Setting the Agenda
Agenda setting is important in all clinic visits. When all concerns are put on the table up front, worrisome issues don’t ‘pop up’ at the end of the visit and the physician and patient can decide together how to spend their time. This strategy has been shown to shorten primary care visits without decreasing patient satisfaction. People remember that their concerns were addressed, not the actual time they got to spend with the physician.
The video below, created at the Mayo Clinic, shows a dermatologist and a patient setting an agenda in a specialty visit. All videos like this are a little corny, but it gives you the idea.
Here is a step-by-step approach to practice in class and in your PCP.
| STEPS | SAMPLE LANGUAGE |
| 1. INDICATE TIME AVAILABLE | “So, we have 20 minutes for our visit today. Let’s take a few moments to talk about how best to use our time together.”
Avoid using “only” – as in “we only have 20 minutes today” – which can signal impatience and make the time seem shorter than it is. |
| 2. FORECAST PLAN FOR VISIT | “I see that this appointment was scheduled yesterday afternoon after you called in due to a fever. So we’ll want to make sure we address that.”
“I know we scheduled this appointment after your last one to follow-up on your blood pressure. So we’ll take a look at that and any new issues that have come up.” “I see that today was scheduled as an annual wellness visit.” |
| 3. ELICIT PATIENT CONCERNS | “What do you have on your list today?”
“What were you hoping we could address today?” “And what else?” Experts suggest using the phrase “what else?” rather than “anything else?” to normalize multiple concerns. |
| 4. NEGOTIATE, SUMMARIZE | “OK–so we’re going to talk about the allergy symptoms you mentioned, and your diabetes–sound good?”
“I know you had a few things on your list, but I’m feeling like we really need to spend the whole visit on your chest pain since that could be serious. What do you think?” “So we will start with talking about the ringing in your ears, then make sure we address your diabetes and do a foot exam as part of that. I think we may not get to updating your vaccinations this time but we can put it at the top of our list for next time. How does that sound?” |