Abstract
The traditional medical consultation comprises history, examination, and investigations, followed by explanation to the patient of diagnosis and management. In the course of studying a series of tape-recorded consultations in a specialist medical clinic for chronic fatigue, we have observed a different structure. In some consultations, those categorised as more `patient-centred', doctors introduced explanation and education into the early history-taking stage. This strategy is contrasted with the traditional approach, where the doctor only elicits information during the history, and gives an explanation later. The `early feedback' strategy may result in patients with chronic illnesses achieving greater understanding of their symptoms. We discuss the implication of these findings for medical training. Keywords: consultation; history-taking; training; communication
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- Epstein R. M., Campbell T. L., Cohen-Cole S. A., McWhinney I. R., Smilkstein G. Perspectives on patient-doctor communication. J Fam Pract. 1993 Oct;37(4):377–388. [PubMed] [Google Scholar]
- Greatbatch D., Heath C., Campion P., Luff P. How do desk-top computers affect the doctor-patient interaction? Fam Pract. 1995 Mar;12(1):32–36. doi: 10.1093/fampra/12.1.32. [DOI] [PubMed] [Google Scholar]
- Levenstein J. H., McCracken E. C., McWhinney I. R., Stewart M. A., Brown J. B. The patient-centred clinical method. 1. A model for the doctor-patient interaction in family medicine. Fam Pract. 1986 Mar;3(1):24–30. doi: 10.1093/fampra/3.1.24. [DOI] [PubMed] [Google Scholar]
- Simpson M., Buckman R., Stewart M., Maguire P., Lipkin M., Novack D., Till J. Doctor-patient communication: the Toronto consensus statement. BMJ. 1991 Nov 30;303(6814):1385–1387. doi: 10.1136/bmj.303.6814.1385. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Waitzkin H. Doctor-patient communication. Clinical implications of social scientific research. JAMA. 1984 Nov 2;252(17):2441–2446. doi: 10.1001/jama.252.17.2441. [DOI] [PubMed] [Google Scholar]