Fam Pract Manag. 2019 Jan-Feb;26(1):32.


Our patients and front-desk staff were often feeling confused after appointments about necessary orders and plans for follow-up. In response, we implemented “checkout sheets” — simple, laminated forms that list patient documents that we frequently print out (e.g., mammogram orders, lab orders, referrals, patient education handouts, and hard-copy prescriptions) and follow-up appointment options (e.g., “FU20 in 3 months with Dr. B for follow-up diabetes”). At the end of my patient visits, I circle items on this checkout sheet using a wet-erase marker, which is a great way to summarize my visit with the patient. The patient then brings the checkout sheet to the front-desk staff, who now know exactly which documents to print out for the patient and when or whether to schedule a follow-up appointment. Afterwards, the laminated sheet can be erased and reused. The checkout sheets have proven popular with our providers, patients, and office staff and have greatly improved our clinical workflow.


We don't typically go into patient visits worried about violence, but incidents do happen. One way to better protect yourself is to be more aware of your surroundings. For example, take a look at your exam room. You don't want a patient who is getting angry to be between you and the door. You also don't necessarily want to block a patient who is getting angry from being able to leave. Consider a triangle where you and the patient have equal access to the door. Second, make sure there are no easy weapons available in the exam room, such as a heavy bottle with which a patient could hit you. Our practice also has call buttons in each exam room, which are meant for notifying staff if a physician needs help with a procedure but could also be used in an emergency.


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to, or add your comments below.


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