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INTRODUCTION

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: www.accessmedicine.com/SmithsPCI (see Preface). (See AccessMedicine video titled “How to Interrupt”: www.accessmedicine.com/SmithsPCI.)

TABLE 3-15-Step Beginning of the Interview

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