Intended for healthcare professionals

Career Focus

Keeping patient appointments to seven minutes

BMJ 2004; 329 doi: (Published 04 September 2004) Cite this as: BMJ 2004;329:s100
  1. Una Coales, general practitioner
  1. Londonufcmd{at}

As an inner city, full time general practitioner raising three children, writing books, and running courses, I need to manage my time efficiently. Here are my tips on how to keep patient appointments to seven minutes. They should apply whether you're in general practice or in a hospital outpatient clinic.


  • Be aware of the time at all times—use your wristwatch, a wall clock, or a computer monitor

  • Keep your consultation room well stocked with forms, stationery, and supplies

  • Improve your typing skills.

  • Delegate tasks. If you need to get hold of an outside line at the hospital, ask reception staff to ring and transfer the call to you

  • Use all available resources—colleagues and the internet. Ring a colleague in the surgery or at the hospital for advice. Use the Google search engine to log on to medical websites for current information

  • Be firm with late attenders. If a patient is more than 10 minutes late reception staff should tell the patient to rebook or put the patient on the emergency list if they cannot wait

  • Be firm with patients with lists. Ask patients to list the items, inform them that it is a seven minute consultation, and ask them to select the most important item and to rebook for the rest

  • Be firm with time wasters. Do interrupt and regain control of the consultation

  • Use non-verbal (body language) and verbal forms of communication to ensure patients feel as though they are being heard

  • Complete all paperwork and dictate referrals in front of each patient. Use their time and not yours

  • Delegate to the patient. Hand the patient any forms or samples to give to reception

  • Housekeeping—take mini-breaks in between patients

  • Call in sick if you are unwell.


  • Argue with the patient—for example, over antibiotics for upper respiratory tract infections. Pick your battles or you will burn out

  • Feel as though you need to do everything NOW.

View Abstract