And, in yet another exciting edition of, "What they taught me in medical school turned out to be completely and utterly wrong:" open ended questions.
I was listening to the medical students talk about a patient interviewing class that they take every year. It's a pretty standard kind of thing. The student interviews a standardized patient (actor) is videotaped and receives feedback from an experienced physician. The biggest thing they always used to press us on - and still continue to impress upon the next generation of medical professionals - is that we should ask open ended questions. For example, questions like "how do you feel about your pregnancy" allow the patient the opportunity to give you much more information than "for how many days have you had a cough." As a resident, I quickly learned that asking open ended questions is absolutely the wrong way to go about things.
In my office, the patient gets asked exactly two open ended questions: 1) what brings you here? (asked at the very beginning of the visit) and 2) do you have any other concerns? (asked at the very end of the visit). If your goal for the visit is to address your patient's complaint and to do it efficiently, it doesn't benefit anyone to allow the patient to go off talking about random, irrelevant nonsense. Once you understand what their complaint is, you - the doctor - should have some ideas about what specific bits of information are important for you to know about. That's what medical school is supposed to teach you. You obtain those specific bits of information by making your questions as pointed and direct as possible. Your goal is not to identify every single problem the patient may possibly have. Your goal is to address the current problem that they're coming to your office with (hence, question #1). I believe it is then prudent to make sure that doctor and patient are both on the same page and that everyone understands everyone else (hence, question #2).
The students are lucky that they have me around to preempt some of the harm that might otherwise be done to their education.
