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April 1988

Diagnostic Value of the Medical History

Arch Intern Med. 1988;148(4):984-985. doi:10.1001/archinte.1988.00380040224037

To the Editor.  —I read "The Diagnostic Value of the Medical History" in the November issue of the Archives with interest.1 I am not surprised that faculty and residents alike claim a high interest in the medical history. I am afraid that they are just spouting the party line. Their actual skill in, use of, and trust of the medical history may be far from what they claim.After having observed over 500 clinical interviews, I am still impressed with the low general level of skill. But no one ever claims to doubt the value of the process; to do so would be equivalent to an admission of incompetence. I recall one resident whom I observed for a month while attending on the medical service at our local university hospital. The resident was egregiously incompetent at relating to people. We had several patients sign out against advice while he

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