The Appointment Is Carrying Too Much Weight | Patient Experience in Women's Health Clinics

When I asked Dr. Somi Javaid what she consistently sees missing in menopause and sexual healthcare, her answer came immediately:

“Time.”

Dr. Javaid is an OB-GYN with nearly two decades of experience in women’s health. She founded and scaled HerMD, trained healthcare providers, and built models of care around areas of women's health that have historically been underserved.

When she teaches other clinicians how to care for menopause patients, she told me that one of the first questions they ask is how they are supposed to accomplish everything required within the time they have been given.

As she explained:

“You cannot take a thorough history, physical exam, talk to patients about risk-benefit alternatives, counsel them, answer their questions, document it, right? Send prescriptions in a five- to seven-minute period.”

She's right.

But what struck me about that conversation wasn't simply that clinicians need more time. It was how much we are expecting the appointment itself to accomplish.

On the other side of that five-, fifteen-, or thirty-minute appointment is a patient who may have spent months, or even years, trying to get there.

The patient isn't starting her journey when she walks through your door

A few weeks before my conversation with Dr. Javaid, I interviewed Dr. Shona Kambarami, an OB-GYN senior registrar with 15 years of experience across three continents.

She told me about her own experience trying to understand what was happening to her body after having her daughter. She was exhausted, her resting heart rate had reached 120, and she was experiencing symptoms she knew weren't normal.

Yet even as a doctor herself, she spent a long time explaining those symptoms away.

“I had a brand new baby, I was breastfeeding, I had a mortgage, it was COVID, I was, you know, I had things to do. I couldn't be sick.”

Eventually, she reached a point where she decided to trust what her body was telling her.

“Okay, I believe me. I believe my body. I'm going to look for help.”

And then she said something I haven't stopped thinking about:

“It took me six months and three hours to make it to that appointment.”

Six months and three hours.

That sentence captures something important about the patient experience that is easy to miss when we focus too narrowly on the clinical encounter.

The appointment may appear on a clinic's schedule as a single 30-minute slot on a Tuesday morning. For the patient, however, that appointment may represent the end of a much longer process.

It may have started months earlier when she first noticed that something felt different. She may have searched her symptoms online, wondered whether stress or lack of sleep was responsible, talked to friends, postponed seeking help, or questioned whether her concerns were serious enough to bring to a doctor.

For some women, there may also be the memory of a previous healthcare experience in which they didn't feel heard or believed.

By the time she arrives at the clinic, she isn't simply bringing a list of symptoms. She may also be bringing uncertainty about what those symptoms mean, anxiety about what will happen during the appointment, and questions about whether seeking help was even the right decision.

Yet we often expect the clinical encounter to address all of this at once.

That's a lot of weight for one appointment to carry.

The solution isn't asking clinicians to do more somehow

This distinction matters because the answer to an overwhelmed clinical system cannot simply be to add more expectations to the clinician's role.

Healthcare providers are already responsible for gathering a thorough history, assessing the patient, discussing risks and benefits, answering questions, documenting the encounter, developing a treatment plan and, where appropriate, prescribing treatment. All of that has to happen within the constraints of a real clinical schedule.

The issue, then, may not be that clinicians need to do more within the appointment. It may be that we need to reconsider how much of the patient journey is being left for the appointment to handle.

A more useful question is:

What doesn't actually need to wait until the appointment?

That is where patient experience design becomes important.

Some of the work can happen before she sits down

Consider two patients booking an appointment with the same excellent clinician.

Both receive a confirmation message with the date and time.

But one patient receives little information beyond the logistics of the visit. The other is given a clearer picture of what to expect: what the first appointment will involve, what information may be useful to bring, approximately how long the visit will take, and what typically happens afterward.

She is encouraged to think about when her symptoms began and how they have changed. She knows what the next step in the process will be. Most importantly, she has a better understanding of what the clinic is there to help her with.

The clinician hasn't gained any additional time.

But the patient may arrive better prepared, with fewer logistical questions and a clearer understanding of what she wants to discuss. That can allow more of the limited clinical time to be spent on the issues that require the clinician's expertise.

It also means the clinic has already started building trust before the patient enters the consultation room.

That matters particularly in women's health, where seeking care can involve a significant amount of uncertainty. A patient may be wondering whether her symptoms are worth investigating, whether she will be believed, whether she will feel uncomfortable raising a sensitive concern, or what the appointment itself will involve.

Those questions don't necessarily need to be answered by the clinician during the consultation.

The clinic's website, booking process, intake forms and pre-visit communication can begin answering them much earlier.

This is why an automated appointment reminder, while useful, isn't the same thing as a patient experience strategy. A reminder solves a logistical problem. A thoughtful pre-visit experience can reduce uncertainty, prepare the patient, and establish expectations before the clinical encounter begins.

The distinction may seem small, but it changes how the entire journey feels.

The experience doesn't end when the appointment does

The same principle applies after the consultation.

A patient can have an excellent appointment, leave with a clear treatment plan, and still have questions a few days later. She may forget something that was discussed, experience a new symptom, become uncertain about what to expect, or realise she needs to arrange a follow-up appointment.

None of those things necessarily mean the clinician failed to communicate.

They are simply part of being a patient.

This is where the systems surrounding the consultation can make a meaningful difference. Post-visit communication can reinforce important information, clarify next steps, explain when and how to follow up, and make it easier for patients to know what to do if questions arise.

The goal isn't to automate the relationship between a patient and her healthcare provider. It is to make sure that the relationship doesn't effectively disappear between appointments.

Good patient experience design should support the clinical relationship rather than attempt to replace it.

We need to design around the reality of care

One of the things I appreciated most about my conversation with Dr. Javaid was that she didn't frame this as a problem of individual providers simply needing to try harder.

She put the problem in much broader terms:

“The system has not only failed our patients, but it has failed our providers.”

That perspective matters.

The woman who has spent six months trying to reach the right appointment and the clinician who has a finite amount of time to help her are both operating within the same system.

We cannot solve every structural problem in women's healthcare through better workflows. Better communication cannot create more clinicians, eliminate long waitlists, or give every provider unlimited time with every patient.

But clinics can decide that the appointment does not have to carry the entire patient experience.

They can prepare patients before they arrive, reduce unnecessary uncertainty, make information easier to understand, reinforce important details afterward, and make the next step clear. They can build systems that ensure essential communication doesn't depend entirely on whether an already busy member of staff remembers to send a message.

Most importantly, they can design the patient journey so that the clinical encounter is supported by everything happening around it.

The appointment still matters enormously. It is where clinical expertise, assessment and decision-making come together.

But it shouldn't have to carry the entire weight of the patient experience.

The care begins before the appointment, and it continues after the patient leaves the room.

Listen to the conversations behind this article

This article was inspired in part by recent conversations on the Wellness & Growth Journeys Podcast with Dr. Somi Javaid and Dr. Shona Kambarami.

Dr. Javaid joined me to talk about building HerMD, women's health innovation, provider education, access to care, and the systems surrounding women's healthcare. Her experience building practices in underserved markets is particularly striking: she described announcing new locations and seeing hundreds of women show up, with thousands joining waitlists for care.

Dr. Kambarami joined me for a deeply personal conversation about perimenopause, medical dismissal, and self-advocacy, including how her own experience as a patient changed the way she thinks about helping women prepare for healthcare appointments.

Together, their perspectives point to a broader question for women's health providers:

What would change if we stopped designing healthcare around the appointment and started designing around the patient's entire journey?

Watch my conversation with Dr. Somi Javaid →

Watch my conversation with Dr. Shona Kambarami →