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The four-part closure statement

Jun 14, 2021 | Blog, Communication Skills for Doctors, Medical Education, Uncategorized

When I’m working with trainees, many have ideas about starting clinical encounters but few have thought about conclusions. 

When I was in grad school, a professor spoke with us about how our society doesn’t end things well — we’d rather say “see you later” than “this is goodbye.” The doctor-patient relationship  needs clear signposts to help patients understand the beginning and ending of the appointment.

Over our last four posts, we’ve discussed the importance of appointment preparationnot interrupting patients, asking “what else?” and co-creating an agenda with our patients. Now we come to the end of the visit.

Straightforward yet overlooked, I find the four-parts of the closure statement very effective.

When the time for the appointment is coming to an end… 

Link back to the agenda and remind the patient our agreed-upon time is ending: “Our 15 minutes are almost up.”

Affirm the patient’s contributions and collaboration: “I’m glad you came in today to get this taken care of.”

Set a follow-up appointment: “Let’s have you come back again next week to follow up on these test results and talk about the issues we didn’t get to today, like your shoulder pain and the forms that need completing for your insurance.” 

Give a heartfelt goodbye: “See you then. 😊


Now it’s your turn. Write down your 4-part closure statement if you don’t have one already.

  1. Time’s almost up.
  2. Affirm patient contributions.
  3. Set follow-up appoitment.
  4. Give a heartfelt goodbye.

Is there something you include in your closing statement I should know about? Tweet me at @DrMarcusG.

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