Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Patients become people through the social history

Merry Jennifer Markham, MD
Physician
August 26, 2015
Share
Tweet
Share

asco-logo One day in clinic, recently, I reviewed my daily schedule with the oncology fellows who were working with me that day. With the exception of the new patients on my schedule, I recognized all of the names on my list. I opened the electronic chart of the first patient to skim the problem list, a handy spot where I keep a summary of all the treatments received for the cancer diagnosis.

“Mrs. Jordan (name and details changed) is just here for routine follow-up. She completed therapy about three years ago, and she’s done great so far,” I said. I went on to tell them that her son was a physician, but that he never came with her to her appointments. He had emailed, once, just to touch base; but it was clear that his mother valued her independence and wanted be in charge of her own health care. She was in her 80s and very clear about her expectations of me and, I’m certain, of her son.

Using the computer mouse, I pointed to another patient on the list.

“Ms. Finley is coming today to discuss her CT scan from last week,” I said.

I planned to discuss chemotherapy with Ms. Finley, and I was sure she would agree based on the scan results that showed progression of her cancer. I mentioned the regimens I was considering to the fellows, as well as my rationale for my top two choices. I fielded questions about chemotherapy selection in platinum-resistant ovarian cancer versus platinum-sensitive disease.

“She’s retired from teaching,” I told the fellows. “She usually comes with her daughter, who’s a pharmacist.” Keeping busy through volunteer work has been very important to Ms. Finley, and it’s helped to reduce her anxiety about her disease. I hoped she was still doing it. If she had stopped volunteering, it could be an indication of her level of symptoms.

I shifted the mouse and hovered the pointer over the next patient.

“This one is coming for routine follow-up,” I said. “She’s usually doing great, except for some arthritis issues. She hasn’t needed treatment for her lymphoma yet. We always talk cooking and food.”

“Ms. Richardson loves good olive oil,” I told the fellows. Ms. Richardson had given me tips on where to buy specialty olive oil locally, and she’s told me how she uses flavored olive oil in her own cooking. She cooks with her grandchildren, and the ability to do this when they visit her means so much to her.

I continued on with my introductions of the day’s patients to the oncology fellows, including a bit about the various diagnoses and treatments and rationale for treatment selection, but even more about who the patient is as a person: what they enjoy, who comes with them to their visits, how they cope with their diagnosis, the type of support they have at home. The information I was giving, I realized, was the social history.

When I was a medical student, I remember learning the value of the social history in discovering unhealthy habits—such as alcohol use, tobacco use, illicit drug use, or a sedentary lifestyle. I learned that the information elicited from a patient during the social history might give insight to the patient’s overall well-being, their coping strategies, and their potential for health risks in the future. As a student, I dutifully made note of my patients’ work history, occupational exposure to chemicals, number and type of pets in the home, amount of caffeine intake, exercise habits, seatbelt use, and hobbies. And while my internal medicine attendings seemed to appreciate my thoroughness, my lengthy social history during patient presentations surely evoked some eye rolls from the residents and faculty on my surgery rotations.

Though I once did it because it was a required part of the medical history, the social history has become one of my favorite things about patient care. It is through the social history that I really get to know who my patient is as a person, beyond the label of the cancer diagnosis. Through the social history, I get to know details about my patient’s life that help me to provide more thoughtful care, more humanistic care.

It is through the social history that my patients become more than just patients with a cancer diagnosis. They become people.

ADVERTISEMENT

Merry Jennifer Markham is a hematologist-oncologist who blogs at her self-titled site Merry Jennifer Markham and can be found on Twitter @DrMarkham.  This article originally appeared in ASCO Connection,

Prev

This doctor is on a mission to take back medicine

August 25, 2015 Kevin 55
…
Next

Don't blame yourself after a cancer diagnosis

August 26, 2015 Kevin 5
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
This doctor is on a mission to take back medicine
Next Post >
Don't blame yourself after a cancer diagnosis

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Merry Jennifer Markham, MD

  • a desk with keyboard and ipad with the kevinmd logo

    I am so sorry I didn’t make this different for you

    Merry Jennifer Markham, MD
  • a desk with keyboard and ipad with the kevinmd logo

    With advanced cancer, there are no guarantees

    Merry Jennifer Markham, MD
  • The art of writing a good consultation letter to another physician

    Merry Jennifer Markham, MD

Related Posts

  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • A physician’s addiction to social media

    Amanda Xi, MD
  • Why social media may be causing real emotional harm

    Edwin Leap, MD
  • Are negative news cycles and social media injurious to our health?

    Rabia Jalal, MD
  • How I used social media to get promoted to professor

    David R. Stukus, MD

More in Physician

  • Physician patriots: the forgotten founders who lit the torch of liberty

    Muhamad Aly Rifai, MD
  • The child within: a grown woman’s quiet grief

    Dr. Damane Zehra
  • Why the physician shortage may be our last line of defense

    Yuri Aronov, MD
  • 5 years later: Doctors reveal the untold truths of COVID-19

    Arthur Lazarus, MD, MBA
  • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

    Nivedita U. Jerath, MD
  • Why this doctor hid her story for a decade

    Diane W. Shannon, MD, MPH
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • Bird flu’s deadly return: Are we flying blind into the next pandemic?

      Tista S. Ghosh, MD, MPH | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • 5 cancer myths that could delay your diagnosis or treatment

      Joseph Alvarnas, MD | Conditions
    • When bleeding disorders meet IVF: Navigating von Willebrand disease in fertility treatment

      Oluyemisi Famuyiwa, MD | Conditions
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The child within: a grown woman’s quiet grief

      Dr. Damane Zehra | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • Bird flu’s deadly return: Are we flying blind into the next pandemic?

      Tista S. Ghosh, MD, MPH | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • 5 cancer myths that could delay your diagnosis or treatment

      Joseph Alvarnas, MD | Conditions
    • When bleeding disorders meet IVF: Navigating von Willebrand disease in fertility treatment

      Oluyemisi Famuyiwa, MD | Conditions
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • The child within: a grown woman’s quiet grief

      Dr. Damane Zehra | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Patients become people through the social history
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...