How do I reply to 'How are you?' in a medical context?
August 3, 2010 5:32 AM   Subscribe

When I go to see my specialists at the hospital when I walk in they always ask: 'How are you?' How should I respond?

Unfortunately, years of social conditioning comes into play and I find I always reply: 'Fine thanks. How are you?' as I would in any other social situation.

Does the Doctor understand that is just a pleasantry or are they actually expecting me to dive right into a list of 'things that are bothering me' at that stage.

If I were to do that in my mind I would be being very rude to the doctor as I would be breaking a social convention. But if I carry on as usual and the doctor expects me to dive into things there is a certain amount of back-peddling in the appointment to contradict what I said earlier.

posted by Nufkin to Writing & Language (20 answers total) 2 users marked this as a favorite
I'm assuming that the doctor is asking to get a gauge on how things are going. I'm sure they realize you've been conditioned to respond this way, but jumping right into what's wrong isn't going to be a problem either. They're your doctor, and you're there because something's wrong.
posted by theichibun at 5:36 AM on August 3, 2010

If I'm not well, I just answer "I'm OK". If I'm really not well, I pause before saying it to make it clear that it's a pleasantry and not a statement of fact.

If that doesn't work, you could say "I've been better."

No, the doctor doesn't expect you to launch in with a list of ailments. This is a preamble. A doctor understands that unless it's a routine follow up, you're there because something needs to get better.
posted by MuffinMan at 5:39 AM on August 3, 2010

I've done both ... when I'm there for something chronic, even if I'm later going to say, "oh, and my back hurts a lot more than it used to", usually I go with the stock "Fine, thanks." As you said, it's a social convention; and if one were to ascribe non-formulaic meaning to it, the "question" is more along the lines of "hey, how's your family/job/life" than "how does your body feel". (Or mind, if you're seeing that sort of specialist, although there I guess there's more of an argument for starting right out being honest with your mood.) If I'm there for something acute, serious or not, I'll usually say, "well, I have X going on ...".

I have a tendency in the latter case to be cranky and say, "I'm here" in a sarcastic tone of voice that says I'd rather not be. It's not something I'm proud of, and I don't recommend it. (Though thankfully the docs I've dealt with generally seem to get why it happens.)

I'm looking forward to seeing other people's responses, since this is something that's bothered me since I was young.
posted by spaceman_spiff at 5:39 AM on August 3, 2010

I tend to respond pretty straight-forwardly: "I'm pretty good, except *thing that I came in for*."

Resolves the social and medical sides of the question at once.
posted by Rendus at 5:50 AM on August 3, 2010 [4 favorites]

I usually respond with a conversational "all right, considering" or "well, you know, I'm here," followed by "and how are you?" If it's someone I've seen previously for a specific condition, I'll provide a succinct update, e.g. "feeling better!" or "about the same as before." It acknowledges both the pleasantry and the literal question.
posted by Metroid Baby at 5:50 AM on August 3, 2010

Usually I take that question as half pleasantry/half professional question so I give a very brief response. I think I do exactly as MuffinMan. I have to override my first reaction of "Fine" and say "...ok" or "not bad" or if I slip up, I'll say "fine... well except that I've been feeling xyz". My response is brief but not quite my usual public response.
posted by parkerjackson at 5:52 AM on August 3, 2010

When it's doctors I see routinely, I tend to give my emotional state in answer to the question -- I assume they KNOW I'm there for a physical problem, so I say, "Fine," or "Good, a little stressed, but good," or "This pain is really getting me down, I'm not coping so well," or something like that. With the doctors I know fairly well because I see them a lot, I think it's both a reflexively pleasantry and a gauge of mental state, which most doctors want to know. Mostly I'm a happy person so mostly I say, "Good" but I do say when it's not good. (This seems to be the right answer since when I say, "Stressed" or "Upset," they always say, "Well, let's get to the bottom of this evil third arm problem and see if we can get your stress under control." whereas if I say "Good" we move along to the physical exam and they still take the pain/problem seriously.)

When it's something acute and it's a doctor I don't know, like I'm at Urgent Care or the ER, I'm usually like "Been better," or "Great, except for the icepick in my head." But dark humor helps me cope with stress, I don't know how appropriate that is.
posted by Eyebrows McGee at 5:56 AM on August 3, 2010

Considering how few minutes doctors actually spend with patients, I let the social pleasantries go, and get directly to the point -- I'd hate to waste my alloted 12 minutes on pleasantries and be forced to skimp on my real reason for being there.
posted by Houstonian at 6:08 AM on August 3, 2010 [1 favorite]

I generally say "I'm all right--how are you?"
If you say you are "all right" it is akin to saying you are standing upright --it is quite a neutral answer.
posted by naplesyellow at 6:11 AM on August 3, 2010

Yeah, Rendus has it. "I'm fine thanks doc, except for this gosh-danged issue."
posted by turgid dahlia at 6:22 AM on August 3, 2010

If you're going for a check up that might affect your benefits or insurance payouts in any way, never ever answer in the neutral or positive. They have ticky boxes and the first one will be 'patient doesn't appear to be experiencing any discomfort'.

Also remember that any pain charts don't show actual pain until half-way through the chart - on a scale of happy face > neutral face > unhappy face - if you think it's 3/10, you'd need 7/10 on their charts.
posted by shinybaum at 6:29 AM on August 3, 2010

*Pritty, pritty good*.
posted by watercarrier at 6:57 AM on August 3, 2010

I've had several eye surgeries lately and my opthamologist always greets me this way.

I sometimes make some very small joke of it like "I'm great, except for this eye thing."

Otherwise I'll just say "I'm well, how are you?" or "I'm well, though I have a couple of concerns about my eye. How are you?"

It's half pleasantry and half earnest request for information. That said, he's not going to think you're a miscreant or a liar if you respond "I'm fine, and you?" and then go on, ten minutes later to say that you feel like you're dying.
posted by 256 at 7:36 AM on August 3, 2010

I usually say "Other than whatever I came in for, not bad." But, and here's the important bit: only if it's true. If you're feeling general malaise, tiredness, other symptoms, in addition to your primary complaint, it's best not to gloss those over with an 'I'm okay other than my sore shoulder' or whatever.

I learned this lesson when I was in the 12th grade. I passed out in the shower, and was not feeling well when I regained consciousness so my mother took me to the doctor. I told him about the passing out in the shower thing. We had a 10 minute or so conversation, and he couldn't figure out what was wrong and ordered some blood tests. And then, sort of on the way out the door at the end of the appointment, something prompted me to mention that my butt had been really sore for several days.

At which point, without even looking up from the piece of paper he was writing on, he said 'Oh, never mind those tests then, you probably have an insert medical term for giant sack of puss in your ass here, come back and let me take a look." And indeed, he was correct, and instead of getting a bunch of blood drawn and waiting a few days to find out what was wrong with me, I got stabbed with a scalpal without anesthetic. Which doesn't sound better, but believe me, it was.

So, while, 'how are you?' is not necessarily an invitation to immediately list all your symptoms, I take a certain amount of pain not to give false information in that statement. If I am not completely fine other than X, I try not to say so.
posted by jacquilynne at 7:39 AM on August 3, 2010

I'll usually say something like "I'm surviving", "Still breathing", or "I'm conscious so it must be a good day."

My husband always says "Insane, how about you?" no matter who's asking.
posted by TooFewShoes at 8:36 AM on August 3, 2010 [1 favorite]

Sadly, I'm noticing that no medical doctors have replied to this question. This is the one time when "I AM a doctor" might be helpful.
posted by CathyG at 9:32 AM on August 3, 2010

This is the one time when "I AM a doctor" might be helpful.

OK, I'll have a go at it. I generally introduce myself, and rather than ask how people are doing, I say "I understand we are here for a tonsillectomy (or whatever they are here for)" Also, since I take care of children, I am often talking to their parents rather than the patient, so the person I am asking might be fine although the patient is not. Having said that, any of the above answers is fine. If you want to answer the question as just social pleasantry that is OK, but if you want to start addressing your problem that is OK too. Most physicians have an ingrained way they introduce themselves and begin talking to patients (i.e. their bedside manner). They may well have used the same introduction hundreds or even thousands of times (I did about 1200 anesthetics last year and introduced myself to virtually all of the families as I described above; multiply that times 20 years and you get a feeling for how automatic it becomes). With that many interactions you get all kinds of responses and learn to take them pretty much in stride (although it still irks me when a parent won't get off the phone or stop playing with their Gameboy while I am trying to talk to them about their child). So in short, answer it however you feel comfortable. If you want to dive right into your complaint they should understand; if you want to start off with a little pleasantry they should understand that too.
posted by TedW at 9:55 AM on August 3, 2010

I would just say "Fine, for the most part...", which answers the social greeting and leads the physician directly to the question of "well, what's not fine?"
posted by jehsom at 10:49 AM on August 3, 2010

It looks like everyone is saying roughly the same thing, which is good.

This is a check up for me, but I believe things have got worse so I will take that into account when answering.

Thank you all.
posted by Nufkin at 11:22 AM on August 3, 2010

I have to go in for a 5,000 km checkup every six months, and when they ask me how I am, I always reply, "That's what I want you to tell me" or "That's what I came here to find out." It always cracks them up laughing.
posted by aqsakal at 1:08 PM on August 3, 2010

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