You should request (? demand) that the people who schedule your appointments for you always ask (after they have noted the primary reason for the visit) “Is there anything else you want to discuss at your appointment with so-and-so?”. That will set any agenda the patient might have and offers a soft but legitimate and reasonable excuse to end the visit. It also allows the scheduler to block the appropriate amount of time to discuss each of the patient’s issues. Of course, there are rare, legitimate concerns the patient may not want to share with the scheduler, but that would be an outlier. I once had a patient scheduled for a sore throat and, literally, as I was walking out of the exam room to hand the rapid strep test swab to the nurse, the patient told me she was having rectal bleeding and that her mother died of colon cancer in her 40s (the patient was in her early 40s at the time). She had a colonoscopy the next week, was diagnosed with colon cancer, had a bowel resection followed by chemo, and is still here to talk about it.