Questions Need to be Purposeful

Being intentional with asking patients questions is important for two reasons. One, it saves time, thus making the process more efficient. Two, my thinking won’t be distracted or misinformed by extraneous, non-useful information. Asking questions with purpose takes practice, but is absolutely essential for both diagnosis and treatment. (When I take a patient’s verbal history, I typically only have 2 potential diagnoses in mind by the end thanks to effective questions.)

If the purpose of a question is to show interest in the patient’s story or to foster rapport, that is a fine purpose. Doing so, however, may confer to the patient that those answers are significant (when they aren’t). What I see novice clinicians frequently do is ask irrelevant questions about symptoms. For instance, differentiating if the pain is burning, hot, achy, or sore. While that may matter, it almost certainly doesn’t matter in the evaluation. Or if a patient says his knee clicks, the clinician dives deep into when it clicks. Again, in 99% of cases that doesn’t give you helpful information. Knowing which answers one needs and which one doesn’t is not easy - and comes with expertise. Once that skill is achieved, the process is streamlined and clinicians become more efficient at helping patients.
​--Laura