From the Guidelines
The best tactic to get accurate information from a patient who is not being forthcoming is to ask open-ended questions (option C). When patients are reluctant to share information, creating a non-judgmental environment where they feel safe to communicate is essential 1. Open-ended questions encourage patients to explain their situation in their own words rather than providing simple yes or no answers. This approach allows the doctor to gather more comprehensive information while building rapport and trust. Some key strategies to achieve this include:
- Orienting the patient to make sure they understand what is going to be discussed and why 1
- Using simple language tailored to the patient’s educational level and avoiding jargon 1
- Providing information that is relevant to what the patient wants to know and to the patient’s goals 1
- Avoiding information overload by providing information in small doses, stopping frequently, and checking for comprehension 1 Direct questions may feel confrontational and lead to defensive responses, while threatening patients or offering gifts are unethical approaches that violate the doctor-patient relationship and medical ethics. Open-ended questions like "Can you tell me more about what's been happening?" or "How has this been affecting your daily life?" demonstrate respect for the patient's autonomy and often yield more accurate clinical information, which is crucial for proper diagnosis and treatment planning. Additionally, acknowledging and naming the emotions of the patient can also help in building trust and getting accurate information 1.
From the Research
Effective Communication Strategies
To obtain accurate and real information from a patient who is not being forthcoming, several tactics can be employed:
- Ask an open question: This approach allows the patient to share their thoughts and feelings without feeling constrained by a specific format or expectation 2, 3.
- Engage in focused active listening: By paying close attention to the patient's words, tone, and body language, healthcare professionals can better understand their perspective and build trust 2.
- Explore the patient's feelings, ideas, and concerns: Understanding the patient's emotional response and experiences can help healthcare professionals address their needs and provide more effective care 2.
- Use the "ask-tell-ask" approach: Providing small chunks of information and checking for understanding can help ensure that the patient is informed and engaged in their care 2.
Avoiding Ineffective Tactics
Certain approaches are unlikely to be effective in obtaining accurate information from a patient:
- Threatening to involve law enforcement: This tactic is likely to create anxiety and mistrust, making it less likely that the patient will share accurate information.
- Offering a gift in exchange for truthful information: This approach can be seen as coercive or manipulative, and may undermine the patient's autonomy and trust in the healthcare professional.
- Asking direct or closed-ended questions: While direct questions may be necessary in some situations, they can limit the patient's ability to share their thoughts and feelings, and may not provide a complete understanding of their experiences 3.