by Edward Leigh, MA
After you have greeted the patient / guest(s) and introduced yourself, now it is time for your opening questions / statements.
Start with a general question. The literature suggests that even if you know the exact reason for the patient’s visit (e.g., “upset stomach”), it best to still keep the opening question general, such as, “Tell me what brought you here.” The initially stated chief compliant may not be the underlying reason for the visit. This is especially true if the underlying reason for the visit is of a sensitive nature (e.g., substance abuse or sexuality issue).
BEFORE asking any details of the first issue, ask the patient, “What else?” There may be no other issues, however asking this question in the beginning will reveal all the issues to avoid the dreaded late-occurring “Oh by the way” issues. Excellent article on the subject:
“Two words to improve physician-patient communication: what else?” Link below http://www.meddean.luc.edu/lumen/meded/ipm/IPM1/TwoWordsBarrierArticle.pdf
Clinician: “Tell me what brings you here?”
Patient: “I have been having stomach pains.”
Clinician: “What else?”
Patient: “Well, sometimes, my toes feel numb.”
(If the patient has no other issues, then ask about the stomach pains.)
Too many issues and not enough time. If the patient has multiple issues and there is not sufficient time to discuss everything, this situation has to be handled delicately to retain an excellent patient experience. Do not say, “I don’t have time to discuss all those items.” Instead, use an “I wish” statement, such as by stating, “I wish we had time to discuss everything that is going on. How about if we discuss two issues and schedule an appointment to discuss the other items? How does that sound?”
Mute Yourself. Once you begin the information-gathering phase, DO NOT interrupt. MUTE YOURSELF! Give the patient 1-2 minutes to fully tell you their story and then ask for details. In the classic study by Beckman and Frankel, they found that physicians prevented patients from completing an opening statement 77% of the time and interrupted their patients in a mean time of 18 seconds. (Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984;101:692–6.)
Start your patient interview with impact through the use of powerful questions!
Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication. The Center focuses on increasing patient satisfaction and decreasing the risk of medical errors. The Center offers high-impact training, consulting and one-on-one coaching. Edward Leigh’s new book, Engaging Your Patients, is due out in the Spring of 2013. http://www.CommunicatingWithPatients.com or 1-800-677-3256