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The doctor may also learn more about the illness from the way the patient tells the story than from the story itself. (1861–1954)

James B. Herrick, MD

This chapter describes a user-friendly step-by-step method for the beginning of the medical interview that has been effective in many hands for more than 25 years.19 Your first task is to master the 5 steps and 21 substeps shown in Table 3-1. We urge you to learn these thoroughly, to the point that they become reflexive—this is easily accomplished by studying and then practicing them. Even though this may seem like a lot to learn, just as you learn the intricacies of cardiac physiology, this is your major task in mastering the medical interview. Using these steps and substeps will make you a more scientific and more humanistic physician—and your patients will benefit (see Appendix B for a detailed humanistic and scientific rationale for being patient-centered). To assist you, we also have developed a video that demonstrates the same skills described here: (see Preface). (See AccessMedicine video titled “How to Interrupt”:

TABLE 3-15-Step Beginning of the Interview

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