What is the first step in obtaining a patient's medical history?

The first step in obtaining a patient's medical history is to ask open-ended questions. This approach encourages the patient to express their concerns, symptoms, and medical background in their own words, which can provide a wealth of information that might not be captured through more restrictive questioning.

Open-ended questions foster a dialogue and allow the patient to share relevant details they might consider important, which could otherwise be overlooked. It sets a supportive tone for the interaction, making patients feel more comfortable and likely to disclose critical information regarding their health.

In contrast, using closed-ended questions can limit responses to simple yes or no answers, which may not capture the full context of the patient's condition. Probing for specific symptoms without first allowing for a general overview may lead to miscommunication or missing key elements of the patient’s experience. Reviewing previous medical records can be informative but typically comes after engaging with the patient to understand their current concerns and symptoms. Thus, asking open-ended questions lays the groundwork for gathering a comprehensive medical history.