What is Summarizing?

Deliberate step of providing an explicit verbal summary to your patient

• Since there are NUMEROUS sources of communication distortion:
  • Patient: ambiguity, forgetting to mention, omitting assuming you already know, inadvertent verbal mistake, non-verbal cues
  • Doctor: misinterpretation, incorrect assumption, bias/prejudice
• Summarizing allows you and the patient to answer important questions
  • You: ‘How do I know that what I’ve understood from the patient is an accurate representation of what they wanted to tell me?’
  • Patient: ‘I know the doctor seems to be listening, but how do I know that they’ve understood me’
• Effective communication:
  • Helical, rather than Linear process
  • Interaction, rather than Direct Transmission

1. Internal Summary: focuses on a specific portion of the interview
2. End Summary: concisely reviews the entire interview

What does Summarizing do for me?

1. Review what you’ve learned so far
2. Order the information into a coherent pattern
3. Recognize any gaps you need to clarify
4. Consider where the consultation will proceed

Can I check that I understood what you’ve said correctly – So you’ve had these headache on and off for years, it’s pulsating, always on one side of the head and you get nausea and vomiting with it?

Yes, that’s about right. I also get very sensitive to light and loud noises. And I can’t work or really function when the headaches happen

Exercise: What are some possible ways that summarizing can backfire on you? For example, how might your patient react poorly if:

1. The summary was not sufficiently introduced
2. You summarize incorrectly
3. You summarize too often

How would you handle each of these situations?

Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (Thrid Edit). London: Radcliffe Publishing.