The structure of patients' presenting concerns: physicians' opening questions

Health Commun. 2006;19(2):89-102. doi: 10.1207/s15327027hc1902_1.


This article uses conversation analysis to develop a typology of questions that physicians use to solicit patients' problems and then tests question-format effects on patients' subsequent problem presentations. Data are videotapes of 302 primary-, acute-, and outpatient-care visits involving 77 physicians in 41 urban and rural clinics, as well as pre- and post-visit questionnaires. The most frequent question formats were general inquiries (62%; e.g., "What can I do for you today?") and requests for confirmation (27%; e.g., "I understand you're having some sinus problems today?"). Compared to confirmatory questions, general inquiries were associated with significantly longer problem presentations ( p<.0001) that included more discrete symptoms ( p<.0001). Physicians were more likely to use confirmatory questions in the urban setting ( p=.003).

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • California
  • Communication*
  • Humans
  • Office Visits*
  • Pennsylvania
  • Physician-Patient Relations*
  • Primary Health Care
  • Surveys and Questionnaires