Step 1
Prepare for the visit
Your appointment will be short. In one careful study, doctors spent about 11 minutes face to face with each patient. In another, the main concern got about five minutes, in a visit that covered six topics. Good evidence
So preparation is the whole game, and this is where we can help.
It is easy to walk out and realise you never said the thing you came to say. The surest way to prevent that is simple. Before you go, decide the few things that matter most. We can help you choose them. Then bring them on one page, and hand it over as you sit down.
Sources: Gottschalk and Flocke, Ann Fam Med 2005; Tai-Seale et al., Health Serv Res 2007. Grade B.
Three lines are enough — in your own words.
- The one question you most need answered.
- What is different since the last visit.
- The point that must be raised even if time runs out.
Then get it to them ahead of time. Gather any results, letters or records you already have. Send your one page through the patient portal the night before. That way it is in your chart when the doctor opens it. It is not being read for the first time while you sit there.
The night before is early enough for the doctor to read it first. It is late enough that you have stopped adding to it. Sent days ahead, it tends to cause worry, because more keeps occurring to you. So hold it until then.
If something important comes up after you have sent it, add a short "one last thing" message. Don't rewrite the whole page.
The one goal is simple: your own words, in front of the doctor and on the record, before the visit begins.
Not for anything urgent. A portal message can sit unread for days. Chest pain, sudden weakness or confusion, trouble breathing, heavy bleeding: these do not go in a portal message. Call emergency services or go in, or use Is this urgent?
Not sure how to use your portal? It almost certainly has a help desk that will walk you through it. Look for the phone number on your clinic's website, or on the portal's login page. Every portal works a little differently, so that help desk can guide you better than any one set of steps we could give.
You will hear "seven minutes" used for this, by us too. It gets used in two ways. Some people believe it is set by how visits are paid for. Others use it as a rough average of how long a visit runs. Those are different claims.
No payment rule sets a minimum or a maximum time face to face. Since 2021, office visits have been billed on the total time a clinician spends on your care that day, or on how complex the decisions are. Good evidence
Sources: US office-visit billing rules, 2021 revision, and our own reading of them, June 2025. Grade B.
Here is what careful measurement finds.
- Observers with stopwatches measured about 11 minutes face to face per patient, in one small study. Good evidence
- Computer records from 21 million visits in 2017 put the average exam at about 18 minutes. Strong evidence
- In videotaped visits of about a quarter of an hour, covering six topics, the main concern got about five minutes. Good evidence
Sources: Gottschalk and Flocke, Ann Fam Med 2005 (B); Neprash et al., Med Care 2021 (A); Tai-Seale et al., Health Serv Res 2007 (B).
Where does the rest of the time go? Watched through the working day, doctors spent about a quarter of their time face to face with patients. About half went on the record and desk work. Most nights added one to two hours more. Good evidence In one large hospital network, primary care doctors spent a median of about 36 minutes on the electronic record for each visit. Strong evidence
That work is measured, and it is billed. The work that finds an uncommon diagnosis is not measured at all. That is the work of hearing the whole story, and of connecting what different parts of the body are doing. The fault is in how the time is structured, not in the people working inside it.
Sources: Sinsky et al., Ann Intern Med 2016, 57 doctors in four specialties (B); Rotenstein et al., JAMA Netw Open 2023 (A).
Time also shows up in decisions. Across 8 million visits, shorter visits were linked with more antibiotic prescriptions that did not fit the illness. Strong evidence A group of general internists argued in 2015 that complex patients may need 30 minutes or longer. That is an expert opinion. Early evidence
Sources: Neprash et al., JAMA Health Forum 2023 (A); Linzer et al., J Gen Intern Med 2015, an expert opinion (C).
What keeps this honest: these are US studies, some of them 20 years old, and visit length varies widely. The point does not depend on the exact number. The visit is short, and far too short for a complicated story. That is why the work you do before you arrive matters so much.
Nothing here is a diagnosis. If anything is urgent, call your doctor or emergency services now. That means chest pain, trouble breathing, a stopped or sharply reduced flow of urine, or fever with back pain.