Sometimes easier to ask our patient to rank how they’re feeling about potential goals on a 1-10 scale, then it is to sit around speculating on how ready they actually are. 

Using a 1-10 scale as a casual check point during a conversation can quickly and effectively get straight to a person’s belief in their ability or their desire to make change. 

A good trick is to ask your patient to rank a general concern and then again later in the discussion to define the specifics that may help them achieve that general goal. 

Here’s an example: 

• General Concern: How confident that you’ll be able to lower your A1C level to where you want it?
• Specific Goal: So if getting off medication is how you’ll know your A1C is at a good place, how do you think you’ll do at making that happen?

You can also think about this ranking system as an opportunity to help your patient clarify their strengths and learn more about their perceived weaknesses. 

That might happen with a 2 part questions starting with something like: Ok! So you’re feeling like a 4 our of 10 is about how well you can cut down on soda.

Follow up questions can be:

• Why is it 4 and not 1?  
• Why is it 4 and not 10?

Here are a few more excellent questions written by Molly Kellogg that are easy to use with a ranking system to get the conversation moving.

Gauging Importance

• How do you think you’d do making that change?
• What might have to be different for the importance to go up a few points?
• What matters most to you about this?
• Are there parts of this that mean more to you than others?
• Would it help to talk more about that part?
• What specific changes do you believe will most likely get you to that goal?
• What are the best / worst things about how things are now?
• If you were to make this change, what would your life be like?

Gauging Confidence:

• How confident are you that you can do this, on a scale of 1 to 10?
• What would make you more confident about making this change?
• How can I help?
• What has been helpful in the past when you successfully made a change?
• What can you learn from previous attempts that didn’t work?
• Who can you lean on for support, while you’re working on this?
• If we break this goal down into smaller pieces, would your confidence increase?