Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Why the well visit? 


There is often a reason for an office visit beyond just “well-check.” It can be challenging and rewarding to skillfully create space for concerns to come out. 

In recent years, I’ve learned to be more of a detective during adult well visits. It turns out that beyond routine preventive care, patients often have health issues they’d like to discuss but need me to open a door and create an opportunity to mention them. The typical open-ended questions like “What brings you in?” “What’s on your mind?” or “Do you have any concerns today?” don’t always work. I’ve become more direct with patients who don’t offer any concerns, since there’s often something interesting and important that motivated their visit. Here are a few techniques to try:


1. “What made you decide it was best to come in for a well visit today?”

I may get an answer like, “Your office said I needed to be seen in order to get my medication refilled,” or “My spouse insisted that I come in for a check-up,” that gives some insight or context. I might even hear about a previously undisclosed concern.


2. If no further problems surface on systems review, I may follow with, “Do you have any health goals you would like to discuss?”

This question can really spark conversation, especially around sensitive areas like weight management. It seems to empower patients to introduce something as their own idea rather than respond to what they are being told to do.


If the visit is simply for health maintenance and prevention, that’s encouraged and perfectly fine. But best not to limit the possibilities. 











This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.