What Patients Decide in the First 5 Minutes of a Visit
The first few minutes of a patient encounter can shape trust, engagement, and willingness to follow a treatment plan. Jim McDannald, DPM, shares practical questions that can help podiatrists better understand patients’ concerns while strengthening relationships and supporting practice growth.
Key Takeaways
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Patients begin forming impressions before entering the exam room, making the practice’s online presence, front-desk interactions, and initial clinical encounter important parts of the overall patient experience.
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Asking targeted questions about daily impact, previous treatments, concerns, and desired outcomes can uncover information that might otherwise be missed and encourage patient involvement in care planning.
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Listening attentively and tailoring communication to the individual patient may strengthen trust and treatment adherence while supporting retention, referrals, and positive reviews.
Transcript
Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text.
Jennifer Spector, DPM: Hello and welcome to Podiatry Today Podcasts where we continue to bring you the best of foot and ankle medicine and surgery from leaders in the field. Today we are welcoming back Dr. Jim McDannald, the founder and director of Podiatry Growth. Last time he spoke to us a little bit about hidden revenue pockets potentially in your practice. And today he's going to touch down on what patients think and what they decide in the very first few minutes of your encounter with them. This can impact both the outcome for the patient and for your practice. So I'm really excited to hear his point of view on this. Welcome back, Dr. McDannald. We've had several guests in the past on this podcast that have stressed how important it is to establish trust with patients. We know that first impressions are key, but what decisions in your experience do patients make about their provider during those first few minutes of an appointment?
Jim McDannald, DPM: That's a really important topic. Patients decide whether they trust you long before they're in a position to judge your clinical skill. Most of this happens in the first few minutes. They're reading one thing, does this person actually see me or am I just another five or 10 minute slot on their calendar? A patient who feels rushed has basically made up their mind by minute three. Here's the part that matters most for the practice. A quiet patient is not always a happy patient. Most of the time silence means that they've checked out. They won't argue with your plan. They'll just nod and leave and never rebook, never refer and never leave a review. Your clinical outcome can be perfect and you can still lose them because they didn't feel heard. So those first few minutes aren't small talk. They're where the relationship starts and grows and a lot of your future revenue and the future care you can provide to the specific patient gets decided early in those minutes. That face-to-face is super important, but I'll also say that the way that you present yourself online, whether it be on your Google Business profile or on your website will also kind of lead that bridge to that face-to-face encounter or your front desk.
Did they have a good interaction when they checked in? So the whole patient journey starting from the time they find out about you until they see you in the chair, there's a lot of touch points that have already happened. So hopefully that people take those seriously because you want that receptive patient and make sure that you're building that solid relationship with them.
Jennifer Spector, DPM: So it occurs to me that we know it's not just what we say, it's how we say it. There's so many components to effective communication with patients. But from your perspective, how does curiosity say just asking better questions change that patient experience and potentially even outcomes?
Jim McDannald, DPM: I would say that when we're in clinic and we've studied all these different diagnosis and treatments, sometimes our exam room becomes less about the conversation with the patient and more like just the doctor explaining. I think it really needs to have better communication for the patient to feel that kind of buy-in with you. The doctor that asked questions and more than one question and then actually listens will build more trust than one who just delivers a monologue about this is the diagnosis you have, this is the treatment plan we're going to have and we're going to see you back in three weeks. I think sometimes with the way that we treat medicine these days or the really packed schedules and sometimes people seeing 30 to 50 patients a day, I understand it's really, really hard, but just one additional question and less of a monologue to the patient can be really, really helpful.
So obviously on the clinical side, when you're curious, it's going to surface things that we'd probably otherwise miss, what they've already tried, what they're actually most worried about, and then understanding what a good outcome looks like to them. That's going to change. When they get those things out loud, that's going to change how they adhere to your treatment plan. A patient who's helped shape the plan or feels going to buy in with the plan is much, much more likely to follow it. So it doesn't cost anything to ask an additional one to three questions for this patient. So it's really important that you listen and it's really important that you build that trust by asking good questions of the patient, listening and then responding to what they have to say. Seems simple, but we get busy sometimes and it's important to have that kind of reminder every once in a while.
Jennifer Spector, DPM: Absolutely it is. And I think that sometimes it's very easy to fall into the trap as a clinician of a prescribed list of questions for a given condition or concern, and we're not necessarily thinking at the patient focus level. So some of these more thoughtful, more pointed, more targeted questions could probably go a long way in helping to improve that trust and outcomes.
Jim McDannald, DPM: No, absolutely. I think there's a very specific question I'm happy to share that I think that can really be helpful. I would keep it to a handful that you use with every patient. One would be, “how is this condition or this problem affecting your day-to-day?” And they'll really unload on you and let you know what's bothering them and they'll feel heard. Obviously like talked about what have you tried already is an important question. What worries you most about this? Because maybe someone wants to run that marathon with their dad or they want to go play soccer with their kid and it's stopping you from doing that. And not only is it having a physical impact, but it's having what they feel like is an impact on the relationship. And then just asking them, “what would a good outcome look like for you?” So one frame, just an overall framework in any conversation is a person needs some of those things from you, whether it be technical advice, emotional support or strategic ideas.
So, a simple follow-up question tells you which one the patient is at and you go down the path with them. Sometimes they're very to the point and they just want to know the problem and they want to know the solution and that's kind of the conversation you're having, but other people want to kind of go down a different road with you. So the reviews and referral piece, that's not a separate activity. The moment you ask one extra question and listen to the patient, it's going to lead to better outcomes, better reviews, better referrals. It's kind of a flywheel for your marketing and for your clinic in a way. Like I said, it's not buying additional ad space or SEO skills. By listening for that three to five minutes and really letting them feel understood and at least heard by you, it's something that can really benefit the relationship, but benefit your practice as well.
Jennifer Spector, DPM: Well, as always, there's so much to learn from our conversations with you and this will not be the last of them. I know we're going to get together at least one more time to talk about a topic important to our colleagues. So thank you so much, Dr. McDannald, for joining us today. And thank you to the audience as well. We look forward to bringing you more episodes of Podiatry Today Podcast. And I'm Dr. Jennifer Spector. Thank you.
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