Brush up your communication skills
How to elicit a patient's ideas, concerns and expectations
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Here are some phrases that you can use to eliciting a patient's ideas, concerns and expectations. They have been adapted from http://www.gp-training.net/index.html
Ideas
- ‘Tell me about what you think is causing it.’
- ‘What do you think might be happening?’
- ‘Have you any ideas about it yourself?’
- ‘Do you have any clues; any theories?’
- ‘You’ve obviously given this some thought, it would help me to know what you were thinking it might be’.
Concerns
- ‘What are you concerned that it might be?’
- ‘Is there anything particular or specific that you were concerned about?’
- ‘What was the worst thing you were thinking it might be?’
- ‘In your darkest moments ...‘
Expectations
- ‘What were you hoping we might be able to do for this?’
- ‘What do you think might be the best plan of action?’
- ‘How might I best help you with this?’
- ‘You’ve obviously given this some thought, what were you thinking would be the best way of tackling this?’
Comments
Don't worry if the ones you wrote down are different to these - yours may be even better. Doctors tend to use phrases that suit their consulting style and that work for them.
Pick out one phrase from each heading that you will feel comfortable using, and try it out.
Don't worry if, when you first use these phrases, it feels a little "clunky". With practice you'll get comfortable using them, and you'll be surprised how much you find out about what's really going on in the patient's mind - and how much it improves the care that you give them.
"But I don't have time..."
These phrases only take a few seconds to ask and to be answered.
Remember, one phrase from each heading is usually enough.
You'll find that they save you time overall - you will be able to narrow your discussion with the patient down to what's really important to them, without needing to "reassure" them on things that they hadn't actually been worried about.
Think
You are called to see a young man who has unilateral loin pain. List:
- three possible concerns he may have about his pain
- three ideas that he might have about it
- and three possible expectations.
There are no rights or wrongs to these questions - just try putting yourself into the patient's mind, and think broadly.
Next page: Examples of possible ideas, concerns and expectations
Study guide by: Michael Harris
Last updated: 12 August 2007