Patient-centred care has been shown to enhance patient satisfaction and lead to better health outcomes. In the patient-centred clinical method, the doctor aims to ascertain the patient’s agenda and reconcile it with his or her own to develop a management plan.
Identifying the patient’s agenda is a key strategy in managing uncertainty. However, hidden agendas are very common in the general practice setting and often only emerge late in the consultation, if at all.
Pendleton introduced the notion of identifying the patient’s ideas, concerns, and expectations as key elements to better understand the reasons for the presentation. This can be remembered by the acronym ICE.
- Ideas
- Concerns
- Expectations
Using this framework, useful questions to help identify the patient’s agenda include:
- “What do you think is going on?” (ideas)
- “What are you particularly worried about?” (concerns)
- “What were you hoping to get out of the visit today?” (expectations)