Sometimes a patient’s needs evolve between the time they make an appointment in the clinic and when come home following it. They may schedule a visit with one intention, but as needs evolve, the conversation discussed in the clinic may change. It would benefit both clinician and patient if better communication happened, not just in the exam room, but before and after it. Integrating technologies like patient portals, texting, and video conferencing before and after the visit can make the face-to-face interaction more productive and higher value for all those involved. Intentions are clear, problems that need to be addressed are addressed, and there’s allowed space for follow up, should anything have been missed. This three-staged approach provides multiple feedback loops that reinforce both the patient’s and the clinician’s needs, leading to more effective visits and more satisfying discussions.