Counseling along with looking after other health issues can be time consuming, so how can we manage our patient’s list of health concerns from the start of the consult

In General Practice, it can be extremely challenging to manage our time, especially when we add counseling into the mix.

How can we manage our time better when our patient has a long list of issues to address, but we only have a short appointment booked.

We can try the following to get all the agendas out in the open from the start, and prioritize and negotiate from there.

Consider starting with....

1. How can I help you today, or what are you hoping to achieve from today?

2. Is there something else?  Some in the health coaching community believe that it’s more “inviting” than, “Is there anything else?”  Aim to list out all of their health concerns.  Don’t be afraid to open up that can of worms.  If our patient goes into too much details, explain to them that you would simply like to zoom out and get the bigger picture first, before zooming in with the details. Be aware of your urge to avoid this step, and  “urge surf” if required.  Once we have the complete list, we can move onto next step. 

3. Assess, prioritize, and negotiate with our patient. Consider the following script. 

I appreciate that these are all important issues for you. Unfortunately, we don’t have a long appointment today, and have time for 1 or 2 problems only.  I wonder which one is most important for you.  For the other issues, can we book a 40 minute appointment?  How does that sound?  I do want to spend more time on it with you to address them properly. 

Ignore the above and take charge if there is a chest pain, or something urgent on the list. With mental health concerns, make sure we have safety first. Once we have safety, we have time to sort things out in subsequent visits.