German Healthcare System: The Psychological Dimension of Anamnesis Truncation by General Practitioners and Specialists

Overview

A common anamnesis practice among German general practitioners and specialists is the rapid interruption of patients just a few seconds after they begin describing their symptoms, often before they have fully conveyed their concerns. This so-called “Anamnesis Truncation” not only has negative medical implications but also carries profound psychological consequences for patients, significantly undermining the trust relationship and overall well-being.

Loss of the Feeling of Being Heard

One of the most fundamental psychological effects of being interrupted by a doctor is the loss of the feeling of being heard and understood. People naturally have a need to fully express their worries and complaints in a safe environment. When this expression is prematurely cut off, it creates the impression that their concerns are being trivialised or not taken seriously. This can lead to a deep sense of disappointment, which weakens trust in the doctor and the healthcare system overall. In the long term, this may result in patients being less willing to discuss future health issues or seek medical advice.

Increased Levels of Stress and Anxiety

The interruption of symptom descriptions by the doctor can significantly increase the patient’s stress and anxiety levels. Expecting a thorough examination and diagnosis, the patient mentally prepares for a conversation in which they can express themselves calmly. However, if this process is abruptly interrupted, it leads to feelings of frustration and a loss of control. The patient may feel that they have not sufficiently communicated their situation, leading to uncertainty and concern about the accuracy of the diagnosis. This unease can follow the patient even after the appointment and negatively affect the healing process, as emotional stress is known to exacerbate physical symptoms.

Lack of Empathy and Appreciation

Another serious psychological impact of being interrupted is the perception of a lack of empathy and appreciation from the doctor. Patients expect their doctors to be not only professionally competent but also compassionate. The interruption of their description can be interpreted as a lack of interest and empathy, significantly straining the doctor-patient relationship. This experience can undermine the patient’s trust in the doctor’s competence and create the feeling of being treated as just another “problem” in a long line of patients, rather than as an individual with unique concerns and needs.

Reinforcement of Powerlessness and Dependence

When a patient is interrupted while describing their symptoms, it can also reinforce feelings of powerlessness and dependence. The patient experiences that their own voice does not count in the interaction and that they are reliant on the doctor’s decisions without being able to contribute themselves. This imbalance in the conversation strengthens the feeling of merely being an object in a one-sided process, which further exacerbates the already existing dependency. For many patients, this can lead to an increased sense of helplessness that extends beyond the specific doctor’s visit and affects other areas of life.

Missed Opportunity to Strengthen the Therapeutic Alliance

One of the most positive psychological effects that is hindered by truncation is the strengthening of the therapeutic alliance between doctor and patient. This alliance is based on trust, mutual respect, and a cooperative attitude, where the patient is involved as an equal partner in the diagnostic and treatment process. The interruption, however, severely hampers the potential to foster this alliance. The patient feels less like a partner and more like a petitioner, which can have a lasting negative impact on the quality of the therapeutic relationship.

Inhibition of Self-Efficacy

The feeling of self-efficacy—the belief that one can actively and successfully influence their own health and quality of life—is also negatively affected by the interruption. If the patient realises that their own words and observations are not sufficiently acknowledged, it can lead to a decrease in self-confidence and the belief that they can contribute to improving their situation. This discouragement can, in the worst case, result in the patient making passive and less responsible decisions regarding their health.

Conclusion

Overall, the described psychological effects illustrate that the interruption of symptom descriptions by doctors is far more than just a time-saving tool. It undermines patient trust, intensifies negative emotions such as stress and anxiety, and prevents the activation of positive psychological effects that are crucial to the healing process. A more conscious approach and a deeper appreciation of patient-centred communication could make a decisive difference—yet this requires time, which many doctors today seem to no longer have.