Finding Out What Your Patient Isn’t Telling You

finding out what your patient isn’t telling you can change the conversation.

During any conversation the clinician or the patient or both can withhold information simply because they don’t think it is important enough to share. When a subjective assessment isn’t going the way you expect it to go, finding out what your patient isn’t telling you can change the conversation.

People often withhold information that they don’t think is relevant not because they are trying to be difficult. They often don’t know what you’re holding back, so how could they know what they know is important? 

For them to offer information they have to know that it matters. What if they have no idea that it matters?

Here are some signs to look for that may indicate that information is being unknowingly withheld:

  • A shift in body language
  • Hesitations or changes in facial expression
  • Words that trigger your curiosity
  • Interpretations that don’t make sense to you
  • Decisions or behaviours that are not consistent with your conversation

Using Labels

If you recognise any of the above, it may be time to probe a little with a sense of curiosity. As I’ve mentioned in previous articles, using labels may be of value.

As an example, if you notice a change in body language or facial expression you could try one of these labels. 

“It seems like that:

  • Triggered a thought?
  • Caught you off guard?
  • Struck a chord with you?
  • Made you feel uncomfortable?
  • You may have misunderstood something I’ve said”

When you hear an interpretation of what you have said that doesn’t make sense you could try:

“It sounds like:

  • I may not have been clear with what I’ve said
  • You’re struggling to understand what I’ve said
  • More information from me may help
  • I need to clarify myself”

Other lead ins to explore whether there may be some unknown, unknowns are:

  • Tell me more
  • Out of curiosity, give me a bit more information?
  • Help me to understand what your thinking
  • How did you come to that conclusion/decision?

Leading Questions

To explore another’s thinking and to find out if there is important information being withheld, ask a short question and then allow the other person to answer with what is important to him/her.

Do not fall into the trap of asking a number of questions all at the same time. This is called asking ‘Leading questions’. Without knowing it you inadvertently lead the individual into answering a question which may not be at the heart of what you are trying to uncover. 

People commonly ask leading questions thinking that it is a quick way to get information. In reality you may miss vital information because the person has responded to the options you provided. You may well find that you will have to go back and ask more questions to get the information you need.

Leading questions are a common cause of keeping the unknown, well… unknown!

A task for you in your clinical conversations is to limit yourself to no more than 2 questions in one sentence. Your aim will be to ask one question and respond to what you hear.

Using labels and avoiding leading questions takes commitment and practice. Lots of it. As your communication skills improve you will get better at finding any unknowns that change conversations.

To learn more about motivational tools through effective communication download my eBook:

“Improving Patient Motivation In Physiotherapy”

I wrote this eBook in response to the most common question I get asked and that is “How do I motivate my patients?”

If you would like to fine-tune your communication skills when working with resistant patients, you might consider working with a coach or mentor.

Or perhaps your staff would benefit from training in this area.

Contact us, and find out more about what we can offer you.

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