PRACTICE PEARLS

USE EMPATHY AND PATIENT AUTONOMY TO ACHIEVE SINGLE-PROBLEM VISITS

Focusing visits on a single problem raises the quality of care, improves your ability to set boundaries with patients, and allows you to be paid fairly in a fee-for-service environment. Using two components of motivational interviewing, empathy and patient autonomy, can help you accomplish single-problem visits.

For example, at a follow-up visit for blood pressure, your patient Sally conveys to the medical assistant (MA) that she would like to speak with you about feeling down lately. Entering the exam room, you say, “Sally, I was expecting to talk to you about your blood pressure today. However, after talking with my MA, I am concerned about your mood. I sense that your mood might be the most important issue. Would it be OK if we focused on your mood today instead of your blood pressure and return to that issue at a future visit?”

This response combines empathy (expressing concern for the patient) and autonomy (having the patient choose her own pathway). Sally can choose to focus on either blood pressure or mood. Giving patients agency is empowering and can help reveal the actual reason for the visit.