Стр. 83 - 2

85
3.
a. Read the article below and complete the gaps with these sen-
tences.
a. both doctor and patient had greater understanding of the
symptoms
b. History-taking was limited to a number of closed questions
c. The patient is considered expert of their own disease
Patient-centered approach to history-taking
Traditionally doctors took the dominant role during consulta-
tions; for many, a doctor’s word was God and, as such, their pro-
fessional expertise unquestionable. Patients were not expected,
neither did they expect to, participate actively in the history-
taking process; indeed, their health was entirely in the hands of
their physician. Medical training was all about the disease, and
the patient as victim of that disease; the disease and the patient
were considered as separate entities.
1 _______________________ regarding the functioning of
the relevant organ or system in order to arrive at an accurate diag-
nosis. The impact of the disease on the patient’s life was barely
considered, if at all.
George Engel, pioneer of doctor-patient relations, soon real-
ized a deeper understanding of patients’ problems could be
achieved through a bio- psychological model. Engel believed
strongly in the patient as the main source of information. The pa-
tient-centered encounter therefore takes on a more holistic ap-
proach, with social, economic, and psychological factors also
playing an essential role in the diagnosis . 2 _________________;
one person’s experience of a disease is fundamentally different
from the next.
So what of the benefits of such a radically different approach
to history-taking? Studies in the 1970s showed that only 25% of
doctors had an open, flexible consultant style; the other 75% in-
terviewed their patients in a tightly controlled way, allowing them
limited participation. Doctors attending three-day communication
skills courses recently at the University of Sussex, UK, were
found to be significantly more patient-centered. Students showed