Your patient’s illness experience can be explored by either (1) recognizing patient cues, or (2) asking specifically about your patient’s perspective 

Picking up Verbal and Non-Verbal Cues

1. Verbal
   • ‘You mentioned your mother had rheumatoid arthritis. Did you think that that’s what is happening to you?’
   • ‘You said you were worried the pain might be something serious. You seem to have given this a lot of thought. Did you have any theories on what this might be?’
2. Non-Verbal
   • ‘I sense that you’re feeling quite nervous. Is something else the matter?’
   • ‘Am I right in thinking you’re quite upset with the explanations you’ve been given in the past?’

Asking specifically about the patient’s illness perspective

1. Ideas (Beliefs)
   • ‘What do you think might be happening?’
   • ‘You’ve obviously given this a great deal of thought. It would help me to know what you were thinking it might be’
2. Concerns
   • ‘What are you concerned this might be?’
   • ’Is there anything in particular you were concerned this might be?’
3. Expectations
   • ‘What do you think might be the best plan of action?’
   • ‘How might I best help you with this?’

 Exercise: During a patient interview, you ask your patient, with well-meaning intent…

1. ‘What do you think might be happening?’
2. ‘What do you think might be the best plan of action?’

Taken aback, that patient states, ‘What? You’re the doctor! How am I supposed to know?”

How might you respond?

Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (Thrid Edit). London: Radcliffe Publishing.