“Why do you ask me the same questions?”
Yesterday a patient, clearly annoyed, asked me “Why do you ask me the same dumb questions each time I see you? How’s your mood been? How’s your sleep and appetite? Any side effects from the medicine? Did the side effects you mentioned last time go away? Is the medicine still serving its purpose?”
Yes, I plead guilty. I do ask these questions frequently. But the patient is annoyed. Shouldn’t I stop? Well…no, and here’s why.
The answers to the questions are important and may have changed since I last saw the person. The stability of the answers or any changes is necessary to consider when changing treatment. Maybe I’ll increase or decrease the dose. Maybe I’ll add or subtract a medication. Maybe there are life circumstances that need to be addressed and no change in medication is needed. You are probably nodding your head saying, “Ok, I understand that.”
So why is my patient annoyed? Perhaps he or she would like to spend the time more productively discussing a recent situation at work or home. I understand that.
I also see their annoyance as a good thing. What? You see, the person is annoyed because they are so accustomed to the questions that they can ask and answer them themselves. “So why waste time in the session with what I can do at home.” That’s what I want, assess yourself. My repetitive questions have been incorporated by the person into their own mind and they have learned to assess themselves the way I do. That’s a good outcome. I want my patients to be able to assess their symptoms on a day-to-day basis. I want them to note the side effects that I might have to address if they don’t subside. I want them to ask themselves “Is the medication helping me with what I want help with?”
Ultimately, we take medication not so much for health (long-term issue) but for quality of life (daily issue). Does the medication allow me to function to my satisfaction? Does the medication provide me with a comfortable state of mind?
Every time you swallow a pill, you consciously or unconsciously ask yourself “Do I really need this?” Well, if you ask yourself my “annoying questions”, you get the answer.
I want my patients to learn the symptoms of their illness, identify when symptoms are stable or not, judge the level of distress and/or impairment, and make treatment decisions accordingly. This ability gives them a sense of control over the illness rather than being a victim of it. And they want to same.