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Avoid Using “Why” Questions with Patients: Apply Friendlier Language

By Edward Leigh, MA

I took my mother to the foot doctor. She is supposed to being wearing support stocking due to swelling in the ankles. Mom has not been very compliant (she is now). The doctor said to her, "Why aren't you wearing the stockings?" This type of question puts people on the defensive. Why questions can come across as abrasive, even hostile. A friendlier version of the question is, "What can we do, working together, to help you wear the stocking on a consistent basis?"

According to the Merriam-Webster Online Dictionary, the word "why" means "for what cause, reason, or purpose." We ask why questions basically because we are looking for a reason in regard to an action. When lawyers have people on the stand, they ask tough questions, why questions (e.g., "Why did you steal the money?"). However, in healthcare, we are working in a therapeutic environment where certain questions need to be asked in a sensitive manner.

Here are some why questions and their better alternatives.

Why Question: "Why didn’t you take the medication as prescribed?"
Better Question: "What was happening that led you to not take the medication as prescribed? Let's talk about solutions."

Why Question: "Why are you still smoking? You have many breathing issues that will only get worse."
Better Question: "I am concerned about your breathing issues. We will explore different options to help you stop smoking."

Why Question: "Why did you lift that heavy piece of wood when you know you have back problems?"
Better Question: "Your back problems are a concern and I want to help you feel better. In the future, you will need to careful about lifting heavy objects."

By the way, why questions can also wreak havoc on personal relationships. A friend of mine told me her significant other became her insignificant other because he would constantly ask her why questions. For example, she would come home from the grocery store and he would ask, "Why were you gone so long?" He looked at her bags from store and asked, "Why did you buy these groceries?" One more example, he would walk into the family room and ask, "Why are you watching that TV Show?" She ended the relationship. She jokingly quipped, "He never asked why I didn’t want to see him any more!"

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