This powerful phrase can change your practice, says Suneel Dhand, MD As physicians, we are used to asking our patients lots and lots of questions. It's our job to elicit information, listen, and then come up with a management plan. There's a standard script every doctor goes through, based on the science of medicine, and we usually have this memorized to a T. And that's all very well and good. However, as with many things in life -- especially those that involve human beings and an emotional (and dare I say, spiritual) component -- it's always more than just the science. There's one great question, however, that doctors utilize to a lesser degree than almost any other. And that's a simple: "What are your goals?" This can come in a variety of different ways, such as: "What are you hoping for?" or "Where do you see yourself in one month?" It can be used at different points, depending on the circumstances -- at the beginning of a discussion, before tests are ordered, or in the case of a hospital attending physician (which I am involved in most) -- right upon discharge. Asking this question has a number of positive effects: 1. It elicits extremely useful information On a rudimentary level, this is obviously important information to know, for anyone involved in the patient's care. Where are they coming from, and what are their goals? Do they expect to be pain-free in one week and back at work? Do they have to be up on their feet for their daughter's wedding next month? This expectation level can then either be tempered, reinforced, or made even more optimistic! 2. It shows you care Asking this basic question will immediately show that a doctor is curious and has a genuine interest in the patient. You are not just a "point-of-contact" person but have taken the time to probe deeper. You are asking a question that helps foster empathy and compassion, the core of a better clinical interaction. Even in a social situation, anyone who is asked a question like this, responds positively because everyone likes and appreciates being able to articulate something that is important to them. And few things are more important than anybody's health. 3. It gives the patient something to think about Life is nothing without having goals and things to look forward to. Even if a patient struggles with this answer (rare), they will have something to ponder over. Hopefully, we are dealing with a reversible illness with light at the end of the tunnel. Even the thought of attending a Yankees game (sorry to anyone who is reading this not in New York and hates this line) can motivate the patient immensely. Time is a precious commodity in healthcare. It's not something that any doctor has in abundance, or can afford to spend on random conversations (even if they really want to). But the above question may only take 2 or 3 minutes and can have an immense effect, especially when a doctor is meeting a patient for the first time. And as with anything to do with communication, this does not mean asking a question in a robotic way! It has to come with the right level of emotional intelligence and done with sincerity. If you are a doctor and already have this question in your repertoire, then well done. But as someone who coaches and teaches physicians communication skills, I am certain that very few ever make use of the simple "What are your goals?" question. Those goals or aspirations, may or may not otherwise come out organically during the discussion, but that's left to chance. So if you're a doctor reading this, try it next time, even just once a day. You may be surprised with how much it's appreciated. It's one example of a small step that a physician (or any health care professional) can take, to improve their everyday communication skills. And there are dozens of more techniques like this that can help, many of which do not even involve asking questions or take even a minute of extra time. All of these little things that help maintain the fast eroding doctor-patient human interaction are healthy things to cultivate. Because they not only help make patients happier and more likely to have a better outcome but also make the work of a doctor a lot happier too. Source
