Every OPD has this one moment that lasts only a few seconds. The consultation is almost over. The examination has been done, the prescription has been written, and we’ve explained the diagnosis as best we can. Then comes the question we’ve all asked countless times.
“Any doubts?”
Almost every time, the answer comes back just as quickly.
“No, doctor.”
For a long time, I took that answer at face value. Now I’m honestly not so sure. I don’t think most patients leave a consultation without questions. I think they leave wondering whether those questions are worth asking at all.
The doubts usually arrive later. When the first tablet is about to be taken. When a family member asks what the doctor actually said. When the medicine strip in hand looks unfamiliar. Or at two o’clock in the morning, when there isn’t a doctor sitting across the table anymore.
“What exactly is this medicine for?”
“Will I need to take it forever?”
“Can I take it after food instead?”
“What happens if I miss a dose?”
“Should I stop once I start feeling better?”
The consultation may have ended, but that’s often when the real questions begin.
Over the years, I’ve realised that silence doesn’t always mean understanding. Sometimes it means a patient doesn’t want to take up any more of the doctor’s time. Sometimes it’s nervousness. Sitting in a clinic can do that to people. Sometimes it’s the shock of hearing a diagnosis for the first time. And sometimes people stay quiet simply because they don’t know what they’re allowed to ask.
Many of us grow up believing that the doctor talks and the patient listens. That trust in the white coat is important, and it should remain. But trust should never come at the cost of understanding your own health. Asking questions isn’t doubting your doctor. It’s taking part in your own care.
So if you’ve ever wondered why you’re taking a particular medicine, ask. If the diagnosis doesn’t quite make sense, ask. If you can’t afford the medicines you’ve been prescribed, tell us. If you’re pregnant or breastfeeding, tell us. If you’re planning to fast, travelling for work, or worried that your treatment simply won’t fit into your daily life, tell us that too. Those conversations aren’t interruptions. More often than not, they become the most important part of the consultation.
We spend years learning diseases, investigations and treatments. But the moment you leave the clinic, you’re the one living with the illness. You’re the one trying to remember which tablet comes before breakfast and which one doesn’t. You’re the one balancing treatment with work, family, festivals, travel and all the ordinary responsibilities that continue long after the consultation has ended. We understand the medical side of the illness, but you understand your own life. Good healthcare depends on bringing those two together.
The longer I’ve worked in clinics, the less I’ve believed that a good consultation is measured by how quickly it finishes. I’ve started thinking it’s measured by something much simpler. Did the patient leave understanding their illness a little better than when they walked in? And did I understand something about their life that I didn’t know before? If the answer to both is yes, it was probably time well spent.
In public health, we have a term for this: health literacy. It sounds far more academic than it really is. Health literacy isn’t about knowing medical jargon or understanding physiology. It’s about understanding enough to make good decisions once you’re back home. Knowing why you’re taking a medicine, how to take it correctly, when to come back, when something isn’t right, and knowing that asking for an explanation again is never something to feel embarrassed about.
But health literacy isn’t something patients build on their own. It grows one conversation at a time. Every question a patient feels comfortable asking strengthens it, and every explanation a doctor takes the time to give strengthens it too. That also means the responsibility doesn’t rest entirely with patients. It rests with us as doctors as well.
If patients aren’t asking questions, perhaps we should ask ourselves whether we’ve made it easy enough for them to ask. Are we rushing through explanations? Are we using words that make perfect sense to us but mean very little to the person sitting across from us? Are we so focused on finishing the consultation that we’ve forgotten it’s supposed to be a conversation?
Listening is easy when someone nods, agrees and moves on. It becomes harder when someone is anxious, confused or asks us to explain the same thing again. But listening is just as much a clinical skill as diagnosing, examining or prescribing. Some of the best consultations I’ve had weren’t the fastest ones or the ones where I spoke the most. They were the ones where a patient finally felt comfortable enough to say, “Doctor… can I ask you something?” More often than not, that question turned out to matter just as much as everything I’d already explained.
Maybe that’s what good healthcare really looks like. A consultation where the patient leaves understanding their illness a little better than when they arrived, and the doctor leaves understanding the patient’s life a little better too. It takes courage to ask and patience to listen. Somewhere between those two, understanding begins. The prescription still matters, of course, but so does the conversation that surrounds it. One treats the illness, the other helps people live with it.