I used to tell my pharmacy technicians not to ask patients if they had any questions.
That sounds like strange advice coming from a pharmacist.
Of course I wanted patients to ask questions. I spent much of my career answering them. But there was something about that familiar question—Do you have any questions for the pharmacist?—that bothered me.
It was too easy to answer.
“No.”
So I taught my technicians to ask something specific instead.
If someone was picking up a new prescription for ciprofloxacin, for example, we might make sure the patient understood how to separate it from certain foods, supplements, or products that could interfere with its absorption. With levothyroxine, we might ask whether the patient understood when and how to take it in relation to food. With an NSAID, we might talk about taking it with food when appropriate to reduce stomach upset.
The point wasn’t to quiz anyone.
It was to find out whether the important part of the message had actually arrived.
An assumption is hidden inside the question, “Do you have any questions?”
It assumes we know what we don’t know.
Think about that for a moment.
You are handed a bottle containing a medication you may never have heard of. The label contains a name you may not be able to pronounce. Perhaps your doctor explained it, but that was twenty minutes ago, along with your diagnosis, your lab results, and three other things you were trying to remember.
Then someone asks:
“Any questions?”
What are you supposed to ask?
The person on the other side of the pharmacy counter knows things you don’t. That’s why you’re there. But somehow we’ve placed the responsibility on you to identify the missing piece of information.
Over the years, I learned that silence was a poor measure of understanding.
People nod for all kinds of reasons. Sometimes they understand. Sometimes they’re embarrassed. Sometimes they’re in a hurry. Sometimes three people are waiting behind them, and they don’t want to hold up the line.
And sometimes they say they have no questions because they genuinely don’t know there is a question they should be asking.
That isn’t unique to healthcare.
A teacher finishes explaining an assignment and asks the class, “Everybody understand?”
Heads nod.
A manager explains a new procedure and asks, “Any questions?”
Silence.
A parent gives instructions to a child who says, “I know.”
Maybe they do.
But we’ve all experienced what happens next.
Information has been delivered. Understanding has not necessarily followed.
There is a difference.
I learned the same lesson in other settings. As a director of pharmacy, explaining a new hospital protocol wasn’t enough; I needed questions to discover what my staff had heard and what I had failed to make clear. Years later, selling microscopes and laboratory equipment, I found that questions often mattered more than the presentation. Before I could explain what someone needed, I had to understand what they were trying to accomplish.
I spent years dispensing medications, but much of what I was really doing was translating. Medical language into ordinary language. Instructions into actions. What the prescriber intended into what the patient needed to do when they got home.
And translation requires more than speaking clearly.
It requires finding out what the other person heard.
That’s why I preferred the specific question. Not Do you understand? but something closer to Tell me how you’re going to take this when you get home.
The difference is subtle, but important.
One asks for reassurance.
The other invites understanding.
That could be something worth remembering outside the pharmacy, too.
Whenever we know more about something than the person we’re talking to, it’s easy to believe we’ve communicated simply because we’ve explained.
But the responsibility for understanding cannot always belong to the person who knows the least.
Sometimes the most important question isn’t the one someone knows to ask.
It’s the one we care enough to ask them.
