If you have been seen at a teaching hospital you have likely been seen by a medical student or resident prior to seeing the (attending) doctor.  They meet with you first and their job is to take your history and present it to the doctor.   Sometimes it goes well but too often it ends up a bit like a game of telephone where your original message is distorted and garbled when it gets to the doctor. 

Let's look at one aspect of what is going on here and why things sometimes go awry.

Chief Complaint

Have you ever thought about the process or framework a doctor uses to get information from you in an interview?  Did you know that they are all taught this framework, the medical interview, in medical school and they continue to use it throughout their career?

Our medical system has changed a lot over the last 20 years, especially for the doctors working in the system.

Intuitively and through our own experiences, we can see that doctors are struggling with the changes including high levels of burnout, frustration and even an increased rate of suicide. 

So, what is it that is causing the doctors’ struggles? 

Based on a 2018 survey, doctors reported their top two least satisfying factors about medical practice as listed below.

EHR design/interoperability                  39.2% 

Regulatory/insurance requirements    37.6% 

Loss of clinical autonomy                       37.0% 

Professional liability/malpractice          30.2% 

Amount of time with patients                12.4% 

Income/compensation ...