I have used patient media in my office for years, its great stuff!

Listening to your tapes and reading your books, you have repeated many times to ask questions and make patients think.

So here is my question - Patient Bob comes in and says I'm sore here and here, well I reply why do you think that is, expecting to hear an answer that the patient is taking ownership for his pain. What is the patients reply 99% of the time, "I don't know" I'm then stuck for a reply besides are you sure you don't know. Please help me out with this one.

My response:

"I don't know" can have many meanings:

1. I'm not sure and I don't want to be wrong.
2. I'm tired and I don't want to play.
3. I'm not certain and I don't want to appear dumb.
4. I'm afraid if I answer it'll set me up for something I don't want.
5. I truly don't know.

I'm sure there are other possible meanings.

Here are a couple of strategies.

"Really? You don't know? Well, do you have a theory?"

Allow the patient permission to fail by responding, "If you did know, why do you think that is?"

Another approach: "You don't know? Really? Good thing I do."

Another approach: "Don't know? No problem. Give it some thought and we'll talk about it on your next visit."

Or do nothing. Throwing out the questions and allowing the patient to think about the answer. Sometimes these things take time.

More fundamentally, be sure you have created a safe place to ask questions. Make sure there is privacy and no audience. Make sure you project a tone of relaxed, nonjudgmental confidence.

Remember, even though when we were in school we were taught that there's no such thing as a stupid question, we came to learn that there could be, especially when the whole class laughed at us!

Patients aren't accustomed to being asked questions from their doctor. This is a new thing for them. You might want to ask them why they think you ask so many questions!

Hope this helps.

Bill