Slow Down to Speed Up: Why Unhurried Consultations Save Time

General practice can feel relentless. On bad days, back-to-back 10-minute appointments, endless admin, and always running behind can leave you feeling inefficient and overwhelmed. Suggesting to a frazzled colleague that they just need to slow down might earn you a Paddington hard-stare (if you’re lucky), yet a recent Annals of Family Medicine paper argues that true efficiency comes from unhurriedness, not speed. The authors support their claim with a comprehensive literature review and—fittingly—six months of weekly discussions. So why should we adopt an unhurried approach, and how can we do so? 

The paper highlights that unhurried conversations lead to careful, kind, and responsive care that benefits both patients and clinicians. While this sounds like an ideal to strive for, there are also practical reasons to adopt a slower, more attentive approach. Research cited in the paper reveals that clinicians interrupt patients 77% of the time during their opening statement—typically after just 11 seconds. This probably stems from a fear of lengthy monologues, but the evidence suggests otherwise. Most patients complete their opening statement in under 30 seconds, and clinicians who don’t interrupt tend to finish consultations more quickly than those who do. Patients given space to talk, often speak for shorter durations while providing more valuable information. In other words, giving patients space to talk doesn’t slow things down; it makes conversations more efficient. Feeling heard not only enhances the patient experience but also reduces the likelihood of repeat appointments for the same issue. Clear communication minimises misunderstandings, unnecessary investigations, and medico-legal risks—ultimately benefiting both patients and practitioners. While many of us learned these core communication skills during our training, the pressures of day-to-day general practice mean they can easily slip away. Taking a moment to pause, reflect, and revisit these fundamentals isn't just a helpful refresher—it’s a way of recalibrating our consultations to benefit both us and our patients.

The authors outline ten communication practices that foster unhurried conversations. Most of us will use these strategies from time-to-time and all of them have the potential to contribute to unhurried conversations. The authors note, however, that it is the combined use of all the behaviours that yields the best outcomes. 

In true NB Medical fashion, here’s your Keep It Slow Summary of the key practices:

1. Shared Turn Taking - This means giving both patients and clinicians equal opportunities to speak - encouraged through verbal or non-verbal cues to invite participation. Open-ended questions are particularly effective at facilitating this.
2. Discussion of Off-Task Topics - Small talk can really help to build rapport, reduce the experience of hurry, avoid depersonalisation and increase patient satisfaction. One study showed that this only needs a few seconds to be effective. 
3. Use of Pauses - Moments of silence naturally create a sense of unhurriedness, often occurring when a clinician pauses to consider a question, or a patient reflects on newly received information. One study found that the use of electronic health records can positively contribute to these pauses—provided it doesn’t lead to multitasking or a loss of eye contact.
4. Moderation of Pace - Matching speech rhythms fosters comfort, understanding, and mutual participation. Patients feel more comfortable when clinicians speak at a similar speed and volume as them.
5. Avoidance of Conversational Interruptions - Conversational interruptions occur when one party cuts off the other mid-sentence to change the topic. These contrast with “cooperative” interruptions, which express support or seek clarity. Well-timed, these can actually enhance communication. Ignoring patient interruptions risks overlooking key concerns or making patients feel unimportant.
6. Minimisation of External Interruptions - External interruptions can lead to more questions from the patient, increasing consultation length and clinician stress whilst decreasing clinician satisfaction with the consultation.
7. Triage of Topics - This doesn’t create unhurried conversations on its own but can help manage consultations. Involving patients in prioritising concerns and addressing lower-priority issues later, reduces pressure and allows more time for key matters.
8. Use of open-ended questions - As mentioned above – these encourage patients to freely share information and are very efficient.
9. Expression of Emotion - Demonstrating warmth, empathy, and active listening does not necessarily take more time, but does improve communication and can make patients feel more comfortable about expressing their own concerns.
10. Use of Open Body Language - Leaning forward, nodding, and maintaining eye contact are associated with increased patient satisfaction, patient participation and active collaboration in healthcare. 

Unhurried does not mean unlimited time. This is about using the time we have differently to practice focused, empathic, patient-centred care. Investing a little more time upfront saves more time overall – fewer repeat visits, fewer complaints and smoother, more satisfying consultations. Small changes in the way we consult can lead to significant improvements for patients and practitioners. Why don’t you try going slower to speed up? How about one small change? Resist the urge to interrupt, slow your pace to match the patient, think about your body language. It might make your day feel a bit less relentless.