Nobody at the practice believed ten minutes was enough. Since nobody could make it longer, they asked a narrower question: what are ten minutes best spent on?
Continuity was measured for a year: what proportion of appointments a patient had with the clinician who knew them. It had fallen to under a third.
Pattern, not presentation
Nothing about the individual consultations was careless. Every clinician was working correctly from what was in front of them; nobody’s job was to look at the shape of the whole thing.
Most of a consultation is reconstruction. If the reconstruction is already done, you get the ten minutes back.
Dr. Priya Ramanathan, general practice
Six months later
Prevention work is invisible when it succeeds, which makes it the first thing cut and the last thing measured.
“I arrive and she’s already read it,” Della says. “So we start at the actual thing.”
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