TPR Lifeline: Why Medical Histories Matter
A medical history alone isn’t enough for a doctor to make a diagnosis. But those facts about family diseases and medications are keys to helping healthcare professionals unlock what may be going on. In today’s TPR Lifeline, Bioscience-Medicine reporter Wendy Rigby finds out from UT Health San Antonio Family and Community Medicine professor Nehman Andry, MD, what we need to know about our medical histories. Here's a transcript of the interview:
Rigby: Medical histories vary in their length and depth. We all know if we go to the ER it’s going to be quicker than if we’re going to be evaluated for a psychiatric issue. So what kind of an accounting of our history do you really need to know: surgeries, medications, family history, past complaints? What’s most important?
Andry: I’d say any major medical conditions that any family members may have. Definitely the causes of death. The age of any condition that was diagnosed. Age of death of family members if they’ve passed away. And then ethnic background is also important. Some conditions are definitely more prevalent in people of certain ethnicities than others.
Rigby: According to the Centers for Disease Control, a study conducted showed that 96 percent of Americans believed that knowing their family history is important. But only one third have actually their family history. What kind of questions should you ask your family members about their medical history? And why do doctors need to know if my grandmother who’s been dead for thirty years died of a heart attack?
Andry: We’re detectives. I’m a detective with a stethoscope and any information or clues you can provide me, it makes my job keeping you healthy, helping you become the best version of yourself, possible.
Rigby: It’s hard for some people to list all of the medications they take, what doses and even, honestly, how to spell them. Should people simply keep a list in their wallet so that they have it with them at all times?
Andry: There’s actually an online tool from the U.S. Surgeon General out called my family health portrait for individuals to enter their family history online in a secure place. And you can update it really at any time.
Rigby: Can you put your medication list in there?
Andry: It’s more chronic conditions or diseases that have been diagnosed.
Rigby: And what is the name of that app?
Andry: It’s called My Family Health Portrait.
Rigby: But as far as medications are concerned, should people keep a list with them at all times?
Andry: It would be helpful if you did have that list. Really if you’re seeing a provider we try to provide you that list at each visit and ask you those questions.
Rigby: Studies have shown that people do lie a lot when they give medical histories. Do doctors know this happens and how do they account for that?
Andry: Well, that’s a tough one. The more straightforward you are with your physician or other healthcare provider, the more we can help yo u.
Rigby: Many people lie about drinking, smoking, illicit drug use and sexual habits. Why should they just come clean about what’s really going on in these areas?
Andry: Bad behaviors can lead to long-term health consequences. That’s not something that’s easy to talk about. But luckily in my position as a family physician I’m able to develop a relationship with patients over time, build that trust. And usually once you have that trust, these types of conversations are much more comfortable.
Rigby: Sometimes a nurse or a medical assistant asks questions about medication allergies. They write it down. Then the doctor comes in, like thirty seconds later, and asks the same questions. Why is that?
Andry: Well, it’s not because we’re not listening. It’s not because we didn’t review the chart. We have to confirm that information.
Rigby: Do you think there will come a time when it will all be sort of in one place? Some sort of electronic health portal where my eye doctor and my dentist and my surgeon and my general doctor all have access to the same sort of information?
Andry: You know, that would make too much sense, wouldn’t it? That would be my dream. That would be amazing. I would love that. I think patients would love that. We’ll see.
Rigby: Dr. Nayman Andry from UT Health San Antonio. Thanks for your time.