The “Long List” Patient

, Jillian W. Wong² and John Koo³

(1)

Department of Dermatology, University of New Mexico, Albuquerque, NM, USA

(2)

Department of Dermatology, University of California, Davis Sacramento, CA, USA

(3)

Department of Dermatology, University of California, San Francisco, CA, USA

Abstract

Dr: Hello Mr. Hawthorne. How are you today?

Pt: I’m good, Doctor. I brought a list with me so that I don’t forget to ask you anything before I leave. Can we go down the list starting from the top?

Dr: Thank you for bringing in the list. I see that you have marked all of these 15 items as important. Do you want to talk about all of them today?

Pt: Yes, please. It’s so hard getting an appointment to see you. I want to have all of my concerns addressed so that I don’t have to wait until next time.

Reflections on the Case

Patients are often asked by their practitioners and the practitioner’s medical society to create a list so as to have all of their concerns resolved in the most efficient way possible. The problem with Mr. Hawthorne’ list is its length, causing you to worry about being able to address them fully and comfortably in a single visit. It is important to take a step back and explicitly acknowledge that this patient has been proactive about taking care of his health. This well-intentioned effort on Mr. Hawthorne’s part and the ultimate product, the list, are not meant to purposefully control the visit or create unreasonable demands on your time – but to save time during a seemingly short dermatologic visit. Of note, there might be other possible explanations for a patient’s list, including insurance reimbursement issues and conflicts with the patient’s personal or work schedule, etc. Therefore, it is important to wait until the patient finishes his opening statements in order to find out his motivation for making a long list.

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