Two Great Questions to Ask Your Patients

Thought I would take a detour from the usual “research evidence” post and write about something I have found incredibly useful in my clinical practice. I have also made a vague attempt at some humour….

I now regularly utilise key two questions in my assessment and management of patients, and without doubt they have given my clinical practice a major boost. They are questions that a couple of very experienced clinicians once suggested I consider asking my patients.

The first one:

What is your understanding of what is wrong with your (insert injured area)?

Obviously there can be a myriad of answers and “shades of grey” but I generally find that patients fall into three categories:

1. The “Switched On” Patient:

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This patient tells you correctly what is wrong with their painful area. This can make treatment really easy when you see that your assessment findings match up to their thoughts. It is however important to communicate to them that they are correct, and also tell them and what they can do about it!

2. The “I don’t know. I am here for you to tell me” patient:

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Great patients to deal with. These patients aren’t silly or stupid, they are a blank page.  Make sure you don’t get lazy and think that you don’t have to explain things well to them or else you might create…..

3. The “Mis-informed” patient:

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These patients can be tricky as you can hear things like:

My SI (sacroiliac) joint keeps slipping upwards and I must learn to hold my muscles tight to keep in place!

My disc is out and needs to be pushed back in!

My sacral mis-alignment is causing my headaches!

These poor patients have often been incorrectly taken down a path of diagnosis and/or treatment that quite clearly does not match up to what we know is best practice regarding their condition. They also may have fallen prey to:

doctor-googlePleasingly by asking them “What is your understanding of what is wrong with your (insert injured area)?” we can straight away get an idea of what beliefs we are dealing with and what we may have to challenge/disprove via our assessment and management. This is not always easy, and sometimes can be downright impossible to do, but I personally think that if you do not target these beliefs you will be battling to improve the patient and have them be compliant with your treatment.

The second question I routinely ask at the end of my first session, or certainly by the end of the next session is:

What is your understanding of what is wrong with your (insert injured area)?

No bonus points for seeing that this is the same as the first question!

Asking this question again will demonstrate to you how well you have explained things and how receptive the patient has been to it. If you are running a bit behind time you might not want to ask this at the end of the session!

Would love to hear some of the questions you think are important to ask our patients. I am sure there are plenty. I have a few more that I plan to post about as I think communication and listening are two of the most critical aspects of our clinical practice.

Thanks for reading.

Posted in: Clinical Reasoning

About the Author:

Mark is a Specialist Musculoskeletal Physiotherapist who consults at both Insight Physiotherapy and Pain Options, in Perth, Western Australia. He specialises in the assessment and management of persistent/chronic musculoskeletal pain. In addition to his clinical role he maintains regular involvement in education of the profession having held a Teaching Fellow position at the University of Western Australia for 10 years and regularly presenting at courses and seminars through the Australian Physiotherapy Association and private education sector. Mark is also a Facilitator for the Australian College of Physiotherapists Specialisation Training Program and a Branch Councillor on the Western Australian Branch of the Australian Physiotherapy Association.

2 Comments on "Two Great Questions to Ask Your Patients"

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  1. Leroy Dekker says:

    Hi Mark

    First of all, I really enjoy reading your informative posts, please keep them coming.

    Secondly, I was sitting in on a patient assessment with Tim Mitchell last year and walked away learning many new things however, there was one question that stood out to me. Ironically it was “What is your understanding of what is wrong with your (insert injured area)?” I have been incorporating it into my own clinical practice and I am amazed at how helpful this question can be in setting you up for a more informative and productive session. I feel as physiotherapists we can sometimes become so invested in telling patients what the diagnosis is and delivering them with improved understandings of their conditions/injuries that we forget to question their own beliefs and understandings, which ironically can have a significant impact on their recovery.

    Thank you and look forward to reading through further posts.

    Kind regards

    Leroy Dekker

    • Mark Gibson says:

      Thanks Leroy. I am bit slack on my replies to comments, sorry for the delay!! 🙂

      I agree, that one question is so important and tells you far more than a lot of our other testing and questions do!

      Thanks again.

      Cheers
      Mark

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