Doctors use new cues to get patient history

Communication techniques can lead to a better understanding of the patient perspective, and, therefore, strengthen the physician-patient relationship.

By Victoria Stagg Elliott, AMNews staff. June 23, 2003.

When Patricia Barrier, MD, was in medical school a little more than a quarter of a century ago, she was taught how to take a medical history -- how to get all the facts out of a patient, but just the facts.

Over the years, however, she has come to believe that there is a better way to communicate with patients, a method that improves their satisfaction, increases their adherence to treatment regimens and reduces her feelings of physician burnout.

She's part of a growing cadre of medical communication experts who favor building rather than taking patients' medical histories.

Central to the approach is its emphasis on maintaining patient perspectives and taking into account their worries and goals.

"We have swung so far to the biomedical, technical side of things, and our patients feel that," said Dr. Barrier, an associate dean for student affairs at the Mayo Medical School in Rochester, Minn., and author of a related paper in the February issue of Mayo Clinical Proceedings. "Now, we have to swing the emphasis a bit more in the other direction to look at the bio-psychosocial dimensions."

Most recently, the concept was highlighted in a special article published in the May 26 issue of the Archives of Internal Medicine.

Paul Haidet, MD, MPH, the lead author and a staff physician at the Houston VA Medical Center, suggested that physicians might get useful information out of patients by using an open interviewing style that encourages them to reveal more than just the biomedical facts.