We’ve all been there. After finishing up a recent patient exam, shaking their hand, and reminding them about their follow-up appointment, just as I’m about to walk out the door, the patient stopped me and said, “But Dr. Fuller, I have a few more questions for you about my medications.” 

Of course, I turned around, sat back down, and answered their questions, despite being short on time. Why? Partly because I didn’t want her to leave confused, and partly because I didn’t want her to leave me a bad review. Because of the delay, I was behind on my schedule for the rest of the day. 

Responding to last-minute questions

These last minute questions seem to be a common theme, but I can’t fault my patients for wanting information about their medical concerns. I realize that patients do not want to make multiple appointments to address different issues. Still, I also realize that running behind schedule, making my other patients wait, and devoting too much of myself and my time to my patients can create a lot of frustration and burnout for myself and my office staff. 

With multiple types of visits like this in one day, I usually work through lunch and am exhausted, overwhelmed, and moody with a pile of unfinished charts to take home after my shift.

I always respected that therapists and psychiatrists can end visits with, “Well, that's all the time we have today; I will see you next week.” How can the rest of us get better at ending our office visits on time, without disrespecting our patients?

Set an agenda first thing

As soon as you walk into the room and greet your patient, ask them about what they want to discuss during the visit—politely ask them not to go into detail but to give you their concerns in brief bullet points. Once you have the list, you can say, “Okay, we have 15 minutes today; what would you like to prioritize on this visit? Anything that we don’t discuss, we can talk about in a future visit.” 

This way, you have politely asked about the issues they want to address while demonstrating boundaries in terms of time and priorities, in addition to foreshadowing that a future office visit may be necessary.

Prepare a strong closing 

If the visit doesn’t seem to be winding down and you are nearing the end of your time, you can tell your patient, “We only have a few minutes left, so let’s talk about any pressing issues…”

Set realistic expectations for yourself

As physicians, we are conditioned to put our patients first and to always be nice. Sometimes, this means we sacrifice our own happiness to please others. We don’t want our patients to think we are being rude or dismissive, but it can feel disrespectful if patients try to bend our boundaries, dictate the time of our office visits, and delay our visits with other patients. Of course, our patients may not realize they are being disrespectful in this way, but we must set realistic expectations for ourselves to stay on time with our office visits. 

Be honest

If your patients want to hold you hostage in the exam room, explain why the visit has to end. Explain that you have a waiting room full of patients, unanswered patient memos, and unopened patient charts you still need to address—while remaining polite, of course. 

Explain that you wish you had all the time in the world to answer their questions, but unfortunately, that is not the reality of your profession. Often, our patients do not understand the many hats we wear as doctors and how time-constrained we are. Being honest and forthright allows them to consider a different perspective and, hopefully, provides insight into why these boundaries are in place.