Education and patient education literature provide evidence that time spent in instruction, particularly when the student or patient is actively involved, is positively related to understanding. Time spent on other tasks is not positively related to outcomes. The way in which health professionals and patients spend their time together, however, has not been adequately researched. A system is described for assessing how patients spend their time in environments where health care is delivered. When the system was employed in a multidisciplinary diabetes clinic, it was found that almost two-thirds of patient nonwaiting time was spent in assessment. Only 20% or 12 to 15 minutes, was spent in instruction; in only four of these minutes wee patients actively involved. Although it may be common sense that people learn better when actively participating in an instructional session, these data suggest that common sense may not be common patient education practice.