Is This Visit Interrupting Something More Important?

By
Dana Arenz
Karen Stenehjem
Stephen Fuest
October 7, 2026

Journal Of General Internal Medicine

At a Glance

Category	Detail
Condition	Interruptions and fragmented attention in outpatient primary care
Key Mechanisms	Multiple communication channels and concurrent responsibilities divide clinician attention and disrupt workflow; the article also describes increased cognitive load and reduced efficiency.
Target Population	Clinicians, clinic staff, and patients discussed in the article’s outpatient primary care examples
Care Setting	Outpatient primary care, where in-person visits occur alongside asynchronous communication and other responsibilities

Key Highlights

Interruptions impair task performance; physician-focused investigations indicate they heighten cognitive load, diminish efficiency, and contribute to clinical errors.
Patients experience fragmented attention, and research cited in the article associates increased physician eye contact with greater patient-perceived trust.
Clinic staff act as communication gatekeepers without standardized expectations; the article links this discrepancy to stress, error risk, job dissatisfaction, and burnout.
The article presents ambient AI documentation and protected periods for asynchronous work as potential structural approaches.

Guideline-Based Recommendations

Diagnosis

The article frames interruptions as a system-level workflow problem and reports that comparable investigations in US outpatient settings have not been performed during the last decade.

Management

Consider dedicated, protected periods for asynchronous work; the article describes this as a promising workflow model.
Develop clearer system-level expectations for communication modalities and staff responsibilities; the article identifies the lack of standardized expectations as a problem.
Consider ambient AI documentation as a potential way to reduce documentation burden, with careful implementation.

Monitoring & Follow-up

The provided excerpt does not specify monitoring measures.

Risks

Interruptions can impair task performance, increase physician cognitive load, diminish efficiency, and contribute to clinical errors.
Fragmented attention affects patients’ experience; increased physician eye contact has been associated with greater patient-perceived trust.
The article links unclear staff expectations with stress, error risk, job dissatisfaction, and burnout.

Patient & Prescribing Data

Patients receiving care in outpatient primary care, as discussed in the article.

The article does not provide medication prescribing guidance. It discusses workflow approaches intended to reduce disruption during in-person visits and manage documentation burden.

Clinical Best Practices

Consider protected periods for asynchronous work; the article describes this as a promising workflow model.
Clarify communication expectations and staff responsibilities; the article identifies the absence of standardized expectations as a source of difficulty.
Consider ambient AI documentation as a potential way to reduce documentation burden and support clinician presence, with careful implementation.