Feb 2005 Table of Contents

BALANCING ACT

Making the Most of Every Minute



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Even in a busy office, it pays to slow down and make every second count.

Fam Pract Manag. 2005 Feb;12(2):80.

Time is at a premium in most family medicine offices. We see many patients every day, often allotting ourselves less than 15 minutes to spend with each one. During that 15 minutes, we have a history to take, an exam to perform, notes to write, problems to solve and plenty of paperwork to complete. It is quite normal for us to feel rushed, yet patients want to feel that their visits are unhurried and that they have our undivided attention. How can we accomplish this? While quality time does not completely compensate for a low quantity of time, we can take steps to slow down, focus on one patient at a time and make the most of every minute.

Greet your patients. On occasion, it may be appropriate to step into the waiting room and welcome your patients, even if you immediately pass them to a nurse for check in. Once in the exam room, make a few seconds of small talk to show your patients that, despite all the distractions of the office, you are now focused on them.

Don't waste waiting time. If you know a patient needs an electrocardiogram (ECG), lab work or a tetanus shot, have the nurse perform the task while the patient is waiting to see you. Explain to the patient, “Mrs. Jones, I was planning to do an ECG at this visit. Why don't I have the nurse get you started while I finish up with a patient?”

Monitor your body language. Though you may often zoom into the exam room rushed and full of energy, make a conscious effort to shift gears by speaking at a normal pace. Don't put your hand on the doorknob while talking. Instead, adopt a listening position: Sit down, put away your pen, push aside the chart and look your patient in the eye.

Examine patients carefully. Even if you know exactly what your patient's problem is just by looking or taking a history, make a point of gently touching a rash, moving a joint or palpating an abdomen.

Ask questions while examining. This will save you time and convey to patients that their problems have your attention. By simply asking, “How long have you had this rash?” you convey that you are interested and want further clarification or information.

Repeat patients' responses aloud. After a patient explains the nature of a problem, repeat the main points of what was just said. For example, you might reply, “So you say it's been like that for two weeks.” The repetition helps you focus on the problem and shows the patient you are listening.

Share your thoughts aloud. This is another good way to demonstrate that you are actively concentrating on patients and their problems. Instead of assuring, “It's just a stomach virus. You'll get over it,” try something like, “Well, there was a case of hepatitis A in the next county, but I don't think that is what you have because ….”

Schedule patients according to their needs. Maximize your time by recognizing that different patients have different needs and expectations. Consider giving busy professionals an appointment early in the day. They might prefer a more efficient “in-and-out” visit in the morning, before you've had a chance to fall behind. Conversely, elderly patients may prefer the last appointment of the day, knowing that you will be able to spend a little extra time.

Reschedule more time as needed. If a patient presents with a long list of complaints or if a particular concern is taking longer than the allotted time, consider a second visit. Instead of saying, “I don't have time for that today,” say, “I really think we need to devote more time to this at a separate visit.” Then walk the patient to the appointment desk.

Bring the visit to an appropriate conclusion. Gently explain to your patients that you wish you could spend more time with them, but the visit has come to an end: “Mrs. Johnson, it is always a pleasure to see little Joey, but my office staff is going to get after me if I don't move on. I'm looking forward to our next visit.”

Walk patients to the checkout desk. While you're at it, offer to grab the diaper bag, push a stroller, move chairs out of the way or lend your arm to an elderly patient.

Perfect timing

Even if you have only 15 minutes to spend with each patient, you can accomplish more than you think. Applying a few of these steps to your daily routine is a simple way to make the most of your time while making each patient feel important.

Dr. Jardim is a family physician practicing in Milford, N.J.

Conflicts of interest: none reported.

Send comments to fpmedit@aafp.org.

Copyright © 2005 by the American Academy of Family Physicians.
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