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Share The foundation of medical diagnosis depends on the story of the illness as you have lived, experienced and remeber it, and so not tests, investigations or procedures
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The foundation of medical diagnosis depends on the story of the illness as you have lived, experienced and remeber it, and so not tests, investigations or procedures
Symptoms identified from a history provide some of the most critical information used in diagnosing a disease. When patients describe the symptoms for which they are seeking professional attention, they are also reporting the story of an illness as they have lived and remembered it, and so it can vary. To some extent, symptoms are a universal human experience. Virtually every person. Experiences some discomfort and is seeking help.
Talking with a patient has a third function: it helps that person feel understood, thereby helping establish a therapeutic relationship. A style of questioning narrowly shaped for the sole purpose of diagnosing a disease ignores much of what patients have experienced and many of their concerns and questions. It therefore often prevents the development of a trusting relationship and diminishes the chances of helping the patient. Talking with a patient about the experience of being ill, on the other hand, can have great value even when nothing can be done about the disease.'
Collecting information with a pre-primed assessment set or computer may be good and more efficient, but it is not advisable for young doctors in training. It is the duty of the senior experienced doctors to identify deficiencies in 'history taking by a junior doctor, and help him or he to rectify the defects and thus help them to be good clinicians.
The disadvantage of a preprinted questionnaire is that you may forget to consider relevant questions and the sequence of questioning required to arrive at a diagnosis. This may result in the future clinician learning to fill in the blanks meticulously, but being unable to collect and analyse data in their brain. This type of "fill in the blank questionnaire" requires no special "history taking skill, and may also result in a delay in arriving at a diagnosis in an emergency.
I have come across some junior doctors meticulously taking a history with these pre-prepared templates, when they should have concentrated on treating the patient. The patient is uncomfortable and at times very ill, but the doctor, primed to ask questions, fails to recognise the patient's problem or to give importance to what the patient has to say.
This makes the patient feel that the doctor is not keen on understanding his current problem, and so loses confidence in the management. The other issue is that when the doctor is taking a history with a preprinted form, there is no eye contact with the patient because the doctor is keen on reading the printed questions. This breaks the patient-doctor relationship and can be disadvantageous to both doctor and patient.
Let us not forget that today's junior doctors are our physicians and surgeons.
Common diseases commonly occur, rare diseases rarely happen
Views on common diseases as seen in primary and secondary medical care vary and depend on the primary care physician or nurse’s training and experience in interpreting symptoms and signs. Mastering this skill takes years of training, practice and passion to heal.
Srivatsa KM. QCJ(BMJ) June 1996, Vol 5;6. Pre-pPreprintedssment Sheet;
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By Kadiyali SrivatsaSymptoms identified from a history provide some of the most critical information used in diagnosing a disease. When patients describe the symptoms for which they are seeking professional attention, they are also reporting the story of an illness as they have lived and remembered it, and so it can vary. To some extent, symptoms are a universal human experience. Virtually every person. Experiences some discomfort and is seeking help.
Talking with a patient has a third function: it helps that person feel understood, thereby helping establish a therapeutic relationship. A style of questioning narrowly shaped for the sole purpose of diagnosing a disease ignores much of what patients have experienced and many of their concerns and questions. It therefore often prevents the development of a trusting relationship and diminishes the chances of helping the patient. Talking with a patient about the experience of being ill, on the other hand, can have great value even when nothing can be done about the disease.'
Collecting information with a pre-primed assessment set or computer may be good and more efficient, but it is not advisable for young doctors in training. It is the duty of the senior experienced doctors to identify deficiencies in 'history taking by a junior doctor, and help him or he to rectify the defects and thus help them to be good clinicians.
The disadvantage of a preprinted questionnaire is that you may forget to consider relevant questions and the sequence of questioning required to arrive at a diagnosis. This may result in the future clinician learning to fill in the blanks meticulously, but being unable to collect and analyse data in their brain. This type of "fill in the blank questionnaire" requires no special "history taking skill, and may also result in a delay in arriving at a diagnosis in an emergency.
I have come across some junior doctors meticulously taking a history with these pre-prepared templates, when they should have concentrated on treating the patient. The patient is uncomfortable and at times very ill, but the doctor, primed to ask questions, fails to recognise the patient's problem or to give importance to what the patient has to say.
This makes the patient feel that the doctor is not keen on understanding his current problem, and so loses confidence in the management. The other issue is that when the doctor is taking a history with a preprinted form, there is no eye contact with the patient because the doctor is keen on reading the printed questions. This breaks the patient-doctor relationship and can be disadvantageous to both doctor and patient.
Let us not forget that today's junior doctors are our physicians and surgeons.
Common diseases commonly occur, rare diseases rarely happen
Views on common diseases as seen in primary and secondary medical care vary and depend on the primary care physician or nurse’s training and experience in interpreting symptoms and signs. Mastering this skill takes years of training, practice and passion to heal.
Srivatsa KM. QCJ(BMJ) June 1996, Vol 5;6. Pre-pPreprintedssment Sheet;