Agenda-Setting for Doctor Appointments: Healthcare that Feels Like a Doctor/Patient Partnership

“It is so cool. It’s a way of structuring the office visit so the patient and the doctor feel they accomplished something. Basically, most doctor visits are a doctor-centered visit, a patient- centered visit or a patient-centered visit with agenda setting. A patient-centered visit with agenda setting is more like a partnership, rather than the patient or the doctor running the show. [The patient-centered visit with agenda setting makes for a] tone of collaboration.” – The California Quality Collaborative, 2010

A few times since I started blogging about chronic illness, I’ve mentioned how I write out an agenda for what I hope to accomplish at each of my important medical appointments. These agendas help me to remember and speak up about the all of the various concerns that have arisen for me since my last appointment with a provider. I even let my partner read the agendas in advance, to see if I’m forgetting anything important that has come up with my health. My agendas help me and my healthcare providers to plan our time together, and they help us to pace ourselves and stay on task.

I first encountered the concept of patient/doctor agenda-setting in 2010, in a presentation by The California Quality Collaborative. The presenters spoke of healthcare practices where the patient was given a form before seeing a physician, to write up all of their concerns. This form was then reviewed by the physician, and helped the physician to figure out what the appointment would involve. It also gave the physician the ability to know in advance whether certain patient concerns would be too time-consuming to address in one appointment, which is helpful for doctor and patient to both understand ahead of time. You can read about the success of this agenda-setting methodology here.

Ideally, I share my agendas with my providers in advance, but I only feel comfortable doing this when my appointments are with doctors who know me, understand my intentions, and trust my judgment. Luckily, this is true of my primary care physician, so each month I email her my agenda a week before our appointment. I print out the agenda and bring it to our appointments, and lately she hasn’t needed a copy from me since she has also printed it out (which feels to me like an endorsement of the process). Personally, I can’t imagine making progress with the care I get for my chronic conditions without these agendas. I highly recommend that other patients see what this technique could do for them.

I would also recommend that healthcare providers work with their patients to set agendas before launching into appointments. It does wonders for helping the patient and provider to pace their appointments appropriately, so both can make the most of the time together. I recommended this practice to my colleagues when I was actively working in healthcare, and now that I’ve had great success with the practice as a patient, I’m even more excited to spread the word.

TIPS FOR AGENDA SETTING:                                             

Patients-

• Be as clear and concise as possible in your agenda. Sometimes I’ve written agenda items in a way that isn’t clear enough to jog my memory; don’t make that mistake. Remember that, if possible, you want your provider to understand what you’re experiencing just by reading your agenda.
• Be realistic about how much you can talk about in one appointment. Organize your agenda with the highest priority items first, so that if you don’t get to the last item(s) it’s ok, since that part of the agenda isn’t as urgent.

Providers-

• Remember that the patient isn’t trying to take away your power, or disrespecting you by taking the initiative to write an agenda. Your input in agenda-making is important, and the advice you have to offer about each agenda item can be invaluable.
• Even if it feels awkward or inefficient to have a minute of down-time during an appointment, it is worth it to get on the same page as your patient. Really take the time to read. Then tell your patients if you have anything to add, and if you think some agenda items will need to wait for another appointment.