The “Chief Concern”

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

Herman Hesse
From Reflections

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