Jun 2003 Table of Contents

IMPROVING PATIENT CARE

Focusing on Today’s Visit

This simple checklist can make your job easier by helping patients clarify what they want out of today’s visit.

Fam Pract Manag. 2003 Jun;10(6):59-60.

Medical practices waste an enormous amount of time and energy every day by failing to address patients’ real agendas during their office visits. For example, a patient may come in to the office for a diabetes follow-up visit and forget to ask for a needed medication refill. Or a patient may not reveal his or her main health concern until the visit time has nearly ended. The results of these situations are unnecessary telephone calls to the practice, frustrated patients with unresolved health concerns and overworked physicians and medical staff.

The solution

To address this problem, our office has developed a “today’s visit” form (see below) that helps our patients focus on what they really want from their physician at the current visit and reminds them of items patients often forget until after they have left the office. We ask all patients to fill out the form when they come into our waiting room, and it takes just a few minutes of their time. We give them the form on a clipboard with an attached pen, making it easy for them to complete.

The form has three brief sections. First, it asks patients to list the “main reason for today’s visit.” This is not always the reason they gave to the scheduler when they called to make their appointment. Second, the form asks patients to list “other concerns I would like to discuss if there is time.” Since most patients do have additional concerns, we find it valuable to solicit this information up front, rather than waiting for the patient to announce, “Oh, by the way, I’ve been having some migraines” as the visit is about to end. Finally, the form offers a checklist of things patients might need but commonly forget to ask about: prescription refills, work or school excuses, referrals needed for insurance purposes and various forms that need to be completed.

Practices can add a variety of items to the checklist and personalize it to their own special interests or to the needs of their patient population. (You can download our first-visit form below and customize it for use in your own practice.) For example, since our practice is interested in not only the physical but also the spiritual dimension of our patients’ lives, we include “I would appreciate prayer today” as an item on our checklist. An amazing number of patients check this option, and we have aides, nurses and physicians ready to provide this service. Other items practices could add to their checklist might include the need for smoking cessation counseling, immunizations, mole checks or medication instruction.

The benefits

The “today’s visit” checklist has helped our practice immensely. As our physicians enter the exam room, they simply glance at the today’s visit form (which the patient has already completed and the nurse has collected) and can see the patient’s full agenda without having to spend precious visit time uncovering these issues. The form has also helped eliminate many unnecessary phone calls to our office from patients who forgot to raise a concern while with their physician. Most important, it has helped us meet our patients’ real needs more efficiently.

Dr. Redka is a family physician practicing with Cornerstone Family Health in Williamsport, Pa.

Conflicts of interest: none reported.

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Copyright © 2003 by the American Academy of Family Physicians.
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