Saul J. Weiner and Alan SchwartzJun 22, 2016
Listening for What Matters
Avoiding Contextual Errors in Health Care
Oxford University Press 2016
When clinicians listen to patients, what do they hear? In Listening for What Matters: Avoiding Contextual Errors in Health Care (Oxford UP, 2016), Saul Weiner and Alan Schwartz provide a riveting account of a decade of research on improving outcomes by incorporating patients' individual life contexts into planning of care. Their groundbreaking studies showed that physicians, while getting the biological details largely correct, frequently disregard personal circumstances that lead to medical errors. Such an assertion might appear intractable or unfit for empirical study, but Listening for What Matters describes a series of creative experiments that strongly support it. From placing fake patients into real clinical contexts to measure the appropriateness of recommendations, to recording interactions between real patients and doctors (for which they developed a system, Content Coding for Contextualization of Care), and finally training groups of medical students to ask about individual context, Weiner and Schwartz build a case for the existence of a widespread problem while simultaneously offering compelling solutions. This is the first of a pair of interviews on communication in health care, to be followed by Samuel Morris Brown's Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human.