How to tell a good story

tell your story phrase handwritten on the school blackboard

Every doctor’s visit has a specific structure that we try to follow in order to get the most information in the most efficient way.  Generally, the visit starts with what is called the Chief Complaint, which is the main reason you are seeing the doctor.  Following that, we investigate History of Present Illness (HPI).  This is the section where the patient offers information about what has been going on and what has been done so far.  Only after that we get to physical examination as well as any relevant labs or diagnostic tests before we arrive at a diagnosis and treatment plan.

As specialists, Ear, Nose and Throat doctors often see patients after they have already been seen by their primary doctor or an urgent care doctor or an emergency room doctor.  Anecdotally, many patients start their story line at what happened in the emergency room or at their primary care doctor.  However, the actual story begins any number of days prior to that when the patient first felt sick, way before they needed to eventually make a decision to go see a doctor for help.  

Many patients start their story with something like: “So I went to the emergency room,” or “They told me at the urgent care visit that have ear infection.” Rather, you story starts not at the moment of your first encounter with another medical professional, but at the very first moment you felt something is not right.

I often have to gently stop patients as they are recounting their story, and ask them to actually backtrack to what I refer to as day #1.  This is the first day that you might have felt that something is not right.  At this point, I am interested in first learning about what your symptoms are and how things were bothersome to you.  Then, I would like to know about the things you have done on your own to help your situation.  Only after that, I would like to also learn what other visit you have had so far, and what treatment plans were given to you that were or were not effective.

In any story telling of a medical caliber, it is always best to tell your story in a chronological order.  This will allow your specialist doctor to keep an open mind about what your symptoms are and what the correct diagnosis might be.

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Posted in: General Health & Medicine

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