Thread by @ShreyaKangovi

1/ Ok by special request from my dear mentee @dn_charles: here’s my version of the HPI for new #primarycare patients.

Key points: welcome them and get to know them as people.

Don’t worry, it takes no longer than usual! I still see 8-10 pts in a morning.

2/ Here are some prompts I use to get a quick overview of my patients’ life stories, including trauma history.

I also try to reflect and synthesize what they’ve told me so that we are on the same page about their strengths/hopes/fears/root causes of any troubles.

3/Then, the medical part of my HPI. Here’s where I ask about what is typically called the social history: sex, drugs, alcohol and cigarettes. This is too narrow to call a social history. I call it ‘habits.’

I skip the Fhx and do it on the second visit.

4/I always write an assessment and plan for each problem, and the. Print out my whole note and give it to the patient. It keeps me honest and ensures there’s no meanness (“difficult patient”) slipping into my note.

Mix of folks who informed my person-centered primary care and others who may be interested. Mostly inspired by #chws.

@SocietyGIM @KBDeSalvo @davechokshi @choucair @PCORI @kevinbmahoney @HMSPrimaryCare @dmgorenstein @BYehia @sarahkliff @judith_graham @davegrande