Why Pre-Visit Workup Matters for Physicians
Posted Jan 25, 2025
Ordering a patient's labs and imaging before their follow-up — not after — is one of the highest-leverage workflow changes an outpatient physician can make. Here are three reasons it works, plus real data from my own practice showing just how much time it saves.
Reason 1: A Lighter In-Basket
The in-basket is a nightmare for busy clinicians, and pre-visit workup drains it at the source. When labs and imaging are done before the visit, you discuss the results face-to-face instead of chasing them afterward — no triage-nurse callbacks, no portal messages, no phone tag to relay results and plans. It also eliminates the wave of predictable messages and prescription requests that normally follow a result, because everything gets addressed in the room. That's a large, recurring chunk of after-visit work that simply disappears.
Reason 2: A Focused, High-Value Visit
With results already in hand, the visit stops being social catch-up and becomes a real working encounter. You walk in with a clear plan: if things look good, you reassure; if not, you address every concern on the spot. The patient leaves with a defined plan — and, if you use after-visit summaries, written instructions to take home. You can also adjust or send prescriptions during the visit and order the next round of labs right then, timed to the results you're looking at, instead of routing that work through your staff later.
This matters financially, too. Your most expensive overhead is manpower — nurses aren't cheap. Every result-callback you hand to a nurse is paid time you could have reclaimed by handling it in the visit.
It also lets you set follow-up timing on the spot. A well-controlled hypothyroid patient might space out to six months; one whose numbers are suddenly off might come back in two. Because the labs are already done, you decide the interval in the room — no "we'll figure out follow-up after your labs," no message, no callback, no front-office loop.
Reason 3: Less Patient Frustration
Set the expectation clearly: labs done before the visit will be discussed at the visit — not messaged or called about a week early. This is on you to communicate plainly, because of a modern reality: patients now get instant notifications the moment a result posts, and with portal access they often see it before you do.
That cuts both ways. If you order labs after the visit, expect patients to see abnormal results fast and immediately message, call, or ask you to follow up — and if you don't respond in what they consider a reasonable time, frustration spikes. Pre-visit workup, with clear expectations, keeps patients calmer and your in-basket lighter.
The Data: We Studied This
This isn't just opinion — we published it. In our retrospective study of 103 patients with newly diagnosed Graves' disease (a demanding group needing frequent follow-up), physicians spent 50% less time on predictable between-visit work when labs were completed before the visit — about four minutes per patient versus eight (P=0.034). Staff time on those results-driven communications dropped significantly too (P=0.008). There's even a direct revenue angle: patients without pre-visit labs were significantly more likely to need an extra between-visit contact and to have medication adjusted between spaced-out visits with no billable encounter — which the study flagged as lost business for the clinic.
One caution: don't judge it in a week. Give a workflow change two to three months before assessing its impact. Be patient and consistent, and it will take you far.
The Bottom Line
Do the work in the visit, and order everything to be completed before the next one. Tell patients clearly that pre-visit labs will be discussed at the appointment, and give them a reasonable window to complete them based on each test's turnaround. You get a lighter in-basket, higher-value visits, and calmer patients — all at once.
Want the full efficiency system? Physician Efficiency Mastery covers pre-visit workflow, in-basket management, and finishing clinic on time — CME-accredited and built for practicing physicians.
References & Further Reading
Makwana A, Morkos M. The Business Impact of Newly Diagnosed Graves' Disease in an Endocrinology Clinic. J Endocr Soc. 2025;9(Suppl_1):bvaf149.1298. https://doi.org/10.1210/jendso/bvaf149.1298
MD Efficacy © 2026, All Rights Reserved.
By visiting this page, you agree to Terms of Use, Privacy Policy, & Earnings Disclaimer.