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Section 1 HISTORY TAKING AND GENERAL EXAMINATION
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1 History taking
DAVID SNADDEN
ROBERT LAING
E MASTERTON
NICKI COLLEDGE
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TALKING WITH PATIENTS
People visit doctors for many reasons. Sometimes it is because something unexpected and catastrophic has
happened to them, but usually it is because of an ongoing problem, a relatively plaint or because
something 'isn't right'. ing to the doctor they may have spoken to family or friends, tried remedies
suggested by them, spoken to other health professionals, . pharmacists, plementary practitioners, or
may have found information on the and brought this with them. Their decision to go to a doctor may only
have been made after these attempts to explain or heal their illness or problem have been essful. By the
time they have reached a doctor most patients have formed some idea of what might be wrong with them and will
have worries or concerns that they need to talk about.
The general practitioner (GP) or family doctor is usually the first point of contact. Even a straightforward visit can
be a big event for patients. They have to decide to go, usually make an appointment, work out what they are
going to say and may have to arrange time off work or for child care. They then have to sit in a waiting room. This
is an almost universal human experience; think about how it affected you the last time you had to do this. Things
can e even more perplexing if the visit is to a hospital outpatient department or part of a hospital admission
when their anxiety and apprehension can get worse as this is where 'serious' things happen. Whatever the
cause, patients are seeking explanation and meaning for their symptoms. Whatever the setting, the doctor needs
to try to work out why patients are there, what they are most concerned about and t