow-Up Communications

Automated appointment reminders can help reduce missed appointments and ensure that patients are ready for their virtual visits. These reminders can include details about the agenda for the upcoming consultation, helping patients prepare. Moreover, follow-up communications should recap key points discussed during the visit, minimizing misunderstandings and reinforcing adherence to care plans.

Integration of Telehealth Platforms

Investing in effective telehealth platforms that seamlessly connect with electronic health records (EHR) ensures that all patient data is accessible during consultations. These platforms enhance clinicians’ ability to review patient history and tailor conversations that address specific health concerns based on prior interactions.

Using Analytics for Continuous Improvement

Collecting and analyzing data on telehealth sessions can provide significant insights. For instance, tracking the occurrence of the doorknob phenomenon in virtual visits can reveal patterns. If certain types of consultations frequently lead to last-minute patient disclosures, practice managers can adjust scripts and agendas to proactively address common concerns.

Addressing Socioeconomic Barriers to Effective Communication

As healthcare providers seek to improve communications in telemedicine, considering the socioeconomic factors affecting patient experiences is essential. Specific demographics, such as racial and ethnic minorities, older adults, and low-income individuals, may encounter unique barriers to accessing virtual healthcare. Recognizing these disparities is crucial for delivering equitable healthcare experiences.

For example, about 10% of U.S. citizens lack internet access, which affects older adults and individuals in rural areas more severely. Tackling these disparities requires creative solutions, like offering community resources or telehealth training aimed at these populations. Enhancing digital literacy can help ensure that all patients feel comfortable navigating virtual appointments.

The Bottom Line

As telemedicine continues to grow as a central aspect of healthcare delivery, addressing communication gaps such as the doorknob phenomenon is critical for improving patient experience and care quality. Medical practice administrators, owners, and IT managers play an important role in developing effective communication strategies and creating an environment that prioritizes patient engagement.

By integrating technology and focusing on inclusive practices, healthcare organizations can establish a responsive and patient-centered telehealth system. Improved communication in virtual healthcare settings not only enhances patient satisfaction but also creates a foundation for successful healthcare partnerships as medical care evolves.

This approach will ultimately contribute to better health outcomes for patients across the United States as healthcare continues to adopt new solutions to meet the diverse needs of its population.