The Medical Interview: Mastering Skills for Clinical Practice

Coulehan and Block’s book, The Medical Interview: Mastering Skills for Clinical Practice, is a wonderfully crafted instructional guide on the art and science of how to conduct a medical interview. It is primarily written for medical students who are just beginning their professional interaction with patients. However, it is also designed to serve as a resource for those who are further along in their education. This book is a complete and concise guide to teach the medical student how to perform the most important source of diagnostic information. The authors believe that seventy to eighty percent of all relevant data are derived from the medical interview. The hidden medical curriculum says that real medicine is based solely on objective data (such as numbers, graphs, and images) while subjective information (such as the patient’s story) lacks value because it lacks quantification. In other words, what patients feel, the suffering they experience, and the disability that haunts them are secondary in importance to physiologic quantities that can be directly observed. Thus, most of the clinician’s energy is devoted to tracking down and treating organ-based disease with little energy left over for the personal, social, cultural or spiritual dimensions of illness. The authors are hoping to convince medical professionals of the importance of nonquantifiable material to diagnose and treat a patient.