Time Demands

Time is one of the greatest challenges for the busy practitioner. Nothing disrupts effective communication more than patients' perception that the physician does not have time to address their problem.

Barriers

• Walk-in patients, who reduce physician time spent with prescheduled appointments.

• Insufficient length of time scheduled for complexity of the visit.

• Hidden agendas of the patient.

• Time for dictation and documentation.

Bridges

• Open-access scheduling. Predict urgent care needs, and create adequate same-day appointment times (Murray and Tantau, 2000).

• Improved triage on the phone. Have appointment staff ask patient if the scheduled amount of time will be sufficient to cover all the issues, or mark certain patients for an extended visit if they typically require extra time.

• Ask patients to bring a problem list with them, and ask them to show the list to the physician at the onset of the appointment. Items can be prioritized and time properly allotted for the visit. Schedule follow-up appointments for lower-priority items.

• Consider dictating or documenting while still in the room with the patient. This will lengthen the contact time with the patient and allow the patient to add any missing information to the record, as needed.

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