2017 ASCO Palliative Care: Patients With Advanced Cancer Prefer Oncologists Not Use Computers in the Exam Room


Key Points

  • Patients with advanced cancer prefer that their oncologists communicate with them face-to-face with just a notepad in hand rather than repeatedly using a computer while in the exam room.
  • Patients perceived physicians who communicated face-to-face without the use of computers as more compassionate, professional, and with better communication skills than physicians who used a computer in the exam room.

Although the use of electronic health records in oncology care has led to improved care for patients, results from a new study show that oncologists need to be cautious about using computers during exam room visits, especially for patients with advanced cancer. The randomized study compared patients’ perception of physicians’ compassion, communication skills, and professionalism between a traditional face-to-face clinic visit and a visit in which a computer is used in the examination room to access and document patient information.

The results showed that a large majority of patients, 72%, preferred face-to-face interactions. Physicians who communicated face-to-face were perceived to be more compassionate, professional, and better communicators. The study by Haider et al is being presented at the 2017 Palliative and Supportive Care in Oncology Symposium in San Diego (Abstract 26).

Study Methodology

The researchers recruited 120 English-speaking adults with advanced cancer and randomly assigned them to watch 2 standardized, 3-minute video vignettes depicting a routine physician-patient clinical encounter. The median age of the patients was 58 years, and the majority of the patients were female and married.

In one video, the physician is having a face-to-face consultation holding a notepad, and in the second video, the physician is in consultation using a computer. Both videos had an identical script and featured actors. Both the actors and the patients were blinded to the purpose of the study.

After viewing each video, the patients completed a questionnaire rating their perception of the physician’s compassion (0 = best, 50 = worst); communication skills (0 = poor, 70 = excellent); and professionalism (0 = poor, 20 = very good). Patients were also asked to rate their overall physician preference.

Study Results

After watching the first video, the face-to-face clinical encounter resulted in better compassion scores (median [interquartile range] = 9 [0–18] vs 20 [6–28]; P = .0003); communication skills 65 [54–70] vs 54 [41–63]; P = .0001); and professionalism 19 [5–20] vs 14 [11–17]; P = .013).

After crossover analysis, the researchers found a significant period (= .004) and sequence (P = .005) effect favoring the second video on compassion scores. After watching the second video, 86 (72%) of the patients preferred the face-to-face communication.

“[The] patients perceived physicians who communicated face-to-face without the use of computers as more compassionate, professional, and with better communication skills,” concluded the researchers.

“This study gives us a message that patients would prefer their doctors to give them undivided attention,” said lead author of this study, Ali Haider, MD, Assistant Professor in the Department of Palliative Care and Rehabilitation Medicine at The University of Texas MD Anderson Cancer Center, Houston, during a press conference announcing the study results. “Better communication can enhance patients’ trust and satisfaction.”

The study authors declared no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.