Advice

I’m a doctor. Here are 5 ways to hack the 15-minute clinic visit.

Q: I feel so rushed during my doctor’s appointments. There’s hardly any time for my doctor to get to know me or to address what concerns me the most. What can I do with these hurried 15-minute visits?

A: Many patients lament how hurried their doctors’ appointments feel. Believe me, I get it. Because as a doctor, I hate it, too.

In many cases, 15 minutes isn’t enough time for physicians to get all the information they need. Many doctors end up running abysmally late trying to ensure the 20 or so patients squished into their daily schedules feel heard and get the time they deserve.

Patients are suffering and frustrated with these crammed appointments, which also are a major driver of physician burnout.

So as a patient, what can you do? If you’ve only got 15 minutes with your doctor, here are a few tips to help you get the most out of the brief visit.

1. Weave in a quick fun fact about yourself

I know this may sound odd when we’re talking about a lack of time. Consider the psychology of the physician here for a moment: Imagine you’re seeing your 11th patient of the day. It’s flu season, and everyone’s masked and hard to recognize. Tales of diabetes and high blood pressure are starting to blur together. You haven’t eaten anything since that stale granola bar during your morning commute.

And then … a revelation: A patient tells you out of the blue that they used to fly airplanes for the army. Or that their teenage granddaughter is teaching them how to ski for the first time. Or that they took up yarn-crafting during the pandemic and just finished a magnificent, crocheted penguin.

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We’re all human. Sometimes, your physician is transformed against their will into a robot. Years ago, we all went into medicine because we wanted to make our patients’ lives better - not fill out paperwork for insurance companies and write lengthy notes that meet billing requirements. These glimpses of the wonderful, unique person you are will remind your doctor that they are treating a person, and not a disease.

Decades of research in the biopsychosocial model of medicine have taught us that patient and physician outcomes are better when we integrate the patient’s story into our care. It takes an extra 15-30 seconds, but I go out of my way to ask new patients to tell me a fun fact about themselves that I make note of with their permission. In doing so, not only do I remember their medical histories better, but we both find it almost invariably brings a tiny, coveted spark of joy.

2. Lead with your most pressing concern

I like to open my visits by asking patients to tell me one thing they absolutely want to make sure is addressed today. Then I dive into other items on our agenda - such as following up on prescriptions or health screening tests.

It’s a classic scenario, and one I’ve experienced time and time again: me reaching for the doorknob at the end of the allotted visit, only to hear that you were saving your most concerning question for last.

Never save the most important thing for last - even if it’s embarrassing or it scares you. By raising your most pressing question first, your doctor will focus more time on what is truly worrying you.

3. Bring written notes to common questions

For new symptoms, your physician will probably ask a set of predictable questions:

• When did the issue start? It’s fine to just have a ballpark - but there’s big difference between a few weeks and a few years ago.

• What interventions or medications have you already tried? Know the medication names and doses - bring in your bag of pill bottles if it’ll help.

• Has anyone in the family experienced something like this? Call your family members ahead of time and ask about their medical history - it can dramatically change what a doctor decides to do next.

Rehearsing your “story” and gathering these details can help ensure our limited time is spent on diving into specifics, a physical exam and counseling - rather than searching for medication names on your smartphone.

4. Give A.I. a chance

When was the last time you met a doctor who spent the entire visit looking at you? How many seconds passed before they broke eye contact and began typing frenetically on their computers?

A.I. is starting to be used in many clinics to listen in on the conversation between patient and physician, and automatically create a note in your chart so that your doctor focuses directly on you, rather than the computer screen. You may not have much control over whether your doctor’s clinic offers it (within the next year or two, you can bet it’ll become more and more mainstream), but if it’s on the table, don’t be scared or ask to opt out.

Paradoxically, I think this kind of A.I. may be a step in the right direction to restore some humanity back to the doctor-patient relationship. Remember: A.I. in health care is heavily regulated. These technologies are HIPAA-compliant and are transcribing - not recording - the conversation.

5. Embrace medical trainees in your visit

If you get your care at a major academic center, there’s a reasonable chance you’ll encounter a trainee - medical students, residents or fellows. This may mean you’ll have to repeat your story multiple times. Once each member of the team has seen you, they’ll gather with the attending physician to come up with a plan.

I realize repeating your story can feel tiresome. But consider these two things: First, studies have shown that doctors are most empathetic when they’re fresh out of medical school. So they may well be the most devoted and sensitive member of your team. Second, when a trainee is involved in your care, you as a patient can actually get a longer appointment time. This means you have a chance to discuss details and worries in a way that may otherwise have felt too rushed with just the attending physician.

You want someone to listen to your whole story. So take advantage of the fact that trainees are dedicated to hearing you and reporting back the best assessment of your case. In my experience, they often become your biggest advocate.

Trisha Pasricha is a physician and journalist who writes the Ask a Doctor column for The Washington Post. She is an instructor of medicine at Harvard Medical School.

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