Health Literacy Consulting How-To Tip
“Do you have any questions?” the clinician asks. Oftentimes a patient answers, “No, no questions.”
I’ve long wondered why it is so hard for patients to ask questions. It could be that patients cannot think clearly when feeling scared or overwhelmed. It might be that they don’t want to feel stupid or appear naïve. Another reason can be cultural or generational, as when people (like my mother) believe it rude to question those in authority. And sometimes people simply do not know what questions to ask.
Regardless as to why, experts in health literacy and patient safety tend to agree that question-asking can help improve learning, confirm understanding, and provide context for new information.
Whether you are a patient, family member or caregiver, practice manager, or clinician — here are some ways to ask questions, or help others do so:
- For patients. Think ahead about what to ask. Prior to appointments, I jot down questions as they occur to me. Just before the appointment, I cluster and prioritize these questions — fitting them all on an index card. This not only reminds me what to ask but also has space to write my clinician’s answers.
- For family members, caregivers. Help others think of what to ask. It’s hard for many people to think “in the moment,” especially when wearing just a skimpy patient gown. If your family member or client cannot think of what to ask, suggest taking a look at AHRQ’s “Question Builder” list.
- For practice managers. Make it easy for patients to take notes by providing paper, pens, and clipboard or other hard writing surface. This is an easy and inexpensive way of encouraging patients to ask questions.
- For clinicians. Ask open-ended questions such as, “What else do you want to know about _______?” rather than a close-ended (yes/no) question of, “Do you have any questions?” Another strategy (learned from Lisa Bernstein, then Executive Director of the What to Expect Foundation) is to model good question-asking behavior. You can do this by saying something like, “Many people dealing with ________ want to know more about ______. Is that something we should discuss?”
Ways to learn more:
- “Questions are the Answer.” From AHRQ (Agency for Healthcare Research and Quality).
- Open Notes: Building Transparency, Trust, and Better Outcomes (HLOL #154). A podcast interview with Susan Woods MD, MPH.
- Lisa Bernstein Talks About Patient-Centered Communication (HLOL #4). A podcast interview with Lisa Bernstein.
- “In Other Words…’Questions Are the Answer’ to Helping Patients Understand Their Health.” H Osborne, On Call Magazine, June 25, 2008.