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Reimbursement and Practice Management

Meaningful Minutes

Teddy Roosevelt

The adage, “People don’t care how much you know – until they know how much you care,” (Theodore Roosevelt) rings true for clinicians. Most clinicians have an opportunity to show they care dozens of times each day.

In their sentinel article Getting the Most Out of the Clinical Encounter: The Four Habits Model, Richard Frankel, PhD and Terry Stein, MD highlight the importance of investing in the patient’s medical concern and eliciting the patient’s input “up front” during an appointment.

I doubt if I’m the only one who appreciates a provider with great bedside manner, who at the same time respects my time and gets me in and out expediently with a great medical solution. What are some tips to get the most out of the clinical encounter?

Patients will share their medical concerns within 2.5 minutes if the provider is focused on the patient, does not interrupt them, and listens well.1 This frees up the remainder of the visit to focus on important medical decision-making.

One approach used by a local medical group for interviewing patients with chronic medical conditions starts with an important question:

  • What medical condition (presenting symptoms or concerns)
  • Brings you (the patient – not the family)
  • Here (specialty clinic or medical office)
  • To see me (specialty provider – not general practitioner)
  • Today (current medical complaint)?

The interview question is asked with eye contact, empathy and affirming verbal and non-verbal signals. It takes about 90-120 seconds to get the required information by listening to the patient’s response. In contrast, when the provider follows a template of queries, getting the same information takes 5 to 7 minutes. Asking an open-ended question helps patients feel engaged in their care. If the patient wanders during the interview, restating the question gently and resolutely can refocus the interview.

When you show you care during the first couple of minutes of a visit, the result will be more meaningful medical minutes during the remainder of each visit.

  1. Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984 Nov;101(5):692-6.

United States