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A couple of weeks ago, I posed this question to the Huddle Slack community:

My initial plan was to use the responses to write an Inefficiency Insights report on real-time patient feedback to help improve the patient experience.

However, one reply from long-time Huddler Andi Schmerin really got me thinking. She described an experience that demonstrated what excellent primary care looks like: timely appointments, comprehensive yet efficient care, and personalized communication that respects the patient's knowledge and addresses their actual needs.

This is ideal, peak clinical care (hard to find!)

Her experience inspired me to create—or add to—a patient experience framework: The Three T's of Care:

If we as clinicians and providers strive to hit these three T's, I believe we can offer truly unparalleled care to patients. Let me explain….

Andi's experience started with something simple but profound: she was seen on time. Not 15 minutes late. Not 30 minutes late. On time.

We as physicians and providers hold patients to strict standards. Most offices have a "15-minute late" policy, under which patients risk losing their appointment slot. Yet we routinely run 30, 45, sometimes 60 minutes behind without the same accountability.

Clinical care is unpredictable, I know that.

But timeliness doesn’t just mean punctuality. It also involves respecting that our patients have jobs, childcare responsibilities, and lives outside our exam rooms. It's about efficient scheduling systems that don't overbook (or book way more efficiently). It's about clear communication when delays happen.

When we consistently run on time—or at least communicate proactively when we can't—we signal to patients that their time matters as much as ours.

Thoughtfulness is about seeing the patient in front of you, not just the diagnosis or the checkbox on the visit template.

In Andi's case, her PCP asked about her professional background and adjusted the conversation accordingly. They could discuss her care at a more advanced level because the physician took the time to understand who she was.

Thoughtfulness also showed up in clinical decision-making. When Andi wanted an early mammogram, her PCP didn't dismiss the request or rubber-stamp it. They had a nuanced conversation rooted in evidence, acknowledged her OB's perspective, and helped her make an informed decision.

This is what thoughtful care looks like: adapting your communication style, considering the patient's broader context, and engaging in shared decision-making rather than top-down directives.

Another Huddler, Yoko Terretta, shared similar experiences in the community. Her oncologist proactively rescheduled her appointments to minimize wait times between visits. Her surgeon believed her the first time about unusual pain and ordered appropriate follow-up. They were thoughtful responses to individual patient needs, not extraordinary interventions.

There’s a tension here. I get that. Thoroughness doesn't mean ordering every test or addressing every possible concern in a single visit. But it does mean being comprehensive in a way that actually serves the patient.

Andi's PCP accomplished this by providing routine GYN care, a service many primary care physicians have stopped offering despite the growing difficulty patients face in accessing OB/GYN appointments. The PCP also took ownership of her stable migraine management, eliminating the need for a separate neurology visit when her treatment plan had been unchanged for years.

That's thoroughness: addressing the full scope of a patient's needs within your scope of practice, reducing fragmentation, and delivering coordinated care.

It's the opposite of the "that's not my area" approach that forces patients to bounce between specialists for conditions that could be managed in primary care.

These three principles are actionable, and I've been trying to implement them in my own clinical practice during residency.

Timeliness has been the hardest for me to control. As a resident, I don't set the clinic schedule. I don't decide how many patients get booked in a four-hour block. But I can control how I communicate when I'm running behind.

When I know I'm delayed, I ask the nurse or medical assistant to let the patient know. A simple "Dr. Dashevsky is running about 20 minutes behind today, we apologize for the wait" goes a long way. It acknowledges the delay and respects their time enough to give them a choice: wait or reschedule.

I've also started being more realistic about appointment complexity. If I know a patient needs extensive counseling or has multiple chronic conditions, I bring the patient back earlier if the patient before me didn’t show up (which is incredibly common).

Thoughtfulness is where I try to differentiate myself. I start every visit by asking patients what brought them in today, not just reading the chief complaint off the chart, but actually listening to what they want to address.

I adjust my language based on the patient in front of me. Some patients want detailed explanations of pathophysiology. Others want the bottom line. Some appreciate when I show them their lab trends in Epic. Others just want to know if everything looks okay.

I also try to acknowledge when something isn't my area of expertise. If a patient asks about a subspecialty issue I'm not comfortable managing, I say so, and then I make sure they get connected to the right specialist rather than giving half-baked advice.

Thoroughness is about knowing when to do more and when to do less. In residency, there's pressure to be comprehensive to the point of excess. Every patient gets a full review of systems. Every symptom gets worked up.

But thoroughness is about addressing the full scope of a patient's needs in a coordinated way.

I've learned to ask: "Is there anything else you were hoping to discuss today?" at the end of visits. Sometimes the answer is no, but other times the answer reveals the real reason they came in, perhaps a concern they were nervous to bring up at the start.

When I can address multiple issues in one visit without compromising quality, I do. When I can't, I'm transparent about it, and we prioritize together.

The Three T's are simply basic principles of good clinical care that get lost in the chaos of modern medicine. And when we deliver on them consistently, patients notice.

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