The Art of the Medical Interview

By Francis DeMichele

Any doctor can order tests, examine vitals, and analyze charts, but to possess the skill to interview a patient well requires nothing short of perfect eloquence. A doctor must show confidence without arrogance and must build trust while placing the patient at ease. At any point during the interview, especially when meeting a patient for the first time, this process can go horribly wrong and become awkward for both the patient and physician. However when done successfully, a good interview will be the foundation for quickly reaching the correct diagnosis and providing optimal care. This interview process used by physicians is not unlike that used by journalists investigating complex societal issues.  

After observing many senior physicians interview patients in the hospital and subsequently attempting to imitate their example with my own patients, I quickly understood the difficulty involved in mastering this skill. Multiple obstacles must be overcome in order to professionally interact with patients. Some patients are suffering because of their conditions and do not wish to be bothered while others come with preconceived aversions to medical professionals. Nonetheless, by asking thoughtful questions and sincerely listening, this process gives patients confidence in the care they receive. 

Learning to conduct interviews, I have found myself drawing from my experience as a former editor of my college newspaper. The key to gathering information for a story depended on my ability to conduct successful interviews. I needed to ask direct questions which would give me the information that I needed without ever seeming offensive. Sometimes people were apprehensive when answering questions from fear of having their words manipulated or turned against them. Once I built a rapport with them and demonstrated my willingness to only report the truth in an unbiased manner, the people I interviewed were willing to cooperate and help me to write an accurate article. 

The nature of medical school often allows students to disregard the value of polished communication skills. In order to build an understanding of the highly technical scientific principles applied in the medical field, the medical school curriculum necessitates a fast paced teaching and learning environment. Students must commit massive data banks of interdisciplinary scientific and clinical information to memory and take standardized board exams to prove their knowledge. To add to the stress and importance of learning the material, a low score can often limit a student’s career options following medical school. Thus, most of the time spent preparing to be a doctor centers around building a strong scientific foundation. Even though making clinical decisions requires a mastered understanding of this scientific material, doctors cannot lose sight of the fact that treating the human spirit requires the skills of an artist. 

Loyola understands the value of human connections in the medical profession and balances their medical curriculum with classes which focus on treating the whole patient. According to an article from the Journal of General Internal Medicine by Dr. Mack Lipkin, Jr., a patient’s diagnosis can be made by the medical interview alone 80 percent of the time. Because a successful interview can be such a valuable asset in clinical medicine, we begin learning how to navigate patient interviews during our first year of medical school. We are taught to consider each individual patient’s circumstances beyond simply the disease or its symptoms. We continue to practice these skills frequently, which prepares us for seeing patients on a regular basis during our third year. 

The ability to clearly articulate and communicate is indispensable whether in the field of journalism or medicine. When writing for the newspaper, journalists need to analyze all of the information obtained and present only the useful and relevant parts in a logical, organized and straightforward article. Similarly, a clinician must consider all of the factors of a patient’s condition and distill what was initially many loosely connected statements into a clear clinical assessment and plan of treatment. When physicians combine scientific expertise with the interviewing skills of pertinent questioning and attentive listening, they can then practice medicine in the ideal way. Like a journalistic interview, a medical interview requires a yearning for the truth tempered by a respect for human autonomy.    

Francis DeMichele, former editor of the Saint Peter’s University Pauw Wow, is a medical student at Loyola University Chicago.