Transcript Training Physicians in the Nursing Home

The Patient’s Story:
history of past medical problems
Seki A. Balogun, MD, FACP
Practice of Medicine-1
Objectives
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Describe the structure of the medical
interview
Describe the content of aspects of the
medical interview
Demonstrate eliciting the patient story
Content of the Medical
Interview
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Chief Complaint
HPI
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Other Active Problems
Past Medical History
Family History
Social History
Sexual history
Review of Systems (ROS)
Who Controls the Interview?
Patientcentered
Doctorcentered
Time
Challenges to Overcome
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Balancing competing opportunities
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Time
Tailoring interview
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nature of chief complaint/presenting problem
patient’s demographic characteristics
Transitioning
Using communication skills
Past Medical History: Content
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Major illnesses
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Hospitalizations
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Surgeries
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Significant injuries
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Medications
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Allergies
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Immunizations
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Gynecologic and obstetric history (women)
Family History
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Current health of
family
Specific familial
diseases
Other family
members with
similar illnesses
Social History - Patient Profile
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How do lifestyle or
personality traits:
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Contribute to illness?
Aggravate or limit
severity of illness
Interfere or help with
getting well.
Impact activities of
daily living
Social History
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Relationships
Occupation
Education
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Health Habits
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military
Smoking, Alcohol, Recreational drug use
Exercise
Diet
Spiritual, cultural and health beliefs