Fam Pract Manag. 2025;32(2):34
USE EMPATHY AND PATIENT AUTONOMY TO ACHIEVE SINGLE-PROBLEM VISITS
Focusing visits on a single problem raises the quality of care, improves your ability to set boundaries with patients, and allows you to be paid fairly in a fee-for-service environment. Using two components of motivational interviewing, empathy and patient autonomy, can help you accomplish single-problem visits.
For example, at a follow-up visit for blood pressure, your patient Sally conveys to the medical assistant (MA) that she would like to speak with you about feeling down lately. Entering the exam room, you say, “Sally, I was expecting to talk to you about your blood pressure today. However, after talking with my MA, I am concerned about your mood. I sense that your mood might be the most important issue. Would it be OK if we focused on your mood today instead of your blood pressure and return to that issue at a future visit?”
This response combines empathy (expressing concern for the patient) and autonomy (having the patient choose her own pathway). Sally can choose to focus on either blood pressure or mood. Giving patients agency is empowering and can help reveal the actual reason for the visit.
SAY “THANK YOU” TO IMPROVE YOUR TEAM'S PERFORMANCE
The simple act of saying “thank you” to the members of your health care team can improve their performance. The key is to focus on recognizing their efforts and contributions.
When researchers from the Wharton School of the University of Pennsylvania studied how expressions of gratitude motivated teams in a call center, they found that when leaders said “thank you” for objective performance results, team members felt more capable and more connected with their team, leader, and organization.1 Team members also felt more invested in the team and their leader, and more interested in contributing to the bigger picture.
Think of it not as informing team members of their accomplishments but recognizing and appreciating their accomplishments. Knowing they are good at their work is nice. Being seen and recognized for it is what builds a motivating sense of connection.2
Here's how this might look in a primary care practice:
During a team meeting, you might say, “Thank you for all your work on colon cancer screening. More than 90% of our patients 45 years and older have gotten their recommended screening.”
During a one-on-one with a team member after interacting with a patient and family, you might say, “Thank you for helping them absorb that diagnosis. We should see better treatment adherence because of it.”
Improved performance in health care translates to better patient outcomes, which is a pretty good return on the time investment of a well-placed “thank you.”
REDUCE LATE CANCELLATIONS AND NO-SHOWS
Setting clear office policies can help protect your practice's bottom line, particularly when it comes to late cancellations and no-shows. A fee for late cancellations or no-shows will help weed out people who aren't serious about being in your practice and guarantee payment if someone doesn't show up. Ask patients to provide a credit card number to keep on file in advance of their first visit. The policy should state that patients will be charged a fee if they cancel a visit less than one business day in advance or do not show. Exceptions can be made for extenuating circumstances at your discretion. Include policies as part of your intake forms, which patients must sign.
One of the most effective strategies to reduce no-shows and late cancellations is to send patients appointment-reminder texts, an option that may be included with some EHR or online portal systems. Text reminders should arrive a week before appointments. You can add reminders at three days and one day in advance as well. Some systems allow patients to confirm or reschedule appointments via text, and staff can telephone those who do not respond.
