Why Ask Silly Questions? Why Indeed

Craig Joseph, MD
By: Craig Joseph, MD
Date: February 12, 2020

Silly QuestionsLast week, I did something crazy: I called my cable company. Now, now, people, calm down. I predict that everyone who just read what I wrote will agree with me that my action was unhinged. If you’re my age, you think it’s insane to call the cable company because they have a reputation for hating their customers and one would only call them if one is filled with self-loathing. If you’re a youngster, you think it’s insane to call the cable company because you don’t know what that means (“Call? Like talk on the phone to another human?” “What is this thing, this ‘cable company’ to which you refer?”) Anyway, I threw caution to the wind and called them.

I had to call the cable company because I needed to replace the remote control that they supply for their boxes. Some of the keys had become sticky, and I was afraid that I might be forced to throw the remote through one of my windows. I suspected if I did that, the repair would not be covered by the cable company. Here’s what I thought would happen during the call:

Me: Hi, I’d like you to ship me a new remote control for my cable box.

Them: What’s wrong with it.

Me: Some of the keys are sticking.

Them: It’ll arrive in a week or so.

Here’s a summary of the actual call:

Me: Hi, I’d like you to ship me a new remote control for my cable box.

Them: I see. You’d like us to ship you a new remote control for your cable box.

Me: That’s what I said. Some of the keys are sticking. I’d like a new one.

Them: Well I’m in tech support. You need cable services.

Me:

Them:

Me:

Them: Want me to connect you?

Me: Yeah . . . because I’d like you to ship me a new remote control for my cable box.

I think you can see where this is going. The person in “cable services” asked me a bunch of questions that were clearly scripted for him, but in no way relevant to my situation. Was I having any problems with other remote controls? Was the cable working alright? Was I having any internet connectivity problems? Has my address changed? OMG, as the kids say. Uncharacteristically, I remained calm and after a few minutes, the request was entered, and I was given an expected delivery date. Phew!

All of this reminded me of healthcare information technology (HIT). On the IT side, I sometimes hear about doctors and nurses calling the helpdesk for what they reasonably perceive to be an easy problem. For example, they entered their password wrong a few times and now they’re locked out. Thankfully, this sort of an issue is typically quickly remedied. Other times with other issues, not so much. Imagine a caller reporting a typo in a new documentation template. This is a less common complaint, and while an IT analyst can fix it in a hot second, the poor helpdesk technician might try to fit this square problem in a round hole. “So, doctor, are you telling me that you can’t write your note?” It rapidly goes downhill from there. It’s no one’s fault in particular; it’s just that uncommon things happen uncommonly, so it is difficult to prepare for those sorts of events.

In healthcare, clinicians are sometimes accused of asking dumb or repetitive questions of our patients. Occasionally, it’s because we’re lazy and didn’t take time to look up a piece of the history. But more often than not, it’s because we want the patient to confirm important data points or we want to hear the patient’s story in their own words, not those of the nurse or the resident. I know the triage nurse wrote that the fever started two days ago, but I want the patient to confirm that to me so we’re all on the same page. From the patient’s perspective, someone already asked so he or she shouldn’t have to repeat the information, but there often is method to the madness on the part of the clinician.

It comes down to this: silly questions are likely just questions that don’t need to be asked in order to solve a specific problem. When I call the cable company to ask for a replacement remote, don’t ask me if my internet is slow. When I call the hospital helpdesk to report a typo in a documentation tool, don’t ask me for my workstation number. And maybe, just maybe, when you’re about to ask a patient for info that’s already in your possession, preface the question with a tiny explanation: “I know you told Dr. Jones over there that the fever started a few days ago, but I’d like to hear the story again in your own words to ensure that I really understand the important details.” That extra clarification with the question can make all the difference in the world.

Any comments or thoughts? Tweet at me @CraigJoseph.

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