The 3 Question Rule

About ten years ago, I started a new job in the field of home infusion. For this job, pharmacists are “on-call” during non-working hours. One particular Sunday, I decided to go on a long run. I was 7 miles from my home when I got a call from the nursing agency we work with. She said that they didn’t have the correct supplies in our patient’s home to do an antibiotic infusion. 

She asked me to go to the infusion pharmacy right away, get the supplies together and call the driver to deliver the supplies to the patient’s home. 

Of course, I immediately said, “Yes! I will have your supplies within the hour.”

I went into a panic. It would take me quite a while to run back home. I was worried about the patient missing a dose of antibiotics. I was worried the nurse would be wasting his time if I didn’t get him the supplies quickly.

After a phone call to my husband, a ride home, and a trip into the pharmacy, I called the nurse to say that the supplies would be on their way. I got this done in about 20 minutes. The nurse then replied, “Oh, I found what I needed in my supply kit. There’s no need for you to send them.”

I wasted my workout, my time, and nearly had a panic attack all for nothing. I learned a valuable lesson that day. The lesson was that when someone asks me a question, I don’t have to answer it. At least not right away. I can stop and find out more about what they’re asking. 

After a few more of those “on-call” situations, I not only averted having to stop doing what I was doing and go into the pharmacy, I developed a little rule that has served me to this day. This rule has saved me time and helps me make the most of my energy. It has allowed me to better serve my coworkers, company, and most importantly, my patients.

I call it “The 3 Question Rule.” 

How The 3 Question Rule Works

The rule is simple. If someone asks you one question, you get to ask three questions before answering their one question. There are many applications to this. In the pharmacy I use this rule:

1. When I need to get clear on what the customer/patient is asking me.

2. When I have a feeling that they aren’t asking what they should be asking.

3. When I need more time either because I need to think about the question, look something up, or the customer is upset.

I’ve even used it for the simplest of questions such as, “Where can I find the vitamins?” or “What aisle are the laxatives in?”  I’ve used it for emotionally charged questions such as, “Can you help me identify a blue pill I found in my daughter’s backpack?” I’ve also used this approach for questions that I didn’t understand at the time of the asking, such as, “Why won’t my insurance pay for my pills?”

Even to this day, I rarely simply answer a question just because someone asked it. I use the 3 Question Rule. I rarely get to that third question, but I know it’s there for me if I need it. 

A True Story Showing The 3 Question Rule  

A woman walked up to the pharmacy counter and asked me where a specific type of chromium was. Using the 3 Question Rule, I first asked her why she wanted it. I did this as we were walking to the supplement aisle. I wasn’t challenging her. I was just inquiring.

She said she saw it on Dr. Oz, so I asked her what the show was about which was the second question. She said it was about the cure for diabetes. I asked her what she hoped to get out of taking this chromium (the third question). She said, “If I take the chromium, I won’t have to take my medicine anymore.” 

This woman was under a serious misconception. A wrong notion could lead to a very bad outcome. I didn’t wish to tarnish Dr. Oz’s good name or more importantly offend this kind lady. So I simply explained what chromium does in the body. Although it is very important for blood sugar control, she couldn’t stop taking her medication. I ended the conversation by reminding her to tell her doctor about this new supplement so he could help track her success. I told her, “Good for you for trying to keep up with your diabetes and make yourself better.”

Another Good Application of the 3 Question Rule

The 3 Question Rule can be most helpful when dealing with people who are complaining about something. Often you need to get to the bottom of what are upset about. It’s not clear because sometimes people start talking without thinking. Also, when people are emotional, they don’t always choose the right words. So, if you ask questions in response to “Why aren’t my pills ready?!!”, you may get to the bottom of the situation. 

Always do so with the tone and intention as if saying to them “I am on it, I am going to fix this or figure it out and make it right.”

For example, if someone is very angry their pills aren’t ready, you don’t want to approach them or speak to them in an accusatory tone. Don’t imply they did something wrong, such as forget to call for the refill. Often people do forget they didn’t call for their refills and then are mad at you for not having them ready. This information isn’t useful because if you bring it up, it will only make someone more angry or defensive. If you find they didn’t call in their refills, you can gently let them know that next time, calling in their refill will make their lives better. In response to “Why aren’t my pills ready??!” you can ask “When did you call them in?” Not “Why didn’t you call them in?” Then you can get closer to the answer as to why they are not ready to prevent future issues like this for them and you. Then you have them thinking. It’s really hard to think and yell at the same time.

Another question could be “Were you expecting your doctor to get a script to us today?” This helps get to the bottom of things as well as buys you time while you diffuse an angry situation.

Remember, just because someone asks you a question, doesn’t obligate you to answer it. A question doesn’t mean that’s what they want or need to know. Just because someone asks you the question, doesn’t mean you can’t take your time in answering. The 3 Question Rule will help you lead your patients. It gives you time to find context and learn about the problem, shows you care, and lets you fix problems more efficiently.

It’s important to remember that you may never get to all three questions. That’s not the point. The point is that you get to be in charge of the interaction and as the one in charge; you get to ask the questions. You may get to exactly where you need to be for a happy helpful interaction after the first question. That’s great. Go with it. The key is to start using this approach today. You’ll serve your customers better in less time and have less stress. 

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