Today the quality of care in a medical office is measured largely by the patient’s visit experience. It is generally assumed that doctors provide equivalent medical care for most conditions. The patient experience and satisfaction, although separate things, are  each dependent on each patient’s expectations, which vary between individuals, cultures and over time.

Meeting these expectations was much easier when I started my gastroenterology practice.  

Back in 1978 a new patient visit with me lasted an hour, starting with the patient seated opposite me in the consultation room, where a detailed history was taken. The nurse then took the patient to the exam room to change into a patient gown and have their vitals taken. A chaperoned complete physical exam would follow, after which the patient got dresses again and ushered back to my office. In the final fifteen minutes we discussed my findings, recommendations and follow-up if required.  I had enough time to learn about family, work environment and other things on the patient’s  mind. There was enough time to connect with the patient and communicate that our office really cared about them. Between eight and ten patients were seen on an average day.

It was my office staff, me, and the patient, without a lot of external filters.


Today a new patient may wait 4-8 weeks or more for a visit that may last at most thirty minutes.  Focus is on their most pressing complaint, as there isn’t time to address everything in one visit. Office staff is frenetic with paperwork, retrieving lab and other records, handling phone calls and emergencies, AND caring for the patients being seen.

The evolution of the office visit over the last 30 years includes technology advances, such as telehealth and the electronic health record, medical consumerism, customer service expectations, doctor’s health grades online, and more patients willing to change physicians for a better experience.  


What hasn’t changed is the need for a caring, empathetic office staff and physician, creating  trust and comfort. People helping people. That’s why Protoqual was created, to help a busy office staff acquire the knowledge needed to exceed patient expectations without disrupting their work day. Engaging, bite-sized animated videos, five minutes a week. That’s all it takes.

 – Dr. Alan Altman

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