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Special Article
May 26, 2003

"Building" a History Rather Than "Taking" One: A Perspective on Information Sharing During the Medical Interview

Author Affiliations

From the Houston Center for Quality of Care and Utilization Studies, a Department of Veterans Affairs Health Services Research Center of Excellence at the Houston Veterans Affairs Medical Center, Houston, Tex (Dr Haidet); the Department of Medicine, Baylor College of Medicine, Houston (Dr Haidet); and the Center for Health Services Research, Department of Internal Medicine, University of California, Davis, Sacramento (Dr Paterniti).

Arch Intern Med. 2003;163(10):1134-1140. doi:10.1001/archinte.163.10.1134

Patients and physicians enter the medical encounter with unique perspectives on the illness experience. These perspectives influence the way that information is shared during the initial phase of the interview. Previous research has demonstrated that patients who are able to fully share their perspective often achieve better outcomes. However, studies of patient-physician communication have shown that the patient's perspective is often lost. Researchers and educators have responded with calls for practitioners to adopt a "narrative-based medicine" approach to the medical interview. In this article, we review the literature on narrative-based medicine with an emphasis on information sharing during the medical interview. We suggest a framework of skills and attitudes that can act as a foundation for future work in educating practitioners and researching the medical interview.

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