The patient's story: integrating the patient- and physician-centered approaches to interviewing

Article Abstract:

Most of the information a physician obtains about a person's illness is through the interview. Traditionally, these interviews have been physician-centered, that is, they have tended to focus on what the physician has to say, rather than the responses of the patient. In the biopsychosocial model of health and illness, the biologic, psychologic, and social aspects of a person's life are all recognized to play a role. Patient-centered interviews are conducted to permit the patient to control the direction of the conversation, with the physician responding with open-ended questions or repetitions of part of the patient's statement. Patient-centered interviewing has been shown to result in greater patient satisfaction, greater compliance with the treatment regimen, and more humane care. However, the patient-centered interview must sometimes be modified if the patient cannot adequately communicate; such as in cases of dementia or severe or life-threatening illness. Some patients, given the opportunity to lead the conversation, will introduce so many problems that the physician must set an agenda for the interview and choose the most salient problems for exploration. Good interpersonal skills on the part of the physician make the patient-centered interview workable. By acknowledging the emotions that the patient displays and by showing respect and support for the patient, the physician will elicit not only the medical information he needs, but the patient's response to his illness. The patient-centered portion of the interview process should occupy about 5 to 20 percent of the time available, at which point, the interview can become more physician-centered so the doctor can obtain more specific information from the patient. By integrating the two interviewing techniques, a physician should have greater understanding of the patient's medical problem and his overall well-being. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Methods, Physician and patient, Physician-patient relations

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Dialogue: the core clinical skill

Article Abstract:

Medical residents may benefit from seminars and short courses that improve their communication and interviewing skills. These courses have been pioneered by the American Academy on Physician and Patient and the Society of Teachers of Family Medicine. A 1998 study found that residents who took a one-month training session performed significantly better in interviewing patients and taking their medical history than residents who were not trained. This illustrates that social skills can be taught and hopefully, such training will be included in all residency programs.

Editorial

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The effectiveness of intensive training for residents in interviewing: a randomized, controlled study

Article Abstract:

Medical residents may benefit from a training session on the proper techniques for interviewing patients. Sixty-three residents at one hospital participated in a one-month training session in interviewing and were then videotaped during patient visits. Patient satisfaction was also assessed and the residents filled out a questionnaire and were tested on their knowledge. Compared to residents who were not trained, residents who received the training scored higher on the tests and scored higher on videotape analysis of patient encounters.

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