Oct 17, 2014

Interviewer: Three things patients should ask and three things all doctors should be sure their patients understand. That's coming up next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Sometimes as a patient when you're in clinic with a physician, you leave and you're like, "I don't know what's wrong with me and I don't know what to do about it," and you're just confused. But if you ask these three questions, and if you're a provider you make sure patients understand the answers to these three questions you could solve all the problems. We're going to find out more about the Ask 3 Program. Darren Doman, he's the Patient Education Specialist here at University of Utah Health Care. What is the Ask 3 Program and it sounds magical?

Doman: It is pretty magical. It's an initiative put together by the National Patient Safety Foundation and it's meant to just help improve communication between health care providers and their patients in efforts to improve health outcomes. So basically they synthesize every visit into three main questions.

Interviewer: Okay.

Doman: First, "What is my main problem?"

Interviewer: Yeah okay.

Doman: That's a good question.

Interviewer: That's a great question. That's why you're there.

Doman: Exactly.

Interviewer: Yeah.

Doman: Put a label on it, give it a name. The second question is, "What do I need to do about it?" And then the third question is, "Why is it important for me to do that?"

Interviewer: I love that because I think it synthesizes in very, three very quick little questions. Like when you're a patient you leave and you don't understand what just happened and you're trying to figure out, "What could I have done to change it?" I think this is perfect.

Doman: Absolutely and there's some research out of Great Britain that shows that when it comes to an outpatient doctor patient interaction, 80% of people leave that visit without accurately recalling any information that the doctor told them.

Interviewer: So it would be hard for them to tell their husband, their wife, their kids, anybody.

Doman: Exactly, but when they probed the 20% that remembered something a little bit closer, only half of them actually got it right.

Interviewer: Really?

Doman: So it's really 9 out of 10 people leave the doctor's office not able to remember accurately what the doctor told them.

Interviewer: That's pretty incredible and that's based on research.

Doman: Based on research out of the UK.

Interviewer: All right so the Ask 3 Program, "What's my main problem?" "What do I need to do?" "Why is it important for me to do this?" Is there any research on showing if people ask these questions what retention rates are?

Doman: Well the most current research that I read was showing that patients aren't actually asking these three questions.

Interviewer: Okay.

Doman: So we need to take a step back, revamp the program, and maybe think about it a little bit differently. Which I think is a perfect opportunity for us to talk to providers and say, "You know, here's three great questions. If your patients aren't asking these questions, why don't you just help them out and give them this information?"

Interviewer: Yeah just make sure that they understand these three things.

Doman: Exactly and that speaks to the need for open communication between patients and doctors to really get the message home. Patients need to be asking the questions, doctors need to be telling the patients the right things, and they need to be checking to make sure that the message was received.

Interviewer: So it sounds like a good idea as a patient if I go in that maybe when it starts getting a little confusing I just need to fall back on those three, you know? Because sometimes the issues get a little muddled right?

Doman: Absolutely, and just bring it back to, "Okay what's the main problem?"

Interviewer: "What do I need to do?"

Doman: And, "Why is it important to do it?"

Interviewer: And as a provider it might be a good idea after you tell them these three things to ask them, "Okay do you understand what your problem is? Tell me what it is." When I was in my communication classes that's all part of listening, it's all part of checking to make sure the person understand what you just said to them is to ask them to tell you what you just said to them.

Doman: Absolutely and providers who are really keyed into this can do it very artfully. They can say, "I think your main problem is this," and then, "Later when you get home what are you going to tell your spouse that your main problem is?" Just to check and see.

Interviewer: Yeah, because a lot of times we assume that the person understood us and we don't want to insult their intelligence by insinuating on some level that they didn't, but a lot of times people don't. I mean there's a lot of a thing that can go wrong with communication, it's not either individuals fault.

Doman: It's true, and double checking message received is never a bad idea.

Interviewer: What's keeping patients from asking these three questions do you think?

Doman: When it comes to patients asking questions in doctors' visits I always think its fear based. They don't want to look stupid in front of their care provider. Maybe they kind of know the answer but they're a little bit afraid of actually hearing somebody else say it. So there are reasons why they might not pipe up and actually ask.

Interviewer: But at that point it's important beyond your ego, beyond anything else, to clearly understand what's going on, what you need to do, and how important it is.

Doman: Sure, yeah.

Interviewer: And how about physicians, is there a barrier to them adopting kind of just these three questions making sure patients identify it? Is it something they ever thought about before?

Doman: I think it takes that moment of just engaging your brain and checking in rather than getting into too much of a routine. Everybody kind of gets their routine going, they kind of do it the same way they've always done it, in and out, keep the flow going. But if we can actually engage with the patients say, "Here's my new routine, here are these three important things that I need every patient to understand," I think we're going to have a better go of patient interaction, better communication, and ultimately better health outcomes.

Interviewer: Any final thoughts on the Ask 3 Program? I think it's brilliant.

Doman: I think its brilliant too, and just getting the word out to patients and providers alike that it's a conversation. It shouldn't be one-sided doctor talking all the time. The patient should have some input as well and if the patient doesn't know quite what to ask here's three good questions. Anybody who asks these isn't going to look stupid in front of their doctor.

Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook, just click on the Facebook icon at TheScopeRadio.com.

For Patients