I can spend 20 minutes interviewing a parent about their child and still not really understand them. During a consult, my interview centers on the objective elements in a child’s history. When evaluating a child for abdominal pain, for example, I have a panel of questions that cover what I need to know to generate a starting hypothesis.
But none of it helps me understand the patient’s mother.
Understanding where the parents are at is critical to both understanding a child’s problem as well as pitching a plan of care. Whether it’s revealed to me or not, parents often come to me with an agenda. If my plan doesn’t meet with their view of the situation, it’s going to be much harder for me to help that child get what she needs.
So at the end of my interview (usually when washing my hands) I launch one or all of the following 3 questions:
- Is there anything you forgot to mention?
- What’s your biggest concern?
- What do you think is going on?
Despite having a few years under my belt I’m always amazed at my inability to predict what’s worrying a mother. This is why I ask. And trying to get at what a parent understands gives me a jumping off point for the education part of the visit.
The experts call these open-ended questions. In medical school I thought the open-ended question was academic nonsense. Now it makes my life a whole lot easier. It gives me what I need to know when helping a family navigate their child’s problem.
From what I understand these questions are equally helpful with adults.