How to structure the patient visit for better communication

When you’re pressed for time during patient visits, your instinct may be to jump straight into your own agenda when you enter the exam room, but doing so can be counter-productive. Patient visits tend to go better if you and your patient are on the same page.

To accomplish this, try structuring your patient visits to start with a brief moment of collaborative agenda-setting. Here’s what that looks like:

1. Orient the patient.

“I know we planned to talk about your blood pressure, but first I want to check if there are some other concerns you hoped to discuss. This way, we can make the best use of our time.”

2. Make a list.

“What concerns would you like me to know about today? … Is there something else?”

Make space for the patient to tell his or her story before the entire list of concerns is elicited, but avoid premature diving into diagnostic questions. Acknowledge that you may not be able to address all the patient's concerns today.

3. Confirm what is most important – to the patient and to you.

“My impression is that talking about your neck pain is most important. Is that right?” or “We may not be able to do a good job on all these concerns today. Which concerns are most important today?”

“In addition to talking about your neck pain, I would like to discuss your blood pressure.”

4. Seek confirmation and commitment.

“Why don’t we start with your neck pain, and then we can check in on your blood pressure? If we cannot do a good job on the other items today, then let's arrange another visit. Does that sound OK?”

Read the full FPM article: “Have You Really Addressed Your Patient's Concerns?”