The truth about open vs closed questions…..and the application in health customer conversations.

A recent AJP Daily article posed the question, “What error makes up 10% of incidents reported to PDL?” Advice offered in this article includes ……… “Open questions, as opposed to closed, should always be used and are designed to draw information from the consumer.”

This is poor advice and should NOT be heeded.  Sadly, the critical questioning skill of knowing when and how to use open vs closed questions, is incredibly simple yet so often mis-taught and misunderstood.  Therefore poorly utilised in the conversations with health customers at the dispensary.  Also sadly, it is not hard to understand why this occurs.  A cursory glimpse into teachings for Pharmacists and their teams often provides obvious explanations.  For example, in the same article, the author writes …………. “Examples of open ended questions include; ‘Please state your address’ or, ‘May I see your Medicare card please?’ or, ‘Can you tell me what you are using the medication for?’”.  All three incorrect examples here provides insight into why Pharmacy staff so often struggle to execute this simple but powerful engagement skill.

Let’s delve a little to explore how these scenarios can highlight correct vs incorrect application of this conversation skill.  Indulge me to provide typical hypothetical answers ….

  • Please state your address? …. Number XYZ, Main street, Suburbia.  This is a short, sharp, factual answer to a question calling for such a response.  This is a CLOSED Q&A, not OPEN, because of the nature of the short sharp factual piece of information called for
  • May I see your Medicare card please? …………… Yes.  This is the classic yes/no response closed question
  • Can you tell me what you are using the medication for ……… Yes – headache.  Again, this is a CLOSED Q&A, not OPEN, because of the nature of a short, sharp, factual piece of information called for

Some people think that a closed question is limited to a yes or no response.  This is not true.  A closed question calls for a short, sharp, factual response , which may or may not be yes vs no.  The other common misunderstanding is that open questions are better than closed questions.  Indeed, the PDL article in question is a great case in point………. “Open questions, as opposed to closed, should always be used”.

Again, not true.  The skill of open vs closed questions is knowing when to ask open vs closed questions.  Open questions are great when you want your patient to speak freely and describe their symptoms, condition or implications thereof.  The great skill is using a combination of both , at the right times, to control the conversation, and to give the patient a great consultation experience.  Honing this skill is partly around following a few simple rules …. some is closer to art and is around “reading the tea leaves” .  This means reading the disposition of the patient and how that changes throughout the conversation and adapting accordingly with the judicious use of open vs closed questions.

This is not just my opinion.  The best research conducted on the skills of open vs closed questions was conducted by the Huthwaite Group , back in the 80’s, and is embodied in the doctrine known as SPIN selling.  I exhort all pharmacy professionals who engage patients at the dispensary to read it!