Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Asking patients the right questions isn’t as easy as you think

Mary Braun, MD
Physician
August 19, 2019
632 Shares
Share
Tweet
Share

I made my 10:20 a.m. patient wait while I told my support staff about my day off.

“I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn’t panic while we waited for EMS. Her husband hit a tree with their van, and she was lying on her back, on the floor between the two front seats. She told me her seatbelt on had been on. This didn’t make any sense, so I asked her more questions. It turned out she had her seatbelt on, but not buckled. In what universe would that keep her safe?”

We all laughed. Eventually, my MA said, “Maybe she thought it instantly clicked if she was in an accident — you know like how an airbag deploys really fast.”

This is why I love working with this MA. She can make connections I do not.

I went to see my patient and realized he was not taking some of the meds on his med list even though the MA’s note said, “The patient confirms that the medication list is complete and accurate.” The way the MAs confirm the med list is to ask the patient if there are any changes to their meds. When the MA asks this, she means, “Are you taking all the meds we have prescribed in the way we’ve prescribed them and has any other doctor added other meds since we last updated your medication list?”

When the patient says, “Nope, no changes,” he means, “I’m still not taking that blood pressure medicine I can’t afford that you prescribed a while ago. I’m still taking my cholesterol medicine in the morning because I can’t remember to take it at night, and I’m taking it every other day because I read on the internet that it’s bad for you, but you tell me it’s good for me, so I’ve compromised at taking it every other day. I’ve been doing it that way for months, so that hasn’t changed either.”

They both think they understand the exchange that just happened. My assistant clicks, “The patient confirms that the medication list is complete and accurate.”

Then in three months, when I check the patient’s cholesterol and find the statin is not nearly as effective as I thought it would be, I question them. They say, “I thought you knew I was taking it every other morning,” and a conclusion of “patients lie” would be understandable, but not helpful. Or maybe I might think, “MAs are lazy.”

I think neither. Patients have their seatbelt on, but not buckled. They are no better at understanding the inside of my mind than I am at understanding the inside of theirs. They have no real way of guessing what is important to me. If I asked the right question, they’d give me an answer I could use. I have to really think about what might be going on in another’s mind so that I can ask the right question. I must pay attention to which questions have given me useful answers in the past and which ones produce confusion. I must be sure my patients understand that my goal is to keep them off the floor of the van, not to hear the seatbelt click.

Mary Braun is an internal medicine physician.

Image credit: Shutterstock.com

Prev

To raise future scientists, address our innate curiosity  

August 19, 2019 Kevin 0
…
Next

Work getting you down? What you watch on TV might be making it worse.

August 19, 2019 Kevin 1
…

Tagged as: Primary Care

Post navigation

< Previous Post
To raise future scientists, address our innate curiosity  
Next Post >
Work getting you down? What you watch on TV might be making it worse.

More by Mary Braun, MD

  • Miscommunication leads to misunderstandings: the tragic consequences of misinterpreted sobriety

    Mary Braun, MD
  • Depression is a notification that the old patterns are not working

    Mary Braun, MD
  • Thinking about frailty like slow-moving PTSD

    Mary Braun, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • We must ask patients obvious questions

    Weijie Violet Lin
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • Is physician shadowing immoral?

    David Penner
  • A love letter to patients

    Marcie Costello

More in Physician

  • Challenging the diagnosis: dehydration or bias?

    Sydney Lou Bonnick, MD
  • Practicing medicine with conviction

    Arthur Lazarus, MD, MBA
  • The power of memory in shaping human identity

    Emily F. Peters and Sandeep Jauhar, MD, PhD
  • Physicians have no autonomy. Here’s how to change that.

    Diane W. Shannon, MD, MPH
  • The erosion of patient care

    Laura de la Torre, MD
  • Navigating adulthood in the digital age

    Eleanor Menzin, MD
  • Most Popular

  • Past Week

    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • How to facilitate caregiver learning and support to improve clinical care outcomes

      Kerri Milyko, PhD | Tech
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • Exploring HIV care and advocacy [PODCAST]

      The Podcast by KevinMD | Podcast
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • The art of pediatrics: Connecting through observation

      Alexander Rakowsky, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Lab Tests That Escape FDA Oversight May Come Under Agency Review
  • Fezolinetant Benefits Women Not Suited for Hormone Therapy
  • Low Tidal Volume Compliance Still Lacking in Mechanical Ventilation
  • IV Immunoglobulin May Cut Infection Risk of Anti-BCMA Agents for Myeloma
  • When's the Best Time to Get the Updated COVID Shot?

Meeting Coverage

  • Fezolinetant Benefits Women Not Suited for Hormone Therapy
  • Plant-Based Estrogen Improves Lipids in Postmenopausal Women
  • New Schizophrenia Treatments Are Coming: Don't Panic
  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • Most Popular

  • Past Week

    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • COVID-19 unleashed an ongoing crisis of delirium in hospitals

      Christina Reppas-Rindlisbacher, MD, Nathan Stall, MD, and Paula Rochon, MD | Conditions
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • The erosion of patient care

      Laura de la Torre, MD | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
  • Recent Posts

    • How to facilitate caregiver learning and support to improve clinical care outcomes

      Kerri Milyko, PhD | Tech
    • Air quality alert: Reducing our carbon footprint in health care

      Shreya Aggarwal, MD | Conditions
    • Exploring HIV care and advocacy [PODCAST]

      The Podcast by KevinMD | Podcast
    • A teenager’s perspective: the pressing need for mental health days in schools

      Ruhi Saldanha | Conditions
    • Challenging the diagnosis: dehydration or bias?

      Sydney Lou Bonnick, MD | Physician
    • The art of pediatrics: Connecting through observation

      Alexander Rakowsky, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Asking patients the right questions isn’t as easy as you think
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...