As a student or new physical therapist, you may feel a bit intimidated by the subjective interview part of an initial patient evaluation. Regardless of your confidence, it’s important that you take the lead during this interview to ensure a productive evaluation.
To help get you started, I’ve compiled a list of 10 subjective interview questions I recommend asking during a physical therapy evaluation.
Personalizing a Subjective Interview
Before reviewing these questions, remember that each patient is different and deserves a personalized approach. This checklist isn’t meant to be an exhaustive list of every appropriate question for your interview, nor is it a formula for successful evaluations.
Your job as the PT is to conduct a conversation with the person across from you in a way that informs future treatments or recommendations.
What makes these conversations intimidating for many new PTs is navigating a patient’s reticence. For instance, you might have one patient who is very quiet or unwilling to share. Getting sufficient information out of such a patient can feel like pulling teeth!
In contrast, another patient might be too chatty and willing to share their entire life story with you. Although it’s great to have information volunteered, too much of it can obscure the evaluation’s focus.
In either of those situations, a roadmap of relevant questions can help you generate a subjective interview and keep it on topic.
Creating a Semi-Structured Subjective Interview
As you work through the list, you’ll notice that it’s not exactly ten single questions. That’s because with a real patient, there will naturally be some back-and-forth; you might need to follow up their answers with one or two additional questions, as I demonstrate below.
Whenever you conduct an interview, aim for a semi-structured approach, going “off notes” briefly whenever clarification or elaboration is needed. But in general, these 10 subjective interview questions will provide good structure, helping you cover your bases in a limited amount of time before moving on to special tests and treatments.
But first, Introductions!
When I conduct a subject interview, I make sure to introduce myself before launching into a barrage of questions. Taking the time for a simple introduction will put your patient at ease and set their expectation for the evaluation.
I use my introduction as a springboard into the first question, as you can see below:
“Hi there! I’m Tim, one of the physical therapists here at the clinic. I’ve worked here for the past four years, and I treat a lot of people with shoulder issues, so you’re definitely in the right place. Today’s evaluation will take about 45 minutes to an hour and will cover things like your range of motion and strength. We’ll finish the evaluation with some exercises and recommendations you can start doing at home. But before we get into any of that, I’d like to get to know you a little bit and see what’s going on. What brings you into the clinic today?”
Question #1: What brings you into the clinic today?
When you ask this question, your goal is to direct them to explain why they’re coming to see you. Now, there’s a good chance that you’ve already seen their patient intake form – or at least I hope you have. You should have a good idea of why you are seeing them, but it’s good practice to ask the patient this.
Your patient intake form might not tell you everything, such as whether they’re issue is a specific injury or something they’ve been dealing with for a long time. But the patient should be able to communicate this, as well as verify what’s been indicated on their paperwork.
Question #2: Do you have a history of this type of pain or other possibly related injuries?
If your patient has come to the clinic for back pain, you’ll want to know whether they’ve had back pain all of their life or whether this is the first time they’ve experienced it. Asking this question will help you understand the onset of the pain and ascertain how long it’s persisted.
Question #3: Tell me a little bit more about the pain. When do you notice it most? Do you experience any problems standing, sitting, walking, lying down, etc.?
After getting an idea of the history of the problem, I like to inquire about functional activities that the patient is struggling to do. This helps me create a specific plan of care focused on helping the patient reach functional goals.
Question #4: Can you point to the area? How would you describe the pain or feeling that you’re having?
Whenever possible, document the patient’s description of the pain with specific qualities such as “dull,” “achy,” “sharp,” or “throbbing.” Be sure to ask if they experience any numbness or tingling.
Try offering a scale for pain assessment, such as this one: “How would you rate your pain on a scale from 0 to 10, with 10 being ‘take me to the ER right now’?”
Question #5: Have you had any previous treatment for this particular issue (physical therapy, injections, chiropractic treatment, surgery)? Did it help?
I like asking this question because it reveals whether or not the patient perceived any benefit from past treatment. That doesn’t mean you should avoid certain treatments just because the patient said it didn’t work. Rather, the answer will reveal what the patient is expecting, especially if they’ve had physical therapy in the past.
Maybe your patient will say, “I’ve tried exercises, and they don’t work,” or something more general: “Nothing’s helped at all.” Remember, you’re treating a person, not just their pain, so it’s important to understand how the patient is perceiving and approaching their treatment plan.
When one of my patients says that “Exercises don’t work,” I’ll lead a particular exercise and ask, “Well, have you done this specific exercise right here?” If they haven’t, I’ll say, “Ok, good – this is different from what you’ve done in the past. Let’s give this a try and see if it helps relieve some of the pain.”
Try to keep the outlook positive and the patient engaged with the current treatment, no matter their opinion on previous attempts.
Question #6: Have you had any imaging done? What did it show?
I ask this not so that I can read or see the actual imaging, although at times it is helpful to see the imaging report or summary. Rather, my objective in asking this question is to understand the results of the imaging.
Question #7: Are you currently taking any medications for this pain? How many/much, and how often?
Knowing the dosage information of a patient’s pain medication can inform the treatment plan by helping you create specific goals. This way, instead of aiming to merely “lessen pain,” your plan of treatment can indicate an objective measure such as, “reduce the need for pain medication by X amount.”
Question #8: Have you noticed any other changes in your health (night pain, fever, chest pain, bowel or bladder changes, etc.)?
Your patient’s answers to this question might raise some red flags and indicate a larger problem. Depending on the patient’s feedback throughout the treatment, you might choose to recommend another provider based on this initial information.
At this point of the evaluation, there’s a good chance you’ve gathered a lot of information about their injury and history. I like to wrap up the subjective interview with these last two questions.
Question #9: Is there anything else I should know about your overall medical history (cancer, high blood pressure, diabetes, surgery, etc.)?
You’d be surprised by the relevancy of this question. Oftentimes a patient will come into the clinic for, say, ankle pain, having had surgery a couple of weeks ago for a hernia or hysterectomy, etc. Although that surgery was unrelated to the ankle pain, it could directly affect your treatment plan. Unless you ask this question, you might never know about it.
Although we can’t always catch everything, asking this question prevents major issues from going undetected. Even if it’s unrelated to the patient’s therapy needs, this information might impact the way you provide treatment. You may need to protect that area or avoid specific movements or exercises that could disrupt it.
Lastly, before going into objective measurements or special tests, I like to ask this final question.
Question #10: What are your goals for therapy? Are there activities that you want to return to – activities that are currently limited because of this?
You’ll get all sorts of answers to this question: some people might become really specific, and others will try to be funny and talk about unrealistic goals or feats they’ve never done before (such as, “Run a marathon!”).
My recommendation is to bring the conversation back to functional activities that are related to their main problem. For example, if they have back pain, one of their goals might be to reach down to the ground and pick up items without experiencing sharp pain in their back. Such a specific, daily task is a great functional goal to work into the plan of care.
Subjective Interview Questions and Other Resources
I hope you find these 10 subjective interview questions to be helpful as you engage patients in the clinic. If you’re interested in printing out this list of 10 questions, you can download a copy here.