April 7, 2021, 5:55 p.m. Margaret Smith, M.D., M.P.H., M.H.S.A. — For many busy physicians, navigating the 15- to 20-minute allotments we are allowed for office visits is a challenge. The competing priorities of patient concerns, chronic disease protocols and preventive medicine recommendations make it almost impossible to conduct a comprehensive visit and still stay on time. Yet we all want to do the best for every patient while keeping our sanity and avoiding burnout.
According to a study conducted by researchers at Duke University in Durham, N.C., using a simple agenda-setting tool at the beginning of the visit can improve patient satisfaction.
As a physician practicing at an academic medical center, I had the opportunity to participate in a residency quality improvement project on agenda setting. During our six-month project, we also found that use of an agenda-setting tool increased patient and physician satisfaction. However, use of the tool did not increase the efficiency of the clinician, but actually increased visit time because the tool was administered as part of the visit. I knew we were on to something important, but we were not quite there yet. So, when I was approached by the AAFP National Research Network to participate in development of an AAFP TIPS topic on agenda setting, I was all in.
Prior to participating in this project, I did not have experience using the TIPS tools. Although I get regular updates from the Academy and remembered seeing promotions for the TIPS library and had even visited the website to view a TIPS topic, I had never used one in my practice. I did not realize what a rich experience this would turn out to be.
The advisory team was composed of two primary care physicians, two patient stakeholders and the AAFP NRN staff team. Throughout my career, I’ve been part of many advisory committees, and I came to realize that the voice of the patient was often absent. The patient stakeholders on our committee were outspoken and passionate about optimizing the patient-physician encounter. The other physician member of the team and I have busy practices and, therefore, were vested in developing tools that would be useful in a variety of patient care settings.
It was important to maximize our time together, so the AAFP NRN team provided pre-work for each of us to think through before meetings. AAFP NRN staff developed drafts for the TIPS tools, and the advisory team provided input on the design, language used and all other aspects of the process. This was a unique partnership. Our recommendations were taken seriously and led to substantive changes to the products.
Often, when you are asked to be a member of an advisory committee, you are expected to rubber-stamp someone’s design. This was not this case for the Agenda Setting TIPS advisory committee. Patient and physician voices were heard equally and made a difference. Ultimately, the resources we developed were better than they would have been without the participation of any one of the three groups: patients, practicing physicians and AAFP staff members. The collaborative approach that the AAFP NRN fostered from the outset was fundamental to the successful development of the Agenda Setting TIPS topic. Including the two end-user groups in the development process bolstered my confidence that our final toolkit would be effective for both patients and physicians.
For physicians looking to optimize their care of patients, the Agenda Setting TIPS topic can bring us one step closer to our goal of providing the best care possible to those we serve and help stave off the burnout that can creep in when our work hours stretch out interminably and the workload threatens to overwhelm us. Lending my perspective to this project was an incredibly rewarding opportunity, and I hope other family physicians incorporate Agenda Setting TIPS recommendations into their own practice communities.