Physician interviewing and counseling training

Abstract

There is an important need to enhance the skills of physicians in conducting medical interviews. The medical interview consists of the primary tasks or content of the medical history. It is the basis for establishing a therapeutic relationship with the patient, ascertaining a clinical diagnosis, and implementing an appropriate treatment plan or health maintenance. Effective medical interviewing skills are prerequisites for learning the skills which are essential for patient counseling. This paper describes the medical interview, reviews videotape feedback models for training, and gives suggestions for the training of physicians as counselors.During the past 20 years, health care has significantly been modified by increased technological advances, medical specialization, and fragmentation of care. Due to these changes, relationship and communication skills are essential for practitioners to interface effectively and humanly with patients and their families. The actual training and implementation of interviewing and relationship skills have not been a priority for most medical school curricula. In fact, with economic cutbacks and the lessening emphasis on developing primary care physicians in the United States, there may be a trend for less instruction or courses in this area rather than the needed increase. Heifer and Hess (1970) claimed that the ability to gather information during the medical interview about patients' symptomatic and asymptomatic problems, as well as the personal concerns about these problems, is the single most important skill that future physicians must acquire. Barnlund (1976) emphasized that no profession has daily contact with so wide a spectrum of subcultures, and none exerts influence over such sensitive matters