The role of interviewing in endocrine practice

BACKGROUND: Interviewing is a basic, yet neglected clinical method that allows to understand how a person feels and what are the presenting complaints, obtain medical history, assess personal attitudes and behavior related to health and disease. In the endocrine setting it provides the patient with information about diagnosis, prognosis and treatment, and establishes a therapeutic relationship that is crucial for shared decision making and self-management. However, the value of this clinical skill is threatened by time pressures and emphasis on technology. Current health care trends privilege expensive tests and procedures and tag the time devoted to interaction with the patient as lacking cost-effectiveness. Instead, the time spent to enquire about problems and life setting may actually help to avoid further testing, procedures and referrals. METHODS: The aim of this paper is to provide an overview of optimal use of interviewing in clinical endocrinology. RESULTS: The basic principles of the art of interviewing are described, particularly as to medical diagnosis and history, health attitudes and behavior (including lifestyle), patient's experience of symptoms and quality of life, allostatic load and psychological distress. CONCLUSIONS: Assessment by interviewing may indeed offer a characterization of the person's psychosocial environment that is missing from current formulations. It may shed light on a number of clinical issues, such as interpretation by the endocrinologist of abnormal hormone values that lack explanation, difficulties in coping with the various phases of illness, maladaptive illness behavior, presence of residual symptoms.