Maximizing the MSQ Value: Beyond the Intake

This video is aimed at helping practitioners maximize the utility and effectiveness of their clinical encounters by honing their art of clinical practice – beyond science, disease, and treatment.

Of course, BOTH you and your patient want improvement as soon as possible for maximum impact – starting with your initial consultation and continuing into every visit thereafter. 

In using the principles of Functional Medicine (FxMED) in their practice, medical and wellness professionals of many modalities utilize a tool called the Multi Symptom Questionnaire (MSQ) or Symptom Checklist.  It’s a scored survey where the patient rates the frequency and severity of many (usually 50-100) symptoms in a wide variety of functional areas and organ systems.  It can provide a quick, high-level review of key body functions in diverse areas such as digestion, skin, energy and more. This list forms your “Bucket of Opportunities” via which to satisfy – and ideally delight – your patient.

The MSQ helps the practitioner track both quantitative and qualitative feedback on the state of their patient’s health.  Some version of it is used nearly universally as part of an intake to a FxMED-informed practice.  Here at SAFM, we encourage practitioners to expand their utilization of the MSQ well beyond the initial session. In fact, we teach that this survey should be submitted before every clinical encounter.

Watch this video to explore the three main reasons we recommend this expansive, ongoing use of the MSQ:

1. Encourages a comprehensive look at symptoms without limiting them to the patient’s main area of focus. This prevents missing key details that the patient may not think are relevant, but could hold the key to critical cues and clues in the overall case.  It allows the practitioner to consider the interconnectedness of various bodily systems – understanding the patient’s health from a holistic perspective, taking into account physical, mental, and emotional factors.
2. Introduces efficiency in the clinical encounter – the patient has already thought about and evaluated key symptoms and provided that feedback in advance of the actual clinical appointment.  This means you don’t have to spend your valuable (often very limited) appointment time asking questions to elicit more information. The MSQ can also provide valuable practitioner question prompts during the visit.  
3. Provides a way to quantify clinical progress and improvement in symptoms, galvanizing the patient’s belief in you and in their own power to heal. Often many things are slowly, gradually improving in functionally-focused care, and progressive improvement in the overall systemic MSQ score helps to keep the patient inspired and acknowledging their progress, while no one single symptom may yet have fully resolved. 

If you search online for “msq symptom checklist”, you will see that there are many customized versions out there, featuring different symptoms, styles, and organization. Of course, it’s important to include additional symptoms that are most likely at play in your particular practice demographics. The version you use for initial intake may ask the patient to fill out the form relative to the past 1-2 years, while the pre-visit version may focus on just the most recent 2 weeks or month, depending on your typical appointment frequency.

Here is a version we used for years in my own practice.  I hope it’s helpful to you!