Every primary care doctor has been there: You’re already falling behind schedule, you’ve got your hand on the doorknob, ready to go to your next visit, when your patient brings up one more thing they wanted to ask you.
How do you prevent this? One way is by making a comprehensive list of concerns at the beginning of the visit, then setting the agenda for the visit based on which concerns need the most immediate attention and which can be handled at future visits.
Making the list starts before the visit, as you review the patient’s chart. Jot down anything that seems concerning. Then ask patients what their concerns are at the outset of the visit. Maybe they brought a paper list. That can help you prioritize things more quickly. Keep asking “What else?” until they have exhausted all their concerns. This makes end-of-visit surprises much less likely.
One you’ve got the full list of concerns, decide whether you can get through all of them in the allotted visit time or whether the patient will have to schedule follow-ups for some of them. Be clear about this at the beginning of the visit so there’s less likely to be frustration later.
While you may not be able to completely eliminate the “doorknob phenomenon” from your practice, effective agenda setting makes it less likely, and keeps any last-minute concerns more manageable.
(For more on agenda setting, try the free AAFP TIPS course.)
Read the full FPM article: “Five Steps to Mastering Agenda Setting.”
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