Why is the medical history important?
The history is vital. Full stop. It is the most important skill of all doctors and health professionals.
Why? 80% of the diagnosis is in the history (10% examination, 10% tests) – so its your key diagnostic weapon.
Also, as the placebo effect (convincing the patient that they will get better) is 50% of your healing power (and that comes from the history) you are foolish not to maximise the placebo.
The art of medicine is to determine why a patient has sought help, and what is the diagnosis – by taking a medical history.
The key skills to help establish the underlying cause of a patients’ symptoms (the diagnosis) is based on:
- Talking to the patient (history)
- Examining the patient (examination), and
- Requesting tests – like bloods and x-rays (investigations).
The information gathered from the history and examination is used to form a hypothesis of the possible underlying diagnosis.
Investigations can then be used to either confirm or refute this initial diagnosis. Some diagnoses can be made just by talking to a patient, while others are reliant on a specific test.
As a medical student, student nurse, physician associate (PA), advanced clinical practitioner (ACP), or allied health professional (AHP) you will learn the art of taking a formal history, examining a patient, and interpreting investigations. But ..
“The history is the most important aspect of the interaction between patient and doctor or health professional”
History taking is about knowing the questions to ask, careful listening to the answers (and recording them). It takes a long time to get good at it – at least ten years after a doctor qualifies [“sorry any student reader! CKDEx Ed”]. This is why it’s vital for doctors to get a lot of experience.
This can only be gained by seeing many, many patients especially in pressure situations like A&E, a GP or hospital outpatient clinic – with you leading the questioning. Watching experienced doctors can help a lot too. Note the questions that lead to useful and less useful answers.
It is the cornerstone of the doctor/health professional-patient relationship and relies on good communication skills – and practice, practice, practice.
The patient needs to like and trust you, for your history taking to be effective.
Other resource
10 top tips for medical history taking
Last Reviewed on 20 April 2024