The Power of Open-Ended Questions

By Marc Belcastro, DO, chief medical officer, Premier Health and Miami Valley Hospital

I have written a series of past articles on a variety of strategies and practices that will facilitate connection and communication with your patients. I also believe that real demonstrations of compassion and empathy can be a critical part of their care and healing. While stress, disengagement, and burnout are real, I know from personal experience and research that these practices will mitigate and help physicians and other caregivers cope with the increasing demands.

Physicians, advanced practice providers, and nurses often position their questions near the end of a patient encounter. I want to focus on the beginning. An open-ended question positioned after an introduction and acknowledgement of the patient is one powerful tool that has a number of advantages to create a connection and deeper understanding of the patient and their family.

I will share some of the open-ended questions that I used during my career in the NICU. Extremely premature infants can experience a number of complications and have higher mortality risks. Families need to be provided with this information. However, it’s not generally helpful when it’s initially offered. I have learned the trauma of that initial moment leads to 90 percent of the conversation being forgotten. In these or other very critical situations, my opening question with the family was simply, “What are you most afraid of?” The various answers my families provided taught me so much about them and allowed me to address these fears with honesty and compassion. I was able to then ease into the medical information that was important.

In less critical situations, the question became, “What concerns you most?” One common answer was the mother’s anxiety about breastfeeding when she was not present and after her discharge if the infant’s stay would be longer than hers. Once this was addressed, her mind was open and ready to receive information. Another less common response was the parent’s or guardian’s ability to visit the NICU after discharge based on distance or lack of transportation. Again, as I explained to them the resources available, a connection was created and the channels of communication opened.

I strongly encourage you to try these methods with your patients. It takes very little time. Some suggestions for the adult population in addition to those above might be, “What would you like me to address first?” or “What about your prior hospital stay can we do better?” These small moments reveal valuable information that will not only improve communication but will allow you to take better care of your patient, which is truly the heart and art of medicine. 

Back to the October 2020 issue of Premier Pulse