“POV: It’s 3am in A&E”

Healthcare providers often strive to follow a “one appointment, one problem” approach, particularly in busy clinical settings where time is limited. This structure allows for focused assessment, efficient documentation, and appropriate follow-up planning. It also helps manage high patient volumes and ensure each concern is given the attention it deserves. However, while this model may work well in theory, it can be challenging in practice—especially for patients living with multiple chronic health conditions.

For these patients, symptoms are rarely isolated. Fatigue, pain, swelling, or shortness of breath could stem from a variety of conditions, or from the interaction between them. It can be extremely difficult—if not impossible—for patients to know which symptoms are relevant to which diagnosis, or which concern is the most “urgent” to bring up. Many feel pressured to prioritize one issue, fearing that bringing up too much will be dismissed as unfocused or overwhelming for the provider.

This creates a mismatch between clinical structure and patient reality. What may seem like minor or unrelated symptoms could in fact be crucial pieces of a bigger picture. Patients may also withhold concerns that don’t clearly fit into the appointment’s perceived purpose, potentially delaying diagnosis or treatment.

Ultimately, this highlights the importance of flexibility and empathy in clinical encounters. While time management is necessary, providers who take a few moments to listen openly—and recognize that health concerns are often complex and interwoven—can foster better trust, more accurate diagnoses, and improved outcomes. In caring for people with multiple conditions, rigid segmentation can sometimes get in the way of truly holistic care.

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