We need proper histories for optimum patient care, says Doctor

A doctor at the University of Sydney has said that detailed, honest patient histories have to be provided if doctors are to provide the best care for their patients.

Zarshis Avari, Medical Student,
University of Sydney. Reproduced with
permission

"We need to know everything in as much detail as possible to figure out an accurate diagnosis that will affect their (the patients') management," says Zarshis Avari, who is currently doing his MBBS at the University.

Avari, 23, said that without the correct medical history, all he and his colleagues can do is make patients as comfortable as possible, without actually treating their ailments.

Rapport

"There will always be patients who will not listen to your advice," he says, speaking from Australia. 

"If you have a good rapport it is very unlikely the patient will be uncooperative," he adds. "In such cases, we can always ask their spouse, relatives or friends too."

"If the patient and their relatives still refuse to answer questions then we can only help them in the most basic of ways," he explains.

"Almost every procedure requires consent, and without that there is nothing left to do but ensure that the patient does not suffer."

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Check List

He also shed some light on the procedure of taking a patient history. "[A patient history] is much more than a check list," he says. "It will be different for each patient. It helps us figure out the best mode of approach. For example a persistent fever can be due to a multitude of causes. 

"With an accurate history, we might uncover that the patient has travelled to a high risk area and treat him for appropriate infections," adds Dr. Avari.

"An accurate history also helps the technicians such as the radiologists and the microbiologists."

"Taking a patient's history is a lot like detective work," he confesses. 

"More often than not we have to tease out pieces of information that we as doctors think are important but may not be so for the patient," he continues. 

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"We also have to enquire about their surgical history, past medical history, any history of disease that run in the family along with a detailed description of their social life which involves questions on their living status, finances, travel, immunisation, pets, etcetera," he adds.

"Of course, as you get experienced you tailor the questions. You wouldn't ask all of these questions to an 18-year-old man with a sniffle," he finishes.