1 s (range 8–69 s) and 15.4 s (range 1–90 s) responses, respectively. When answering the KCQ, patients were interrupted by the physiotherapist in 25 out of 42 consultations (60%), whereas in the other 17 consultations (40%), patients’ answers came to a natural stop before the physiotherapist spoke. Out of these 25 interrupted consultations, responses to closed questions (n = 16) were interrupted sooner (mean = 19.9 s) than open (n = 4) check details (mean = 24.8 s) and open-focused questions (n = 5) (mean = 45.2 s). This exploratory study aimed to identify the preferred phrasing of physiotherapists when opening clinical encounters

in musculoskeletal outpatient settings. The results indicate that clinicians are in favour of using open questions when asking patients about their ‘problem presentation’ in both initial and follow-up clinical encounters. Open questions give patients the opportunity to express their own ideas and experiences freely, whereas closed questions only look for a ‘yes’, ‘no’ or simple fact response ( Evans et al., 2008). These results relate to previous research, which has highlighted that when practitioners use open questions at the start of their consultations, patients report greater satisfaction and adherence to treatment, as they feel the practitioner has listened to them, which facilitates the therapeutic relationship

( Robinson learn more and Heritage, 2006 and Zolnierek and Dimatteo, 2009). In the present study, physiotherapists favoured the question: “Do you just want to tell me a little bit about [your problem presentation] first of all?” which is a problem-focused symptom query, and is both a question and an MYO10 invitation. In lay terms, this could be described as an open-focused question, as it allows the patient to direct the problem aspect. The ‘just … tell me’ component is eliciting

a narrative and the clinician is not presupposing a specific angle or problem, or displaying prior knowledge of the patient’s problem, thereby occupying a less knowledgeable (K–) epistemic status ( Heritage, 2012). It is evident that the question is phrased as a yes/no interrogative and displays an entitlement contingency, however it still gives the patient an entitlement to decline. Finally, the temporal component ‘first of all’ sets up that there is more to come and the patient will therefore have further opportunities to tell their story. This style of question was favoured over: • narrative open questions (“Do you want to tell me your story”); The findings of the current study are comparable to that of Marvel et al. (1999), who observed that in 34 out of 264 interviews between physicians and patients, physicians followed open questions with open-focused questions when addressing patients’ agendas. They commented that this is a ‘useful’ style to adopt as it avoids gathering an extensive list of patient concerns rigidly at the opening of the interview (Marvel et al., 1999).