How to Optimize Short Patient Appointment Times Without Sacrificing Care

An earlier version of this article appeared on this website in April, 2024

If you’ve ever looked at your schedule and wondered how you’re going to fit high-quality patient care into 15-minute slots, you’re not alone.

Across every specialty, limited visit times are one of the top drivers of physician stress, frustrated patients, and after-hours charting. Short visit times increase the likelihood of medical errors and inappropriate treatment, drive up inbox volume and unnecessary follow-ups, and contribute to physician burnout.

While you may not have control over your clinic template, there are ways to make your day run more smoothly, without compromising care.

This guide walks you through through practical, real-world strategies that will help you to streamline visits, reduce your cognitive load, improve patient flow, and decrease your after-hours charting time. Although they are not a substitute for sorely needed systemic change, these small improvements will increase patient satisfaction and help you end the day with more bandwidth.

Pre-visit Information Collection

Empower your medical assistant to gather the essentials

• Have the MA record symptoms, including duration and severity, before you enter the room. This prepares you and reinforces the MA’s value as part of the care team.

Ask patients for their top three concerns.

• When patients list their priorities up front, you can structure the visit more effectively and reduce unexpected “one more thing” moments.

Scan these notes before entering.

• A quick review before opening the door helps you walk in with a plan and guide the conversation with intention and presence.

Standardization and Checklists:

Use quick-reference checklists for common diagnoses.

• These promote consistency, streamline documentation, and support pre-authorization when needed.

• When you take the time to make a checklist, you’ll be more likely to include all the pertinent information, which limits follow up phone calls and clarification.

Provide standardized protocols for procedures and testing.

• Clear, repeatable instructions reduce variation, support your staff, and keep visits moving smoothly.

• Standardized orders also mean less likelihood that you’ll be asked for additional information by the testing center or referral later.

Efficient Communication Techniques

Teach-Back Method

• Ask patients to explain the diagnosis or treatment plan to you in their own words. This quick check ensures they truly understand what to do next.

• While it may take an extra minute or two during the visit, Teach-Back often saves time later by reducing confusion, unnecessary portal messages, and preventable follow-up visits. It also improves adherence and patient confidence.

Closed-Loop Communication

• Closed-loop communication is used with staff, not patients. When an order or instruction is given, the receiver repeats it back (“You want a CBC and TSH today?”), and the sender confirms to close the loop.

• This simple habit prevents errors, reduces rework, and supports efficient teamwork, especially in busy clinical settings where interruptions are common.

Leverage Technology and Tools

Use EMR templates, macros, and AI tools

• Well-built templates reduce cognitive load, speed documentation, and increase consistency.

• Consider AI tools if available, but keep in mind their pitfalls. These include the potential for introducing error, adding extraneous information, and the fact that they are not written in your own words, which means that future chart review may be more cumbersome.

Provide high quality patient education resources

• Directing patients to trusted and vetted handouts or videos cuts down on repeated explanations and post-visit questions.

Delegate What You Can

Routine tasks can often be handed off to your team.

• Refills, standard lab orders, and routine follow-ups can frequently be managed by MAs or nurses using established protocol

Assign follow-up tracking to staff.

• When necessary, checking whether a patient completed labs, started a new medication, or scheduled a procedure or referral can be delegated rather than handled in your inbox.

Smarter Scheduling Strategies

Build brief buffer times when possible.

• Short breaks every couple of hours help you recover from delays, take a bio break, and recalibrate.

Cluster similar appointments.

• When feasible, grouping related visit types reduces mental switching and improves your overall efficiency.

Structure the Visit Intentionally

Sit down and face the patient.

• It immediately builds trust and helps patients feel heard — even in short appointments.

Open with: “What brings you here today?”

• This keeps the visit aligned with your patient’s priorities and reduces unnecessary back-and-forth chitchat that can derail the appointment.

The Bottom Line

By optimizing your clinic flow, you’ll improve:

• Patient care

• Patient understanding and adherence

• Staff morale and engagement

• Your ability to stay on schedule

• Your end-of-day workload and energy

Over time, these small steps can reduce your stress, improve the quality of care, and help you finish the day with a greater sense of accomplishment and control.

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“Doctor, You Just Don’t Have Time for Me Anymore”

An earlier version of this article appeared on Doximity.com in 2023 where I was an Op-Med Fellow (2022-2023).

“Doctor, I feel like you just don’t have time for me anymore.”

My 92-year-old patient Mr. Gray peered at me through his thick glasses, his bushy eyebrows knitted together. I felt my breath catch in my chest.

Mr. Gray was right. As the constraints of medical practice had tightened over recent years, time had become a limited commodity — and something I had lost control over. I did my best to make the brief encounters that now passed for office visits feel like something more, but a threshold had clearly been crossed.

It had not always been this way. Over the 20 years that I had cared for Mr. Gray, my medical practice had changed almost unimaginably.

We had gone through three iterations of the EHR, each more onerous than the last. Like many other groups faced with the economics of 21st century health care, my large cardiology practice had been acquired by a health care system several years prior. Over that time, we had gradually ceded control.

Several more patient slots had been added to the morning and afternoon schedules, meaning less flexibility for those who needed a little more time. And our scheduling department was in the process of being moved out of our office and into the larger system for the sake of efficiency.

Following our very first encounter when he was hospitalized with a cardiac illness, Mr. Gray had become a regular in my clinic. I was always happy to see him on my schedule. He might have been a little cantankerous, but he was never afraid to speak his mind. And I felt that we had achieved a great partnership.

Despite his age and long list of health issues, his mind was bright. He always asked great questions, and he loved to challenge me, but he was usually willing to accept my recommendations after we had talked things through.

Reeling from the sting of his accusation, I promised Mr. Gray that I would make the time for him. I assured him that he was important to me, and I apologized deeply.

Although I had not created this situation, I was determined to make sure that I repaired it to the best of my ability.

Mr. Gray was not the only one who had noticed this constriction of time, and ultimately he wasn’t the only patient for whom I surreptitiously bent the rules.

But his age and his medical complexity made the idea of what essentially boiled down to far less than 10 minutes face-time patently absurd.

Mr. Gray had the audacity to remind me of my Hippocratic oath. Faced with his rebuke, I felt compelled to go beyond helpless banalities about “the system” and “the computer.”

The current health care system often rewards those who see more patients, spend less time, and generate higher RVUs. A 92-year-old man’s request for physician time might seem inefficient and irrelevant by those standards.

Yet Mr. Gray reminded me of the importance of living up to the principles that had inspired me as a younger and more idealistic physician.

I contacted our scheduling department and cajoled them into placing an alert on Mr. Gray’s chart, noting that two patient slots would be required for his visits. This was not standard procedure, and I knew that it might be considered an inappropriate use of limited office time by the number crunchers in management. On the other hand, as a senior cardiologist, I had worked with the in-house office staff for many years, and my unusual request was granted without question. Mr. Gray understood that I was going to bat for him, and it was clear to me that he appreciated the effort.

From that point on, every visit with him was a reminder of why I became a physician in the first place. Mr. Gray and I were able to discuss his complex health concerns in detail, review the options, and ensure his understanding.

Over this time, I got to know Mr. Gray on a more personal level. An artist since his late 70s, he often brought in paintings that he had made, setting up the examining room as a small gallery. His art would be propped up on the examining table and the desk would be carefully arranged when I walked in. Birds, animals, buildings, historical events — all were subjects that caught his fancy. But he wasn’t only a painter.

Mr. Gray delighted in showing me photos of his raised-bed garden on his smartphone. And over time I learned more about his years in the military and later life as a farmer on the Great Plains. I believe that the trust our relationship created contributed to his longevity.

When Mr. Gray was 95, I decided to retire from my cardiology practice and return to school to study for a fine arts degree in hopes of eventually teaching in the medical humanities. I dreaded having to tell him goodbye.

I checked and rechecked his upcoming appointment, booked for my last month of practice. A few weeks ahead, I saw that a scheduler had moved the appointment to the schedule of one of our practice’s PAs. Although technically this was in line with the practice’s standards, and the PA was very kind and competent, it was not what I had promised Mr. Gray.

By that time, the scheduling department had been centralized and merged with a larger call center serving many different practices. Despite my calls and messages to the scheduling center, the appointment was never moved back to my schedule. Apparently the 30 minutes Mr. Gray required was no longer recognized as a physician appointment by the system.

Nevertheless, I managed to get hold of Mr. Gray that evening by phone. I will always be grateful for that. During our call, I let him know that I would leave him in good hands with one of the other physicians in the practice, and I thanked him for inspiring me.

About six months later, I learned that Mr. Gray had passed away. I was notified when his daughter, whom I had never met, brought one of his paintings to the office as a gift for me.

There may be those who believe this type of care is anachronistic or idealistic. It certainly didn’t optimize revenue, if we look at these longer visits purely from the standpoint of office throughput and RVUs.

But I believe that Mr. Gray’s story is a cautionary tale for these times of metrics and corporate management. When efficiency and productivity take precedence over years of connection and trust-building, we may lose something beautiful and ineffably human. And in the end, the care we provide may itself suffer.

While it may be optimal, offering two blocks of time for complex patients is not always supported by the constraints of the system. Most doctors no longer own their practices, and, as in my experience as an employed physician, they may have little say in the way their schedules are configured.

Fueled by lower reimbursements and a drive for greater profitability, many health care systems demand greater productivity with fewer resources. Meanwhile, the EHR requirements become ever more onerous.

We can’t depend on the systems that control healthcare to make the changes that we seek. It’s up to physicians to collectively lead the way toward making the patient the priority again. No one else shares our unique vantage point, nor our personal investment in the care of our patients. The time we spend with our patients is more than simply interaction and social connection, valuable as that may be.

The doctor-patient relationship is by its nature collaborative. There are tangible benefits to establishing trust. We may unwittingly break those bonds when we are perceived as rushed or pressured.

Patients may not understand the forces that have created these conditions. Instead, they may understandably interpret these experiences as impersonal and incomplete, a failure of the physician to care.

Time is a crucial element that links the science of medicine to the art of practice. As physicians, our strength lies not only in clinical expertise, but in our ability to build meaningful, purposeful connections—channels through which trust, understanding, and optimal care can flow. Without trust, even the most skilled care may be diminished. For patients with complex, overlapping conditions, or those who hesitate to ask questions for fear they'll be dismissed or misunderstood, this connection is a lifeline.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary coaching discovery session, click the button below.