Questions to Ask Patients
Questions for clinicians and nurses seeing patients over time rather than for the first time: how treatment is actually going, what it is costing, what has been lost, who is at home, and what the patient understands about the plan.
The questions
Open any question for the note
What do you want to make sure we cover before you leave today?
Why ask it
Asking at the start rather than the end stops the appointment from being consumed by whatever you opened with. Patients often hold their real question until they judge there is time for it, and this tells them there is.
What has changed since I last saw you?
Why ask it
Broader than asking about the condition, so it picks up a new drug from another clinician, a hospital visit, a bereavement, or a job ending. Any of those can explain a change in the numbers better than the disease does.
How has the plan we agreed on been working in practice?
Why ask it
The phrase in practice invites the truth: that the exercises take an hour they do not have, or the appointment was at the wrong end of the city. A plan that was never workable will read in the notes as treatment failure.
Which of your medicines do you end up skipping, and what makes you skip them?
Why ask it
Assuming some skipping is normal removes the pressure to claim perfect adherence. The reason given is the useful part, since side effects, cost, and dosing three times a day each call for a different fix.
Is any of this costing you more than you can manage?
Why ask it
Cost is a common reason treatment quietly stops, and patients rarely raise it unprompted because it feels like a private matter. Ask about transport and time off work as well as prescription charges.
What did you take away from the last set of results?
Why ask it
This checks understanding without quizzing them, and the gap between what was said and what was heard is often large. Correcting a wrong belief now is easier than after they have acted on it for six months.
What have you read or been told about this that you would like me to comment on?
Why ask it
Invites the internet search and the relative's advice into the open, where you can address them. Patients who are dismissed on this stop mentioning it and act on the information anyway.
What is the hardest part of living with this day to day?
Why ask it
The answer is frequently something no treatment on the plan addresses: fatigue, the toilet, embarrassment, the constant admin of being ill. Naming it is often the first time anyone has asked, and it sometimes points at a fixable problem.
What have you stopped doing that you would most like to get back?
Why ask it
Gives you a goal in the patient's own terms, which is more useful than a target value. It also reveals what they consider recovery, which may be narrower and more achievable than you assumed.
How are you sleeping?
Why ask it
A plain question that opens onto pain at night, breathlessness lying flat, anxiety, nocturia, and side effects. Patients answer it readily because it does not sound like a psychiatric question.
How has your mood been through all this?
Why ask it
Asked as part of the illness rather than as a separate topic, this is easier to answer honestly. Long-term conditions and low mood travel together, and untreated low mood undermines everything else on the plan.
Who is at home with you, and what would they do if you got worse overnight?
Why ask it
Turns a general question about support into a test of the actual plan. Answers involving nobody, or a partner who could not lift them or drive, change what is safe to arrange.
How are you getting to appointments?
Why ask it
Missed appointments are often a transport problem rather than a motivation problem. A specific answer lets you schedule around a bus route or a lift, which does more for attendance than a reminder letter.
Do you feel safe where you are living?
Why ask it
Ask it directly, alone, and in a flat tone, and be ready to act if the answer is no. It also picks up cold housing, stairs someone can no longer manage, and falls that have not been reported.
Is there anything about your beliefs or daily practice we should build the plan around?
Why ask it
Better than a general question about culture, because it asks for something actionable: fasting periods, dietary restrictions, views on particular treatments, preferences about who examines them. Asked in advance, it avoids a conflict at the point of treatment.
Who do you want in the room, and who may we share information with?
Why ask it
Worth settling early and revisiting, since families change and so does what a patient wants shared. Record the answer, because staff otherwise default to whoever is present and most insistent.
How confident do you feel about handling this between visits?
Why ask it
A low answer identifies where education or a follow-up call is needed, and a very high answer sometimes signals that the seriousness has not landed. Follow up with what specifically would make them less certain.
What would make you call us rather than wait for the next appointment?
Why ask it
Turns your safety-netting advice into their words, which shows whether it was understood. If their threshold is far above yours, restate the specific signs and where to go with them.
If things were to get worse, what would matter most to you?
Why ask it
A calm question to ask early rather than in a crisis, when there is time to think and nothing is being decided. Answers tend to be about home, independence, and particular people, and they should be recorded where the next clinician will find them.
Can you tell me back what the plan is from here?
Why ask it
Asking the patient to restate it, framed as a check on your own explanation, catches misunderstandings in under a minute. Errors show up most often around doses, which appointment comes first, and what to stop.
Is there anything you have not mentioned because there was not a good moment for it?
Why ask it
Names the reason things go unsaid, which makes it easier to say them. What surfaces here is often the symptom that felt embarrassing or the fear that felt unreasonable.
Seeing Patients Over Time
Practical guidance for the conversation itself
In the Room
Ask what they came for before you review the file
Opening with the last result puts the visit on your agenda for its whole length. Thirty seconds spent asking what they want covered usually saves time later and stops the important item from arriving as you stand up.
Assume imperfect adherence and ask about the reason
Which ones do you end up skipping produces information; do you take your tablets produces a yes. Cost, side effects, complexity, and doubt about whether a drug is doing anything each have a different remedy.
Check understanding by asking them to explain it back
Frame it as checking your own explanation rather than testing them. Errors cluster around doses, timing, and what to stop, and they are much cheaper to find in the room than at the pharmacy.
Ask the sensitive questions alone
Safety at home, mood, substance use, and what a patient wants shared cannot be asked reliably with a relative present. Build a reason to have a moment alone rather than asking the relative to leave in front of them.
Write down what matters to them, not only what you found
The activity they want back, the person they want called, what they said would matter if things got worse. That record is what makes the next clinician's conversation continuous rather than a fresh start.
Common Pitfalls
- Reading non-attendance or a stalled treatment as disengagement without asking about transport, work, childcare, or cost.
- Asking do you have any questions as the closing line. It reliably produces no, because it signals the visit is over.
- Explaining to the relative who speaks the most confident English rather than to the patient, when a professional interpreter is available.
- Recording a patient as declining treatment without documenting what they were told and what their reason was.
- Leaving goals-of-care conversations until an acute deterioration, when the patient may be too unwell to take part in them.
- Adding to the medication list at every visit and never asking whether anything can come off it.
Adjusting to the Visit
- Routine review of a long-term condition: what has changed, how the plan is working in practice, adherence and cost, function, and what would make them call.
- After a hospital admission: what they were told on discharge, what changed on their medication list, what they are afraid will happen again.
- A patient who is deteriorating: what matters most to them, who they want involved, and where they would prefer to be cared for. Keep the language plain and leave silences.
- A short or telephone appointment: agenda, the single change since last time, adherence, and teach-back on the plan.
- A patient you suspect is not telling you everything: ask one open question, wait, and resist filling the pause.