Three phrases you can use to help patient visits stay on track

When a patient visit goes on too long and puts you behind schedule, the rest of the day can feel rushed, chaotic, and frustrating. Sometimes, a lengthy visit is unavoidable because of clinical concerns. But other times, it’s the result of trying to do too much or failing to notice that a conversation has simply gone off track.

To keep visits running on time as you meet patients’ needs, try using the following phrases:

1. At the start of the visit, say: “I understand you’re here today to talk about X. Is there anything else?” Repeat the question until the patient answers, “That’s it.” Then add your own items to the list and, together with the patient, decide which concerns you can address at the current visit and which, if any, will require a future visit. You will end up with a shared agenda to guide the visit.

2. After you’ve addressed the items on the agenda, ask: “Do you have any questions or concerns about what we discussed today?” A common mistake many physicians make is asking patients, “Do you have any questions or concerns?” Although you do need to verify that patients understand what you have discussed at the visit and give them an opportunity to ask questions, don’t make your query so broad that it invites unnecessary conversation.

3. At the end of the visit, if the patient says, “Oh, by the way,” and mentions another problem, say: “I’m glad you brought that to my attention. To deal with it effectively, we’re going to need more time, so I’d like to schedule another appointment.” Even if you’ve set an agenda, patients may sometimes wait until the end of the visit to bring up another concern, perhaps because of fear, embarrassment, or other emotions. As long as the issue is not an emergency, the best approach is to acknowledge and validate the concern but maintain the structure of the visit. Over time, this will teach patients to prioritize their concerns even before you ask them to do so.

Read the full FPM article: “Sticking the Landing: How to Create a Clean End to a Medical Visit.”