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A key component of history taking involves exploring a patient’s ideas, concerns and expectations (often referred to as ICE). Asking about a patient’s ideas, concerns and expectations allow you to gain insight into how a patient currently perceives their situation, what they are worried about and what they are expecting from the consultation. It can sometimes be challenging to use the ICE structure in a way that sounds natural in your consultation. As a result, we’ve put together some example phrases for covering each of the three points.
Ideas
Examples of how to explore a patient’s ideas:
- “Tell me about what you think is causing the problem.”
- “Do you have any theories about what might be going on?”
- “It’s clear that you’ve given this a lot of thought and it would be helpful to hear what you think might be going on.”
- “What do you think might be happening?”
- “What’s your best guess as to what is causing this?”
- “Do you have any ideas as to what is going on at the moment?”
Concerns
Examples of how to explore a patient’s concerns:
- “What’s your biggest worry at the moment regarding what this might be?”
- “Are you worried about this being anything in particular?”
- “In your darkest moments, what do you worry about?”
- “What’s the worst thing you were thinking it might be?”
- “What’s your number one concern regarding this problem at the moment?”
Expectations
Examples of how to explore a patient’s expectations:
- “What were you hoping I’d be able to do for you today?”
- “What would ideally need to happen for you to feel today’s consultation was a success?”
- “What do you think might be the best plan of action?”
- “What were you hoping would happen today?”
- “You’ve obviously thought about this quite a bit, did you have any thoughts on the best way we could tackle the issue?”