Open-Ended Advice

By Scott P. Robertson, HeLP Fall 2017 Student Intern

Amongst the traditional professions of medicine and law, the initial interview is regarded as one of the most important phases of the overall professional-client interaction.  Within this primary stage of inquisition, the professional has the potential and capability to effectively make or break the entire case moving forward by either obtaining all of the relevant information or missing out on key facts.  Whether the professional happens to be a pediatrician investigating a patient’s respiratory symptoms or an attorney probing a homicide suspect, he or she needs to obtain the whole story in order to advise the patient or client on the appropriate course of action.  Despite the vast difference in the line of questioning between what one might ask a sick child about the origins of his cough or wheeze and what one might ask an alleged murderer about the night in question, there is a common theme amongst the professions when it comes to interviewing: open-ended questions are invaluable tools in obtaining a comprehensive picture of the patient or client’s surrounding circumstances, leading to a deeper understanding of his or her issues.

Imagine you have a new client in the office seeking your assistance in obtaining damages from his employer due to injuries he claims to have suffered on the job.  The wheelchair in which the client sits and the look of agony upon his face serve as overwhelming evidence of an injury, and you’ve never been much of a fan of the company he wishes to sue.  As an attorney, your duty is to zealously advocate for your client’s position, so you ask him a few questions about the harm of the injury and the employer’s role and then you eagerly begin filing a claim.  Unfortunately, in your haste to get the ball rolling, you never gave the client an opportunity to give you the whole picture and missed the fact that the client had put himself in an unsafe position in the first place and may have caused his own injury.  A simple open-ended inquiry such as “tell me everything that happened that day,” would have allowed you the opportunity to see that there was much more work to be done before deciding whether a claim should be filed.

Now imagine you are the same client’s physician when he presents to the emergency room post-injury with difficulty breathing, along with a productive cough and diffuse pain throughout his chest and abdomen.  After learning that the patient was harmed in an accident at work, you immediately begin working the patient up for a traumatic injury and procure the assistance of multiple nurses, lab technicians, and medical students.  In your haste to treat the patient, however, you failed to learn that the patient had recently been overseas and had been exposed to tuberculosis.  This not only changes the treatment the patient should be receiving, but it also leaves you and your staff fully exposed to a deadly disease.  A simple open-ended inquiry such as “tell me more about that cough,” would have allowed you the opportunity to hear information on its origins that would have allowed you to effectively treat the patient and protect your staff from unnecessary contact.

One cannot overstate the importance of allowing a patient or client to give a professional the full picture before diving in to an analysis and solution.  Asking questions without directing towards a particular diagnosis or cause of action may be difficult for physicians and attorneys alike, as professionals thrive on healing their patients and serving their clients.  However, it is extremely important that all professionals put their zeal aside and allow patients and clients to give them the whole story before jumping to a potential diagnosis or potential claim in order to obtain all of the relevant information.