Have you ever wondered why your colleague was able to get important additional information from your patient, even though you thought you took a good history?
We all learned how to ask open-ended questions in school, but what if you could take that knowledge a step further by changing how you ask questions to improve patients’ medical histories.
Think about asking patients to tell you why they are there to see you; resist stating what the nurse has written down during triage. Specialists, don’t assume that patients know why they have been referred, because often times, all they know is that their provider asked them to see a specialist. Patients may be unsure about which problem they are being seen.
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Once you have established the reason for their visit, ask them why it is important for them to have this illness addressed. Patients have many reasons why they go to a provider. For example, if a patient indicates he or she is interested in losing weight, ask why, because, to your dismay, the patient may not want to do it for the health benefits. Establishing motivation is important; you can use this information to help patients attain their goals and improve their health even when it wasn’t the initial motivation.
Some patients report not wanting to take medication or are non-compliant with their medication. As clinicians, our initial instinct is to tell them why their treatments are so important, but often, we don’t give patients the opportunity to explain their reluctance. Their concerns could be about the costs or the side effects and not about the treatment itself.
Ask patients why they made this decision, because once you know you can address the concern and likely find a solution patients can live with. You could also consider asking patients what they will commit to in order to stay off of medication.
When it comes to addressing a new illness, or even an old one, ask patients what they are willing to do to better their health. This type of interviewing allows patients to co-partner with you, and it also makes patients take responsibility for their health. After all, that is what we as providers want, right?
Ask patients to list one or two things that they will commit to do by their next appointment. Record it in their chart. During the next appointment, ask them to tell you how they have done with the intention that they had set and be sure to acknowledge what they have done well.
If patients didn’t meet their commitments, ask them to tell you what prevented them from meeting their goals and then ask them to recommit. If there are barriers, figure out the problem and work out a solution with them to find a way to overcome those barriers.
If you are interested, check out the book Motivational Interviewing in Health Care by Stephen Rollnick, William Miller and Christopher Butler. I have learned a great deal from reading this book and my patient outcomes have improved. Partnering with patients instead of dictating their care makes a difference.
Ask patients how they would like their life or health to be different and take a minute to listen. You will out what is most important to your patients because then you’ll have a path to go down.
Sharon M. O’Brien, MPAS, PA-C, is a practicing clinician with an interest in helping patients understand the importance of sleep hygiene and the impact of sleep on health.
