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You can be the optimal medical historian

Last week I visited the Big Store in Minneota to hear author Dana Yost, a former Minneota and Cottonwood resident and former Independent editor, discuss his recently-published work “1940: a History of Minneota, Minnesota.” Its well-researched pages describe daily life in this pre-World War II town and how its people were affected by the greater events in the state, country, and world, and, in various ways, how Minneota had a role in influencing the state, country, and world. A significant number of personal histories from interviews with Minneota residents from that era were included in Dana’s book.

The description of the interaction of Minneota’s residents in creating the picture of the 1940s town reminded me of the well appreciated aspect of medical care, i.e., the medical history, which has more recently been recognized as a very important part of the doctor-patient relationship which I have discussed in prior columns.

Until the 1950s-60s, the doctor-patient relationship was dominated by the physician from a “top down” aspect. With the development of more sophisticated aspects of medical care such as specific diagnoses, improved understanding of the role of medication, clinical technical advances, and the changing role of the hospital from a short term residential center to a diagnostic and therapeutic agent for cure and rehabilitation, the patient was able to assume a nearly equal role in the doctor-patient interaction which led to greater patient success and responsibility. One of those responsibilities was providing optimal information about the personal health of the patient himself. He/she was able to give specific information about himself/herself, thus aiding the doctor in the diagnosis and treatment. Historically, such a situation was always present and encouraged, but changes in the relationship have facilitated improved care and outcomes.

In the past, I have encouraged patients to obtain and maintain medical information about themselves which may be of great value in time of medical need. Such information as immunizations, surgical and medical history, travel history, and especially the history of illnesses, health conditions and unusual deaths of family members are very important in patient illness consideration. Genetic considerations are very important.

This week, I received information from a medical information website about a medical study in which patients completed a pre-examination medical history facilitated by computer usage, which led to significant improvements in diagnosis and the treatment of illness. We have all experienced the usual procedure of a personal history and the present medical problem obtained by a physician staff member (nurse, assistant, etc.) in addition to the physician’s discussion. Of course, when the physician knows you, all aspects of care are facilitated. However, the study discussed above lends itself to the more rapid pace of modern clinical medicine. I, myself, was recently asked to complete a pre-examination personal medical history by a computer questionnaire by the office of a medical professional even before I had met him.

As a medical professional and a patient in the contemporary medical scene, I do appreciate these advances in the doctor-patient relationship facilitated by modern medical practices. Many of these changes are modern methods applied to centuries-old medical practices. In view of the rapidly changing aspects of modern medical care, it is very important than patients realize they need to be active participants in their medical care.

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