Guidelines regarding “one problem per visit” policies

Preamble

The College of Physicians and Surgeons of Nova Scotia recognizes that unexpected demands on physicians’ time can place burdens on practice schedules that are typically very tight. It is nevertheless essential that physicians respond appropriately to the needs of patients who present with multiple questions or problems. The College therefore encourages its members to be familiar with and to observe the following guidelines.

Guidelines

1. Avoid an inflexible “one problem per visit” policy. Be prepared to deal with additional problems or questions if necessary. Factors to take into account are the patient’s age, degree of infirmity, intellectual sophistication, and the distance from their home to your office.
2. Itemize and prioritize the patient’s problems early in the appointment to make good use of time.
3. Always consider the possibility of urgent or emergent problems.
4. Use tact and diplomacy when explaining why you must schedule a future appointment rather than deal with the problem immediately. (e.g. “There are other patients waiting for me right now” or “I am not set up to do that procedure or investigation right now” or “To deal properly with that question, I’ll need more time than I have right now”).
5. Recognize that office staff play a key role in communicating with patients, and brief them accordingly.

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