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Take a Good History

Formerly of the Department of Neurology, Derriford Hospital, Plymouth, UK

EXTRACT

When I was a medical student in the 1960s it was drummed into me that the diagnosis was made from the history, examination and special investigations, but the most important was the history. Despite the explosion of advances during the past 20 years, this is still true today, at least in clinical neurology, and yet histories are becoming increasingly shorter and they are frequently inadequate and incomplete.

We enter medicine for many different reasons but I suspect the two most frequently given are a love of meeting people and a desire to help them, but unfortunately because of the pressures we are under, particularly the junior staff, that joy and satisfaction appear to be disappearing and medicine is becoming more mechanical. Protocols and guidelines proliferate at an alarming rate and the emphasis has switched from the history to multiple screening tests and scans. It is now difficult to be seen ...

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