Office Visit Types

There are multiple types of office visits, all of which are named by the specific medical office. However, there are a few general types that have similar names, including New Patient/Establish Care or Re-establish Care, Urgent/Acutes, Non-Urgent Problems, Follow-ups, Procedure Appointments, ER Follow-ups, Physical Exams, Medicare Wellness, Well Child, Worker’s Compensation, Department of Transportation (DOT) Physicals, New Pregnancy, Musculoskeletal New Problem/injury, Vaccinations/Injection Only, and Blood Draws. Each type of visit usually has a specific amount of time allotted and, based on provider preference, a maximum number of appointment types allowed per day. We will review the Medical Assistant's role during each appointment type, possible aftercare requirements, and typical appointment length. It is important to note that the appointment times are mainly consistent with small private offices, as the bigger the clinic, the less time the provider typically spends with the patient.

 

New Patient/Establish Care Visits

New Patient/Establish Care appointments are typically scheduled for patients the office has not yet seen. Whether the patient is a newborn, child, or adult, the office will have multiple forms to be filled out. These forms can include past medical record releases, patient history (even if it is only birth history), billing, release of information, and registration. For newborn and infant visits, the appointment is typically around 30 minutes. For adults, the new patient appointment can vary from 30 minutes to 1 hour.

 

Appointments to Re-establish Care are for patients who have previously been seen in the office, but it has been more than three years since their last appointment. At a re-establish care appointment, the patient will be asked to complete all necessary paperwork as if they were a new patient. During these appointments, the Medical Assistant will collect the patient's initial vitals. This will serve as the patient's baseline until they are seen regularly and patterns can be established. This appointment typically consists of a review of past medical history, blood work, and vaccinations when necessary. Sometimes, the provider may do a physical exam if there is no specific problem and the patient's health history is not complex.

 

New Pregnancy

New pregnancy appointments typically occur between the 6th and 8th week of pregnancy based on the patient's last menstrual cycle.¹ At this visit, the Medical Assistant will take the patient's vitals and acquire a urine sample for urinalysis (this is typically used as the patient’s baseline and to check for high sugar levels, proteins, ketones, and bacteria in the urine).² The patient will have to fill out a medical history form, and the provider will review the patient's current and past medical history, date of last menstrual cycle, medications the patient is taking, and social history.¹ The provider will establish the patient's estimated due date and possibly perform a physical exam, including a breast and pap exam when needed.¹ In some offices, the provider will also do an ultrasound, but if they do not have one available, the provider will typically refer the patient to get an ultrasound and have them get blood tests done. Blood tests are used to check the patient's blood type and hemoglobin levels, check for antibodies, and to detect infections.¹ These appointments are typically 45 to 90-minute visits, depending on whether or not the patient receives an ultrasound.

 

Physical Exam Visits

Physical Exam appointments happen yearly; this type of appointment is for the provider to assess the patient’s overall health, address the patient's concerns, complete any age-related screening tests, administer any needed immunizations, and collect blood work, as appropriate. The Medical Assistant’s responsibility is to set up for a pap and breast exam if necessary, collect all patient vitals, including an eye exam, give them their physical exam paperwork, address any questions that the patient has about the paperwork, give questionnaires, and address any necessary aftercare. Physical exams are typically 20-minute to 1.5-hour appointments, depending on practice size. 

 

Medicare Wellness Visits

Medicare Wellness appointments are for patients who have Medicare insurance. During a Medicare appointment, the provider will assess the patient’s health, perform any necessary age-related screenings (cancer, depression, etc.), and monitor the patient's health risks due to age. The Medical Assistant will gather the patient's vitals and give them the necessary questionnaires. Medicare Wellness exams are typically 30-45 minute appointments. 

 

 

Well Child Visits

Well-child appointments are for children from birth to 18 years of age. During a well-child exam, the provider will assess the child’s overall health and address any questions from the child, parent, or guardian. At this time, if needed, sports physicals can also be done for the child. The Medical Assistant will acquire vitals and help with paperwork if necessary. The Medical Assistant will also complete any aftercare, including but not limited to vaccinations and procedures like ear lavages. These appointments are typically scheduled for approximately 30 minutes.

 

Urgent/Acute Visits

Urgent/Acute visits are appointments for time-sensitive issues, including urinary tract infections, earaches, minor lacerations, new lesions, migraines, upper respiratory infections, and sore throats. At this visit, the Medical Assistant will take the patient’s vitals and a brief history of the present concern; the provider will assess the patient's issues. The Medical Assistant may be asked to perform point-of-care tests such as Strep, Flu, RSV, COVID, or urine dips. They can also perform ear lavages and administer medications (such as pain relief for migraines or antiemetics for nausea and vomiting). These appointments are typically scheduled for 15-30 minutes, depending on the complexity of the problem. If the patient has a laceration that needs stitches or staples, the provider may require 45 minutes to 1 hour. 

 

Non-Urgent Problems Visits

Non-urgent problems are appointments for issues that are chronic or long-term in nature; this includes concerns with persistent rash, contraception discussion, or non-acute mental health concerns. These appointments are typically not urgent and can be scheduled for a few days out. The Medical Assistant will take the patient’s vitals and have the patient complete necessary questionnaires to aid in the clinician's assessment. These appointments are typically scheduled for a 20-30 minute time period. 

 

Musculoskeletal New Problem/Injury

Musculoskeletal New Problem/Injury appointments, sometimes called Orthopedic New Problem/Injury appointments, are for patients with issues or injuries to their musculoskeletal system, which includes bones, joints, ligaments, tendons, muscles, and nerves.³ At this appointment, the Medical Assistant will take the patient’s vitals and a brief history of present concern. After the provider sees the patient, they may send a referral for diagnostic imaging or to any specialty offices like physical therapy, acupuncture, osteo-manipulative treatment, chiropractor, or massage therapies. This appointment is typically scheduled for 15-20 minutes.

 

Follow-up Visits

Follow-up visits are appointments for issues requiring more than one visit or surveillance. This can include medication check-ins, mental health status check-ins, ensuring the patient is stable or improved on a treatment, post-op care, wound care, wart treatment or re-treatments, IUD post-insertion check, and test of cure after communicable disease/infection treatment. Short follow-ups are typically 15-30 minutes, and long follow-ups are 30-45 minutes. The Medical Assistant will collect vitals and give questionnaires if necessary. In some offices, the provider will be checking in on the patient's diabetes and may want an A1c done before coming into the room; the Medical Assistant can draw this. 

 

ER Follow-up Visits

Hospital/ER follow-ups are appointments after a patient is in the hospital, whether for a procedure, surgery, or emergency.  When the patient is leaving the hospital, their discharge summary gives instructions to follow up with a specialist or primary care provider within a certain amount of time; the office will typically get a copy of the visit and discharge, so they will see the recommended time for follow-up. For an ER follow-up, the Medical Assistant will take the patient's vitals and do any after-care necessary, like blood draws or medication administration. ER follow-ups are typically 30-45 minute appointments. 

 

Procedure Visits

There are many types of procedures that can be performed in the outpatient clinic setting. Some examples include Incision and Drainage (I&D), Biopsy, IUD or Nexplanon insertion/removals, Cryo or Trichloroacetic treatment of warts or moles, joint injections, or IV antibiotics/fluids. With procedure appointments, the Medical Assistant will be required to set up or set out any instruments and supplies needed, collect the patient’s vitals, give the patient the procedure consent form to review, and answer any questions regarding the consent form. The Medical Assistant may also be required to assist the provider with the procedure. Once the procedure is complete, the Medical Assistant will gather all specimens (if any) and prepare them for the laboratory. The Medical Assistant will need to clean up the exam room per infection prevention standards and ensure all supplies and instruments are cleaned and/or sent for cleaning (if sterile processing is required). The times can vary for each procedure, but often will require at least scheduling a 20-minute slot.

 

Worker’s Compensation Visits

Workers’ Compensation appointments are for patients who have had an accident at work and need to have an appointment or multiple appointments. Some offices do not complete Workers' Compensation appointments but refer them to Occupational Medicine Clinics. During these appointments, the provider will assess the injury and refer for any necessary imaging or specialty offices like physical therapy, acupuncture, osteo-manipulative treatment, chiropractor, or massage therapies. The Medical Assistant will collect the patient's vitals, send referrals to specialty offices, or help the patient schedule imaging. These appointments are typically around 30 minutes. 

 

Department of Transportation (DOT) Physical Visits

Department of Transportation (DOT) Physical exams care for patients trying to acquire a Commercial Driver’s license. At a DOT physical, the Medical Assistant will have the patient leave a urine sample for urinalysis, collect the patient's vitals, and complete hearing and vision exams.⁴ The provider will assess the patient's overall health and fitness for DOT. This appointment is typically 30-45 minutes.

 

Vaccination/Injection Visits

Vaccination/Injection appointments are typically scheduled with the Medical Assistant; the provider will order the vaccine(s) or medication(s), and the Medical Assistant will administer the injections to the patient. Typically, the medications or vaccinations administered have been previously discussed with a provider or are a long-term therapy. Some examples of injections given at these kinds of visits include Depo Provera (a long-term contraception), antibiotics like ceftriaxone or penicillin recommended based on lab results and previously discussed with the patient as the therapy plan by a clinician, routine vaccines like Tdap, HPV, Flu, COVID, RSV, or subsequent vaccines like rabies or shingles. This appointment is typically 15-20 minutes. 

 

Blood Draw

Blood Draw appointments are typically scheduled with the Medical Assistant. During this appointment, the Medical Assistant will complete a blood pressure check on the patient and then draw the blood for the patient. This appointment should only take 15 minutes at most. 

 

The different types of visits depend on each office. Every office is different, and some providers will need more or less time for each appointment.  Knowing how the office works, its protocols, and how to schedule each appointment is vital for the Medical Assistant. To learn more about office visit types, specialty appointments, and up-to-date medical advances applicable to Medical Assistants, check out CMAreview.com.

 

References

1. Mayo Foundation for Medical Education and Research (MFMER) (2022, August 6). Pregnancy week by week. Mayo Clinic. Retrieved January 25, 2024, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882
2. American Pregnancy Association (2021, December 9). Getting a Pregnancy Urinalysis: About Prenatal Urine Tests. American Pregnancy. Retrieved January 25, 2024, from https://americanpregnancy.org/prenatal-testing/urine-test-urinalysis/
3. The American Academy of Orthopaedic Surgeons (2022, March). Orthopaedics - Orthopaedic Surgeons. OrthoInfo. Retrieved January 25, 2024, from https://orthoinfo.aaos.org/en/treatment/orthopaedics/
4. Concentra (2019, September 30). What Does a DOT Physical Consist Of? Retrieved January 25, 2024, from https://www.concentra.com/resource-center/articles/what-does-a-dot-physical-consist-of/