On average, family physicians address approximately three or four health problems per patient visit and even more for patients with chronic conditions. Given the complexities of many patients’ health issues, how can you make the most of patient visits? Christine Sinsky, MD, a general internist and vice president of physician satisfaction at the American Medical Association, offers the following tips.
Sinsky advocates pre-visit planning and recommends enlisting the help of nurses for this task. “The day before, the nurses will review the records of all the patients scheduled for the next day,” she says. Nurses can then brief physicians on individual patients, their preventive care needs, and any new test results before the doctor heads into the examination room. This way, physicians can get right to the patient’s main concerns.
Know the Visit Agenda
Before the visit, make sure to familiarize yourself with what the patient wants to discuss and what you need to address. Sinsky’s office asks patients to complete a one-page pre-appointment questionnaire that elicits the reason for the visit, problems with current medications, and a general review of lifestyle and organ systems.
Consider Pre-Appointment Labs
If you know what tests a patient needs before the visit—such as routine tests for a chronic illness—Sinsky suggests ordering labs and other tests before the patient’s next appointment. Pre-appointment lab results can then be discussed face-to-face with the patient at the visit, eliminating the need for follow-up when results become available.
Physicians should know a little information about the patient’s work, hobbies, social life, and other important nonhealth-related factors. Sinsky asks the nurse at her organization to report “something medical and something social” before she joins the patient. “This helps me understand where the patient is coming from. For example, did the patient’s husband just die, or did they just have a wonderful vacation? Those are two very different contexts,” Sinsky says.
Physicians may hesitate to ask patients personal open-ended questions (such as, “Tell me about yourself”), wrongly assuming that such a conversation will take too much time. However, such questions can actually be efficient ways to reveal key patient information, Sinsky says. “Patients will almost invariably tell you about all the contextual things you need to know, what’s important to them, and their objective for the visit."
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