Consultations: One-Step or Two-Step?

Doctors sometimes overwhelm patients with too many details and choices; while the intent is to help the decision process, sometimes the opposite outcome occurs. The most effective consultations are those in which the process is simplified and the decision is not viewed as complex. In most cases, this can be accomplished.

A more time-consuming example of over-kill, and one that I find doctors can sometimes be defensive about, is a policy of turning what could be single-consultation visits into a two-meeting process. In this environment the first visit is typically an evaluation, and the second meeting becomes a case presentation meeting.  I have only run into a few practices that do this routinely, and there are obviously some cases where two (or more) consultations may be required. However, I suggest that in most practices, the reason for having two meetings stems from the doctor’s desire to be detailed and thorough, even though that issue may not be of the same importance to the patient as it is to the doctor. In fact, if frequently isn’t.

So the desire to cover details with the patient is not necessarily a good reason to have two meetings. It’s worth mentioning that, in order to have a second meeting, the patient must travel to your place of business, while you don’t have that inconvenience. Put another way, would you be so keen to have two meetings if it required you and your staff to travel two times to the patient? Speaking as a busy parent, I can tell you that I would very much prefer to make one trip to your office, even if it means that some details may not be covered.

Secondly, most practices I work with have one visit with the patient in which both the assessment is made and the case approach is presented, and they do this routinely with no deterioration in perceived value on the part of the patient. This point alone tells us that there is little to be gained by either party with having routine cases follow a two-step consultation process. Finally, if you are serious about growing your practice revenue, having multiple meetings for routine cases will have a significant negative impact on your time management, and thereby, your ability to see more patients. For all of these reasons, it would be worthwhile to experiment with a one-step approach. My money is on better time management for you and your team with no deterioration in quality of care. In fact, if your patients were to read this post, they would enthusiastically encourage you to follow the examples of most of your peers and make the change to a single meeting, for their benefit as well as yours.