The Medical Interview: Mastering Skills for Clinical Practice

by Coulehan, John L.; Block, Marian R.

• ISBN13: 9780803602670
• ISBN10: 0803602677
• Edition: 3rd
• Format: Paperback
• Copyright: 1997-05-01
• Publisher: F a Davis Co

Summary

-- Presents a succinct explanation of the patient interview process that is written at the level of the medical student
-- Many clinical examples, including 125 excerpts from actual clinician-patient interactions
-- Sample interviews highlight both good and bad technique
-- New chapters include: Interacting with the Patient in Primary Care, Telling Bad News, and Understanding the Patient's Beliefs and Values

Table of Contents

Introduction The Poor Historian	xvii
PART ONE BASIC SKILLS: UNDERSTANDING THE PATIENT'S STORY	1	(134)
CHAPTER 1 I Attach the Same Meaning Interviewing as a Clinical Skill	3	(17)
OBJECTIVITY	4	(1)
INTERPRETATION VERSUS OBSERVATION	5	(3)
PRECISION	8	(2)
SENSITIVITY AND SPECIFICITY	10	(1)
REPRODUCIBILITY	11	(2)
SCIENCE AND ART AT WORK	13	(2)
SAGA OF THE FIFTH WHEEL	15	(3)
SUMMARY: SCIENCE AND ART IN INTERVIEWING	18	(2)
CHAPTER 2 With Simple, Kindly Words Respect, Genuineness, Empathy	20	(22)
RESPECT	23	(2)
GENUINENESS	25	(2)
EMPATHY	27	(1)
LEVELS OF RESPONDING	28	(5)
USING WORDS TO IDENTIFY SYMPTOMS AND FEELINGS	33	(1)
NONVERBAL COMMUNICATION	34	(5)
CHALLENGES TO UNDERSTANDING EXACTLY	39	(1)
SUMMARY: CORE THERAPEUTIC SKILLS	40	(2)
CHAPTER 3 Why Should You Come to Consult Me? The Chief Complaint and Present Illness	42	(24)
THE SETTING	43	(1)
GETTING STARTED	43	(2)
THE CHIEF COMPLAINT	45	(4)
THE PRESENT ILLNESS	49	(8)
A FEW EXAMPLES	57	(2)
CHALLENGES TO ELICITING THE CHIEF COMPLAINT AND PRESENT ILLNESS	59	(5)
SUMMARY: CHIEF COMPLAINT AND HISTORY OF THE PRESENT ILLNESS	64	(2)
CHAPTER 4 Transforming Experience into Memory Other Active Problems, Past Medical History, and Family History	66	(15)
OTHER ACTIVE PROBLEMS	67	(2)
THE PAST MEDICAL HISTORY	69	(4)
FAMILY HISTORY	73	(7)
SUMMARY: OAP, PAST MEDICAL HISTORY, FAMILY HISTORY	80	(1)
CHAPTER 5 Gaining Richness and Reality The Patient Profile	81	(21)
WHAT GOES INTO THE PATIENT PROFILE?	82	(2)
DEMOGRAPHICS AND OCCUPATION	84	(1)
CULTURAL AND HEALTH BELIEFS	84	(4)
LIFESTYLE	88	(3)
RELATIONSHIPS	91	(2)
SEXUAL HISTORY	93	(4)
THE PATIENT PROFILE AT WORK	97	(4)
SUMMARY: THE PATIENT PROFILE	101	(1)
CHAPTER 6 No Air of Finished Knowledge Review of Systems, Physical Examination, and Closure	102	(18)
THE REVIEW OF SYSTEMS	102	(7)
TRANSITION TO THE PHYSICAL EXAMINATION	109	(2)
CONVERSATION DURING THE PHYSICAL EXAMINATION	111	(4)
ENDING THE INTERVIEW	115	(3)
SUMMARY: THE ROS, PHYSICAL EXAMINATION, AND CLOSURE	118	(2)
CHAPTER 7 I Shall Enumerate Them to You Getting It All Down and Communicating to Others	120	(15)
WHAT GOES INTO THE WRITTEN HISTORY	121	(2)
FUNCTIONS OF THE MEDICAL RECORD	123	(1)
FORMAT OF THE MEDICAL RECORD	124	(6)
PROBLEM-ORIENTED RECORDS	130	(2)
SUMMARY: THE CLINICAL NARRATIVE	132	(3)
PART TWO BASIC SKILLS IN PRACTICE: APPLYING THE PATIENT'S STORY	135	(148)
CHAPTER 8 A Different Silhouette Pediatric and Geriatric Interviewing	137	(21)
THE PEDIATRIC PATIENT	138	(9)
THE ELDERLY PATIENT	147	(9)
SUMMARY: TECHNIQUES FOR YOUNG AND OLD	156	(2)
CHAPTER 9 The Real Satisfaction Interacting with the Patient in Primary Care	158	(25)
SOLVING COMMUNICATION PROBLEMS IN PRIMARY CARE	159	(12)
SPECIFIC ISSUES IN MANAGED-CARE SETTINGS	171	(4)
PREVENTIVE HEALTH CARE	175	(1)
CONFIDENTIALITY AND TRUTHFULNESS	176	(3)
MALPRACTICE LIABILITY	179	(1)
SUMMARY: COMMUNICATION IN PRIMARY CARE PRACTICE	180	(3)
CHAPTER 10 Seal Up the Mouth of Outrage Interactive Problems in Interviewing	183	(29)
INTERACTIVE STYLES	184	(9)
SOMATIZATION	193	(5)
DIFFICULT FEELINGS IN THE MEDICAL INTERVIEW	198	(11)
SUMMARY: DIAGNOSING AND TREATING THE "SICK" INTERVIEW	209	(3)
CHAPTER 11 Something New and Dreadful Telling Bad News	212	(15)
BARRIERS TO COMMUNICATING BAD NEWS	213	(5)
EMPATHY AND INTERACTION IN TELLING BAD NEWS	218	(4)
ADVANCE DIRECTIVES	222	(3)
SUMMARY: COMMUNICATING BAD NEWS	225	(2)
CHAPTER 12 The Quiz-Docs Will Catch You Questionnaires and Computers	227	(11)
USES OF QUESTIONNAIRES	228	(6)
COMPUTER-ASSISTED HISTORY TAKING	234	(2)
SUMMARY: QUESTIONNAIRES AND COMPUTERS	236	(2)
CHAPTER 13 Is This Case Serious or Not? Clinical Judgment in the Medical Interview	238	(13)
COMPONENTS OF CLINICAL JUDGMENT	240	(3)
JUDGMENT GUIDELINES FOR THE MEDICAL INTERVIEW	243	(1)
BIAS IN CLINICAL JUDGMENT	244	(5)
SUMMARY: CLINICAL JUDGMENT IN THE INTERVIEW	249	(2)
CHAPTER 14 For the Moment At Least I Actually Became Them Understanding the Patient's Beliefs and Values	251	(14)
THE PATIENT'S VALUES AND YOUR OWN	252	(1)
UNDERSTANDING WHAT THE PATIENT BELIEVES	253	(5)
WHEN DO YOU NEED TO KNOW MORE ABOUT THE PATIENT'S BELIEFS?	258	(1)
ELICITING HEALTH BELIEFS IN THE INTERVIEW	259	(4)
SUMMARY: DISCOVERING WHAT THE PATIENT BELIEVES	263	(2)
CHAPTER 15 Not Through Argument But By Contagion Education, Informed Consent, and Negotiation	265	(18)
EDUCATION: CONVEYING THE INFORMATION	268	(2)
INFORMED CONSENT	270	(5)
NEGOTIATION	275	(6)
SUMMARY: INFLUENCING THE PATIENT	281	(2)
Index	283