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Author: Wayne J. Altman, M.D.

Medical Interviewing and the Doctor-Patient Relationship
Fall 2011
W. Altman, MD
Tufts University School of Medicine

The Rest of the Story: Past Medical History, Family History, and Social History, pt.2

Introduction

With the doctor-patient relationship as a foundation, and the history of the present illness (HPI) in the foreground, often, some of the most critical information comes from the patient’s background. It is essential to develop a systematic and artful way to elicit information from the patient’s Past Medical History (PMH), Social History (SH), and Family History (FH).

Learning objectives

By the end of the lecture, you will be able to:

  • Explain the importance of the Past Medical History (PMH)

  • Explain the importance of the Social History (SH)

  • Explain the importance of the Family History (FH)

  • Identify the components of each of these segments of the patient history

  • Begin to develop a systematic way to elicit this data

  • Start practicing the art of eliciting this data

Specific competencies students are expected to perform within the context of practice after this lecture.

Elicit a thorough and appropriate PMH

  1. List chronic illnesses, surgeries, and hospitalizations with approximate dates

  2. Obstetric and Gynecological histories

  3. List medications with exact dosage

  4. List allergies to medications including the reaction to the offending medication

Elicit a thorough and appropriate FH

  1. Begin with an open-ended question

  2. Elicit pertinent negatives such as diabetes, heart disease, colon/prostate/breast/ovarian cancer, alcoholism, mental illness

Elicit a thorough and appropriate SH

  1. Discuss home life

  2. Discuss work and/or school

  3. Elicit a sexual history

  4. Discuss substance abuse including cigarettes, alcohol, and drugs

  5. Discuss safety including intimate partner violence, seatbelts/helmets, guns

Required Reading

Handout summarizing components of Past Medical History (PMH), Social History (SH), and Family History (FH)