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Patient-centered interviewing

INTRODUCTION

Medical interviewing is the exchange of relevant information about the patient and the development of a therapeutic relationship with the patient. Interviewing is the fundamental medical skill; it is the vehicle for the clinician-patient interaction in virtually all circumstances, through which is obtained most of the information about an individual patient [1]. Interviewing generates the information needed for diagnoses more often than the physical examination and laboratory investigation combined [2-5]. In addition, interviewing produces the most data needed for treatment and prevention and is the major way in which information of all types is transmitted to the patient [6,7]. Finally, interviewing itself determines how the clinician-patient relationship evolves and the therapeutic potential of the encounter [6,8]. Conversely, the quality of the relationship with the patient influences the quality of data exchanged [9,10].

Clinicians will perform more than 150,000 medical interviews during a career [11]. This topic review will consider how to improve interviewing skills and, in so doing, make medicine more scientific and humanistic.

THE INTEGRATED PATIENT-CENTERED MEDICAL INTERVIEW

The goal of the interview is to elicit relevant personal and symptom data about the patient. The interviewer interprets this information in light of her or his medical knowledge and formulates a description of the patient in biopsychosocial terms, and makes an integrated biological, psychological, and social diagnosis [7].

The biopsychosocial model — The biomedical model (often called the disease model or biotechnical model) describes patients in terms of diseases and excludes most psychological and social aspects of the person [7,12]. This model has been responsible for many of medicine's successes but has often neglected the psychosocial dimension of care.

The biopsychosocial model describes the person in biological, psychological, and social dimensions [13]. It is both a humanistic and scientific model for medicine, including the person with the disease as well as the disease itself [6,7,9,13]. The biopsychosocial model explicitly acknowledges the connections between mind and body and that the patient can be adequately understood and described only as a whole person [9].

                           

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Literature review current through: Apr 2013. | This topic last updated: Jan 2, 2013.
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