Primary care medicine is the new frontier in medicine. Every nation in the world has recognized the necessity to deliver personal and primary care to its people. This includes first-contact care, care based in a posi­ tive and caring personal relationship, care by a single healthcare pro­ vider for the majority of the patient's problems, coordination of all care by the patient's personal provider, advocacy for the patient by the pro­ vider, the provision of preventive care and psychosocial care, as well as care for episodes of acute and chronic illness. These facets of care work most effectively when they are embedded in a coherent integrated approach. The support for primary care derives from several significant trends. First, technologically based care costs have rocketed beyond reason or availability, occurring in the face of exploding populations and diminish­ ing real resources in many parts of the world, even in the wealthier nations. Simultaneously, the primary care disciplines-general internal medicine and pediatrics and family medicine-have matured significantly.

This book draws together a wealth of research and scholarship concerning the medical interview and structures the large domain of knowledge addressing the medical interview and related skills.

I. A Framework for the Medical Interview.- 1. Three Functions of the Medical Interview.- 2. Hypothesis Testing.- 3. Therapeutic Aspects of the Clinical Encounter.- 4. The Interview as a Clinical Negotiation.- II. The Structure and Process of the Medical Interview.- 5. Performing the Interview.- 6. The Mental Status Examination.- 7. Use and Management of Physicians' Feelings During the Interview.- 8. Barriers to Effective Communication.- 9. Patient Education in the Medical Encounter: How to Facilitate Learning, Behavior Change, and Coping.- 10. Enhancing Cooperation with the Medical Regimen.- III. The Context of the Interview.- 11. Patients and Their Lives: Psychosocial and Behavioral Aspects.- 12. Cultural Factors in the Medical Interview.- 13. Gender Effects in Physician/Patient Interaction.- 14. The Bilingual Interview and Medical Interpretation.- 15. Conducting a Family Interview.- 16. The Telephone Interview.- 17. Terminating the Doctor/Patient Relationship.- IV. Specific Interview Situations.- 18. Interviewing Pediatric Patients.- 19. The Geriatric Interview.- 20. The Sexual History.- 21. Personality Styles.- 22. Interviewing the Psychotic Patient.- 23. Effective Interviewing and Intervention for Alcohol Problems.- 24. Interviewing the Suicidal Patient.- 25. Caring for Patients with Life-Threatening or Terminal Illness.- 26. Delivering Sad or Bad News.- 27. Bereavement.- V. Values, Ethics, and Legal Issues.- 28. Shame, Humiliation, and Stigma in the Medical Interview.- 29. Medical Ethics and Doctor/Patient Communication.- 30. The Role of the Medical Interview in the Physician's Search for Meaning.- VI. Teaching and Faculty Development.- 31. Educational Theory and Teaching Medical Interviewing.- 32. A Developmental Awareness for Teaching Doctor/Patient Communication Skills.- 33. Standardized (Simulated) Patients and the Medical Interview.- 34. Teaching with Role-Play: A Structured Approach.- 35. Teaching Interviewing Using Direct Observation and Discussion of Actual Interviews.- 36. Teaching Medical Interviewing: The Lipkin Model.- 37. Evaluating a Faculty Development Course on Medical Interviewing.- VII. Evaluation of the Interview.- 38. Evaluation of Medical Interviewing: Concepts and Principles.- 39. Evaluation Instruments for Medical Interviewing Skills.- VIII. Research on the Medical Interview.- 40. An Overview of Research on Medical Interviewing.- 41. A Guide to the Research Literature on Doctor/Patient Communication.- 42. Coding Categories for Investigating Medical Interviews: A MetaClassification.- 43. Affective and Nonverbal Aspects of the Medical Visit.- 44. Psychological Research on Diagnostic Reasoning.- 45. Accuracy of the Medical History: A Review of Current Concepts and Research.- 46. Patient Recall and Comprehension After the Medical Visit.- 47. The Patient-Centered Interview: Research Support.- 48. Patients' Assessments of Quality.- Appendices.- A. Instructional Use of Audio and Video Recording John Femino and Catherine Dubé.- B. Bibliography.