‘Tell your patients to write a list!’

May 8, 2017

Consider a routine consultation – you are asked for a repeat prescription, you check their BP and then diagnose some paraesthesia in their hand as early carpal tunnel syndrome…. and just as you are about to terminate the consultation, you get hit between the eyes with: ‘My partner has just lost his job and talked about ending it all last night’ or ‘My son has just announced that he wants to change gender’.

The throw-away line at the end of the consultation can seldom be ignored. The patient may save their last minute concern out of embarrassment or a reluctance to raise the topic. You then have to deal with it there and then, and come up with some solution until another appointment can be arranged.

Set expectations at the time of booking

Good communication in the reception area and in your consulting room can mitigate situations like this by managing your patient’s expectations effectively and ultimately, saving time.

Ensure practice staff are trained about patient expectations. When a patient phones for an appointment, the receptionist should advise the patient of the standard consultation timeframe and how many issues can be covered in that time ­– one or two issues. If the patient has multiple issues, the receptionist can suggest that the patient book a long consultation.

If you have an online booking system, it could require the patient to nominate the number of issues that need to be dealt with during the consultation and then allocate a long consultation if there are multiple issues.

Avoid the ‘end-of-consult sabotage’

It’s a good idea to check with the patient early on in the consultation about their agenda to determine what their expectations are as to what will be covered during the consultation. Listen carefully to why they are seeing you and clarify any unrealistic expectations as to what can be covered in the time available.

One way to avoid the ‘end-of-consult sabotage’ is to encourage your patients to write a list of all the issues they want sorted out. This will allow you to prioritise the items on the list. The patient can help you decide the order of importance for each item and you can start working from the top and systematically cover as many items as time will permit. If you don’t get through all the items, then the patient can arrange another appointment.

More information?

Read our article ‘Managing patients who present with multiple issues in a standard consultation’ and download our posters to remind patients of their obligations when booking an appointment.

Complete our eLearning course ‘Effective communication’ or read our factsheet ‘Managing unrealistic patient expectations’.

Share your view

We welcome your feedback on this article – email the Editor at: editor@avant.org.au