When to dig and Where to dig

I read the article of Beach et al. regarding clinician response to patient emotion with great interest. They demonstrated that providing space for patients' elaboration on the feeling increased consultation time while explicitly focusing on patient affect decreased it.

According to Schein (1), providing space for conversation using "humble inquiry" is vital when exploring ways to help. It is "the fine art of drawing someone out, of asking questions to which you do not know the answer, of building a relationship based on curiosity and interest in the other person." It is similar to inductive foraging (2) in terms of not directly digging a specific theme that a questioner wants to know beforehand. On the other hand, the communication actively focusing on emotions may be classified into a "diagnostic inquiry", which can be helpful if the direction is correct but can also be unsuccessful. For example, speaking emotion is sometimes embarrassing or suffering, and the responder may not want to be asked. As a result, it may threaten the patient-physician relationship or patients' well-being.

In light of the above, family physicians need expertise in dealing with the two uncertainties in communication in a consultation: when to dig and where to dig.

References
1. Schein EH. Helping: How to Offer, Give, and Receive Help: How to Offer, Give, and Receive Help. Berrett-Koehler; 2011.
2. Donner-Banzhoff N. Solving the Diagnostic Challenge: A Patient-Centered Approach. Ann Fam Med. 2018;16(4):353-358. doi:10.1370/afm.2264