History of Present Illness

  • James BinderEmail author
Part of the Current Clinical Practice book series (CCP)


Eighteen seconds. Maybe 23 s. That’s all the time an average patient has to tell his story before he is interrupted. Seventy percent of patients never get to finish their story [1, 2]. Why? The obvious answer: physicians feel rushed for time. However, that does not explain the 18 s fully. Why not interrupt after 2 s? I think the 18 s is a cursory attempt to listen to the patient before moving to the real task of the interview: gather symptom data needed for diagnosis. It is a false dichotomy. During the opening phase, the clinician listens to the patient and begins to gather psychosocial and biological data needed for accurate diagnosis (see Chap. 2). This takes 3-5 min to accomplish, not 18 s. The clinician listens to the patient and gathers data during the second phase of the interview as well. Only, the emphasis shifts to gathering the data that the patient does not spontaneously offer and that the clinician needs for accurate diagnosis.


Chest Pain Sore Throat Present Illness Strong Engagement Person Technique 
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Copyright information

© Humana Press, a part of Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Marshall University School of MedicineHuntingtonUSA

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