Computers in the exam room: differences in physician-patient interaction may be due to physician experience

J Gen Intern Med. 2007 Jan;22(1):43-8. doi: 10.1007/s11606-007-0112-9.


Background: The use of electronic medical records can improve the technical quality of care, but requires a computer in the exam room. This could adversely affect interpersonal aspects of care, particularly when physicians are inexperienced users of exam room computers.

Objective: To determine whether physician experience modifies the impact of exam room computers on the physician-patient interaction.

Design: Cross-sectional surveys of patients and physicians.

Setting and participants: One hundred fifty five adults seen for scheduled visits by 11 faculty internists and 12 internal medicine residents in a VA primary care clinic.

Measurements: Physician and patient assessment of the effect of the computer on the clinical encounter.

Main results: Patients seeing residents, compared to those seeing faculty, were more likely to agree that the computer adversely affected the amount of time the physician spent talking to (34% vs 15%, P = 0.01), looking at (45% vs 24%, P = 0.02), and examining them (32% vs 13%, P = 0.009). Moreover, they were more likely to agree that the computer made the visit feel less personal (20% vs 5%, P = 0.017). Few patients thought the computer interfered with their relationship with their physicians (8% vs 8%). Residents were more likely than faculty to report these same adverse effects, but these differences were smaller and not statistically significant.

Conclusion: Patients seen by residents more often agreed that exam room computers decreased the amount of interpersonal contact. More research is needed to elucidate key tasks and behaviors that facilitate doctor-patient communication in such a setting.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude to Computers*
  • Communication*
  • Cross-Sectional Studies
  • Faculty, Medical
  • Female
  • Humans
  • Internship and Residency
  • Male
  • Medical Records Systems, Computerized*
  • Physician-Patient Relations*
  • Primary Health Care
  • Surveys and Questionnaires
  • Time Factors
  • Virginia