The First Question EVERY Healthcare Professional should ask their patient

At last!

I received this image in a group of more conventional medical colleagues, many of them true allopaths, and I was happy to see that, finally, medicine is starting to wake up to the need to focus its efforts on promoting health and not just treating illness. It's turning to well-being, not just symptom control. This is great for patients, especially those who depend on “insurance” medicine and the SUS, which are necessary and very noble when practiced with a real interest in the patient's well-being. It seems that this movement, which is still timid and not very evident in mainstream medicine and is less than 10 years old, has already been emphasized, preached and practiced by those seeking a more functional, holistic and integrative approach to medicine for decades.

I, Dr. Icaro Alves, graduated in Medicine from UnB almost 20 years ago, when it was one of the best medical schools in the country. We had some of the best doctors in the country as teachers and, in the subject of Semiology (how to take a clinical history, approach and examine a patient, in general), we learned that the first contact with a patient should begin with a “general question”, which would allow the patient to talk about their suffering and describe it, providing important clues for the diagnosis. This is a noble teaching, but I don't think the “initial question” we were taught is the most appropriate. Instead of asking “what are you feeling?”, the doctor should ask “how can I help?”. This simple shift can change the focus from the disease to an emphasis on the health professional as someone who is genuinely interested in helping the patient recover, maintain and improve their health.

Later, I myself became a lecturer in undergraduate and postgraduate courses in Semiology and Complementary Examinations, among other subjects. On how to listen and approach the patient, I quickly learned and have been teaching this for more than 15 years, in courses and lectures all over the country: if we health professionals let the patient speak for at least a minute at the beginning of the consultation, without interrupting them and attentively, after asking “How can I help?” or “How can I be of service to you?”, they will tell us the most important things so that we know how to help them, reach diagnoses and treat them in the most effective and humane way. All you have to do afterwards is elaborate on what you've said.

In my opinion, the best doctors really focus on health, truly supporting the patient in their process of improving their body, mind, spirit and social relationships. This is the definition of health, as can be seen in icaro.med.br/4Pillars. From the first question in the office to the interaction with the patient, including the time and quality of the assessment, examinations, diagnoses, guidance and treatments, the focus must always be on the patient's health.

Are there exceptions? Of course there are! But it's important to know “the rule” so that we can better choose who will take care of one of our most precious assets: our health.