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CONTEXT: Previous research indicates physicians frequently choose a\npatient problem to explore before determining the patient's full spectrum of\nconcerns. OBJECTIVE: To examine the extent to which experienced family\nphysicians in various practice settings elicit the agenda of concerns patients\nbring to the office. DESIGN: A cross-sectional survey using linguistic\nanalysis of a convenience sample of 264 patient-physician interviews. SETTING\nAND PARTICIPANTS: Primary care offices of 29 board-certified family physicians\npracticing in rural Washington (n = 1; 3%), semirural Colorado (n = 20; 69%),\nand urban settings in the United States and Canada (n = 8; 27%). Nine\nparticipants had fellowship training in communication skills and family\ncounseling. MAIN OUTCOME MEASURES: Patient-physician verbal interactions,\nincluding physician solicitations of patient concerns, rate of completion of\npatient responses, length of time for patient responses, and frequency of\nlate-arising patient concerns. RESULTS: Physicians solicited patient concerns\nin 199 interviews (75.4%). Patients' initial statements of concerns were\ncompleted in 74 interviews (28.0%). Physicians redirected the patient's\nopening statement after a mean of 23.1 seconds. Patients allowed to complete\ntheir statement of concerns used only 6 seconds more on average than those who\nwere redirected before completion of concerns. Late-arising concerns were more\ncommon when physicians did not solicit patient concerns during the interview\n(34.9% vs 14.9%). Fellowship-trained physicians were more likely to solicit\npatient concerns and allow patients to complete their initial statement of\nconcerns (44% vs 22%). CONCLUSIONS: Physicians often redirect patients'\ninitial descriptions of their concerns. Once redirected, the descriptions are\nrarely completed. Consequences of incomplete initial descriptions include\nlate-arising concerns and missed opportunities to gather potentially important\npatient data. Soliciting the patient's agenda takes little time and can\nimprove interview efficiency and yield increased data.