What should you do when your patient brings a list?

Today’s health care consumers are expected to be proactive, self-managed and informed members of the health care team. One way for patients to become more involved in their care is to bring a list of questions to each visit. For example, the Agency for Healthcare Research and Quality advises patients to “Write down your questions before your visit. List the most important ones first to make sure they get asked and answered.” Although many health care quality and patient safety organizations have made similar recommendations that patients bring a list of questions to their office visits, few guidelines exist as to what should be on the list, how and when the list should be presented, and how much can realistically be discussed during a standard office visit. Many patients are confused about the best way to create and share lists, and many physicians dread them. How should we respond to these patients and their lists? How many questions can we cover in one visit? What should we do if the questions on the patient’s list do not match what we want to talk about? This article explores these challenges and offers strategies for creating a shared agenda for the office visit while maintaining an efficient practice.