hisTory taKinG..riGiD,no?

Well, I just got back from my hosp visit..it ws the first for this term n we were practising abdominal examination..as usual, we finished early..kinda dull today..but on the othr hand, learned lots of stuff as well..

History taking is said to contribute about 80-90% of the diagnosis..so here, i jst wanna share how we're taught in taking patients' medical history n how they do it here in uk..coz im not sure how it's done back home..assuming it's pretty much similar though(universal??)

Basic framework of medical interview

1. Greetings & consent ---> building rapport with the patient
2. Demographic info ----> name, age, job
3. Presenting problem ----> symptoms
- E.g Pain : severity, onset( sudden/acute/chronic), character(sharp shooting/dull), radiation, frequency/pattern, duration, relieving & exacerbating factors, associated features
4. Associated symptoms
5. Background info/Risk factor ---> family history (FH), social history (SH-smoking n drinking), drug & allergy history (DH), Past medical history (PMH)
6. Effect on patients ( in daily routine etc)
7. Patients' belief & expectation ---> Ideas, Concerns, and Expectation
8.Summary

Well that's it..sometimes i do feel it kinda rigid, u knw like hav 2 follow the framework every time. But then i realise, it's not the matter of getting it in order, but it's the matter of getting it right..coz in reality it might not go that way coz patient cn sometime deviate us to their personal story or some of the info might have already in the record..still, it's gud to have the framework n it's order in mind so the interview will be more organised and won't be confusing the patient of us keep coming back n forth..but to as a new comer like me..we cn sometime be too 'tied up' with the question hence making the history taking looks like a "job interview" or something..esp during the osce!!it's like we're rushing the patient to fill up the checklist we hav in mind...well it's only 5mins though in osce..so definitely we need to rush things dwn..but in real interview..really need more practise so i won't be missing anything..