# 135 May 2011

"Paradise does not make itself known as paradise until we have been driven from it."?

Herman Hesse
From Reflections

(continues below)

mental health professional trainings
primary care professional trainings
psychological assessment supervision and consultations
Shawn Christopher Shea
links and recommended readings


# 135 May 2011

The "Chief Concern"?

TISA Description of the Problem: The concepts of person-centered counseling and person-centered medicine have greatly enriched the arena of clinical interviewing. In the following tip Padma Lai,MD provides a tip that resonates wonderfully with these approaches.

Tip: In medical school, you learn about the "chief complaint"?. In clinical practice, you realize there is a "chief concern". From this perspective I ask my patients:

"Of all of your symptoms what is the most concerning to you?"

TISA Follow-up: Dr. Lai's wisdom points with a Zen elegance to the importance of viewing each patient as a unique individual and the importance of uncovering that individual's personal viewpoints, priorities and worldviews. In addition, the word "complaint" tends to have a negative connotation in many cultures as with, "nobody likes a complainer". The word "concern" lacks this baggage. It would be nice if the concept of "chief concern"? would replace "chief complaint"? in the standard medical and mental health write-up.

Tip provided by:

Padma Lai, MD
Practice Limited to Endocrinology
Syracuse, New York

TISA is a site dedicated to advancing the science and art of preventing suicide and teaching clinical interviewing