Family physician Robert L. Wergin is all too familiar with the challenge of finding enough time to spend with his patients. Since he began practicing more than three decades ago, the Milford, Neb.-based physician has seen the amount of face-to-face time he spends with patients fall. He attributes that to his EHR (documenting while interacting with patients is difficult, he says), the complicated regulatory environment, lack of standardization of quality metrics among payers, and complicated payer requirements.
The resulting time crunch, says Wergin, who is president-elect of the American Academy of Family Physicians, takes a heavy toll. "In my practice and in family medicine, I think relationships are important — you knowing me and me knowing you," he says. "I think there are evidence-based articles that show that just that one thing can improve your outcomes by almost any measure."
But Wergin doesn't need to read those articles to know that this is the case — he sees it on a daily basis. Just recently, one of his elderly patients visited his practice because he was not feeling well. As soon as Wergin began interacting with the patient, he sensed that something was seriously wrong. "We ended up being much more aggressive than I might have been with someone I didn't know," he says. "I knew his cognitive functioning and alertness was changed and we ordered a CAT scan and he actually has a brain tumor that we diagnosed early."
Many of you have similar stories to share, and you don't need to be told how important your relationships with patients are. But as the amount of time you can spend with them decreases, you do need to find new ways to protect those relationships. Here are some simple ways to ensure that you are maximizing your patient visits.
Start off right
Since you're already pressed for time, getting patients back to your exam room on time is critical. One way to help guarantee patients are ready in the exam room when you are: streamline patient check-in, says Atlanta-based practice management consultant Elizabeth Woodcock, founder of Woodcock & Associates.
Any information that patients can fill out and return to your practice prior to appointments, such as medical history information and administrative forms, should be completed and returned in advance, says Woodcock. That way, staff won't need to gather that information at check-in, and they will have extra time to address any unexpected questions or problems that arise, such as issues related to benefits eligibility.
Asking patients to complete and transmit pre-visit paperwork, of course, will require some pre-visit communication. Since most patients tend to return paperwork to practices the same way they receive it, Woodcock recommends electronically transmitting paperwork to patients, such as through a patient portal. That way, patients will likely send the information back through the portal electronically, which will help streamline data entry.
Pre-visit paperwork is not the only homework that staff should assign patients. They should also ask patients to bring a list of relevant health information with them to appointments. That list should include any medications and/or supplements they are taking and the dosages; any allergies or recent allergy changes; and any major life changes or new stressors, says Wergin, adding that patients with acute illnesses should list their symptoms and the duration of the symptoms. When patients bring this list with them to the exam room, it streamlines the patient visit because patients can quickly consult it when questions arise, says Wergin.
To make certain patients know what to bring with them to appointments, consider posting this information on your practice's website or patient portal, asking staff to remind patients when booking and/or confirming appointments, and/or routinely highlighting it in your practice's patient newsletter. Wergin's newsletter, for instance, often includes a short "tips on seeing your doctor" blurb.