What makes a doctor's visit effective for a patient?

How to Make a Doctor's Visit Effective

The most effective doctor's visit requires structured preparation before the appointment, active patient participation during the encounter, and clear follow-up planning afterward—with both patient and physician sharing responsibility for optimizing communication and outcomes.

Pre-Visit Preparation

For Patients

• Send patients educational materials 1-2 weeks before the appointment to help them organize their concerns and questions systematically 1
• Use pre-visit questionnaires (15-20 minutes to complete) that identify barriers to treatment adherence, functional limitations, emotional health concerns, and social/environmental needs 1
• Have patients identify their top 1-3 goals for the visit in writing before arrival 1
• Encourage patients to bring a list of all medications and any questions about their treatments 1
• Reduce missed appointments by 30% through reminder systems: send information packets about when/where to attend, parking details, what to bring, and follow up with a phone call one week before the appointment 1

For Physicians

• Review the patient's medical information thoroughly before entering the room 1
• Establish 1-3 specific goals or take-home messages you want to communicate during the visit 1
• Anticipate the patient's emotional responses and likely questions based on their clinical situation 1
• Arrange for adequate time and an appropriate private location for the conversation 1

During the Visit: Core Communication Skills

Opening the Encounter

• Use open-ended questions to start the visit, such as "What can I do for you today?" rather than closed-ended confirmations like "Sore throat, huh?" 2
• Solicit the patient's full agenda early by asking "What else would you like to address today?" until all concerns are identified 3
• Explore the patient's understanding of their disease before providing information 1
• Sit down, make eye contact, and maintain a calm demeanor to foster trust 1

Essential Questions to Ask

The following questions establish common understanding and patient-centered care 1:

• "What is it you want of me/what can I do for you?"
• "How do you see your condition going in the future?"
• "How does your condition affect you?"
• "What concerns do you have about your treatment?"
• "How do you feel about this prescription?"

Information Exchange

• Listen actively without interrupting and construct questions based on what the patient has said 1
• Address the patient's explanatory model of their illness—their beliefs about what's causing symptoms and what they expect from treatment 1
• Provide information that is timely and oriented to the patient's specific concerns rather than delivering generic information 1
• Check for understanding after providing information by asking patients to explain back what they heard 1
• Coordinate with other providers so patients receive coherent recommendations, and explain any differences of opinion between providers 1

Addressing Hidden Agendas

Be alert to four clinical situations that suggest non-biomedical reasons for the visit 4:

1. Patients unduly troubled by minor symptoms: Ask "What do you imagine is causing your illness?"
2. Diagnosis seems unimportant to the patient: Ask "How had you hoped I might help you?"
3. Patients express dissatisfaction with care: Explore this directly as their real motivation may not have been addressed
4. Visits without change in clinical status: Ask about current life stresses

Addressing Barriers to Care

Systematically inquire about practical barriers that affect treatment adherence 1:

• Financial concerns (medication costs, copays)
• Transportation difficulties
• Ability to perform daily tasks at home or work
• Emotional health (anxiety, depression, stress)
• Social support availability
• Health literacy and understanding of instructions

Post-Visit Actions

Provide Written Information

• Always give patients written information about their personal treatment plan 1
• Include specific instructions about medication timing and dosing, as patients often make incorrect assumptions (e.g., one-third of patients spread steroid tablets throughout the day rather than taking them in the morning as intended) 1
• Provide written action plans for chronic disease self-management, which significantly reduces hospitalizations, emergency visits, and unscheduled doctor visits 1

Empower Patient Self-Management

• Give patients control of their condition through structured self-management education, which improves medication adherence and reduces healthcare utilization 1
• Set realistic, achievable goals that patients can work toward between visits 1

Documentation

• Document important discussions in the medical record so all providers have access to the patient's concerns, goals, and agreed-upon plan 1

Common Pitfalls to Avoid

• Interrupting patients early: This prevents full agenda-setting and leads to unmet concerns 3
• Using closed-ended opening questions: These reduce patient satisfaction with physician listening and communication 2
• Assuming diagnosis is the patient's primary concern: Many patients seek care for reassurance, information, or help with life stresses rather than diagnosis alone 4
• Failing to address the patient's explanatory model: When physician and patient models of illness diverge without reconciliation, adherence suffers 1
• Providing only verbal instructions: Without written information, patients frequently misunderstand or forget treatment instructions 1
• Not exploring "non-new problems": Agenda-setting questions often bias toward new complaints while neglecting chronic disease management needs 3

Organizational Factors That Improve Visit Effectiveness

Structure services to address patient preferences 1:

• Sufficient time for the doctor to listen
• Continuity of care (seeing the same doctor)
• Low travel costs and convenient access
• Treatment that demonstrably relieves symptoms

These organizational improvements enhance outcomes without requiring longer visit times 1.