The Medical Interview: Clinical Care, Education, and Researchby Mack Jr. Lipkin, Samuel M. Putnam, Aaron Lazare
Primary care medicine is the new frontier in medicine. Every nation in the world has recognized the necessity to deliver personal and primary care to its people. This includes first-contact care, care based in a posi tive and caring personal relationship, care by a single healthcare pro vider for the majority of the patient's problems, coordination of all care by the patient's personal provider, advocacy for the patient by the pro vider, the provision of preventive care and psychosocial care, as well as care for episodes of acute and chronic illness. These facets of care work most effectively when they are embedded in a coherent integrated approach. The support for primary care derives from several significant trends. First, technologically based care costs have rocketed beyond reason or availability, occurring in the face of exploding populations and diminish ing real resources in many parts of the world, even in the wealthier nations. Simultaneously, the primary care disciplines-general internal medicine and pediatrics and family medicine-have matured significantly.
Description: This book is the first of a planned series in primary care aimed at teachers of primary medicine. The preface suggests the whole series will be strongly weighted to psychosocial issues. This first volume is a compendium attempting to cover, and to some extent codify, the entire field. It covers theory, structure, effects of the interview, interviewing techniques, special interview situations, ethics, interview teaching, and research on the medical interview.
Purpose: The aim is to "coalesce the finding of the 1970s through the early 1990s into readable segments" to the end of encouraging research, education, and faculty development in medical interviewing.
Audience: Although aimed at a fairly broad audience, the book will mainly be of interest to specialists in the field of the interview itself and perhaps to psychologists and counselors.
Features: The first section is really an annotated guide to the literature of the past 20 years with the references incorporated into the text at the rate of about one to three references per paragrapha technique that adversely affects readability. The interview process described, while instructive, is so elaborate and involved that it would be impractical in day-to-day use in a busy office. Those chapters that are how-to chapters (The Sexual History, The Geriatric Interview) are likely to be the most useful to the practicing physician.
Assessment: Some of the chapters devoted to specific interviewing situations, especially those on cultural factors, are quite good. Useful examples of bad interviewing technique are scattered through the text as well as good advice on how to make contact with the patient, guide and interpret the interview, and avoid pitfalls. But more particularly, specialists in the medical interview, its development and assessment, will find much information has been collected here for them.
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