The Closing

It is important that the interviewer pace the interview so that adequate time is left for the patient to ask questions and for the physical examination. About 5 minutes before the end of the interview, the interviewer should begin to summarize the important issues that were discussed.

By the conclusion of the interview, the interviewer should have a clear impression of the reason why the patient sought medical help, the history of the present illness, the patient's past medical history, and the patient's social and economic position. At this time, the interviewer may wish to say, ''You've been very helpful. I am going to take a few notes.'' If any part of the history needs clarification, this is the time to obtain it. The interviewer may wish to summarize for the patient the most important parts of the history to help illuminate the important points made.

If the patient asks for an opinion, it is prudent for the novice interviewer to answer, ''I am a medical student. I think it would be best to ask your doctor that question.'' You have not provided the patient with the answer that he or she was seeking; however, you have not jeopardized the existing doctor-patient relationship by possibly giving the wrong information or a different opinion.

At the conclusion, it is polite to encourage the patient to discuss any additional problems or to ask any questions: ''Is there anything else you would like to tell me that I have not already asked?'' ''Are there any questions you might like to ask?'' Usually, all possible avenues of discussion have been exhausted, but these remarks allow the patient the ''final say.'' At this time, the interviewer can thank the patient and tell him or her that the physical examination will begin.

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