The Visit: Time with the Physician
Physicians have limited time to meet with patients, making it exceedingly important that the time they do have is spent in the best possible way. Here are some innovative examples of processes that practices have introduced to improve the office visit.
The teamlet model is an example of how a primary care provider can partner with one or two other office personnel, such as medical assistant or nurse, as “health coaches” who can proactively orchestrate chronic illness care and prevention through pre-visit planning, in-visit closing of care gaps (e.g., by performing diabetes foot exams, providing immunizations, and scheduling diabetes eye exams), and between-visit outreach. Health coaches may also provide self-management support to patients with diabetes and other chronic diseases. Each patient cared for by the teamlet would participate in an expanded visit with the clinician and the health coach and receive regular follow-up phone calls or emails from the coach.
Team documentation, or scribing, involves a medical office staff member remaining in an exam room with a physician and patient during the medical visit to enter orders and type progress notes per the physician’s guidance.
- UCSF Center for Excellence in Primary Care: Team Documentation & Scribing Evaluation Toolkit (PDF, 622 KB)
Expanded Visit Paradigm
Health care practices have also transformed the traditional 15-minute physician visit by expanding visits beyond the primary provider encounter with pre- and post-visit consultations, between-visit contacts, and/or community care away from the clinical site.