Health Education Reform?

In my first year of med school, a preceptor asked a small group of us, "From what part of a patient encounter do you get the most information - the history, the physical exam, or the lab tests?" Almost everyone said lab tests. I went out on a limb and said physical exam. The answer, obvious to most physicians in practice, is the history. Studies have quantified this.

If a group of people who had managed to get into medical school didn't know this, does the general public know that the most important part of many of their medical encounters is the part at the beginning when they are asked a bunch of questions? So if you come in with pain, we want to know when it started, where it is located, how long episodes last, the quality and severity of type of pain, what other symptoms are associated with it, what makes it better, what makes it worse, what have you tried for it, etc. Often we have a pretty good idea of what is happening just based on that. There are a number of acronyms for these bits of info and they have to be documented for a physician to get paid.

So then I am thinking back to Health Education class. I learned about nutrition, exercise, sex ed, etc. But I never learned how to talk to a doctor. Or more precisely, how to communicate information to a doctor in a somewhat coherent manner. We do that in elementary school English - main idea, topic sentences, etc. But if we teach students to organize their paragraphs, why can't we teach them to organize their symptoms? Is there a "garbage in, garbage out" component to our health care woes that we should think about?

So how about we have some joint English and Health classes to learn how to present our medical complaint information as effectively as possible so doctors don't have to waste precious time interrogating it out of us (or giving up and ordering the test)? And how about some joint Health and Math classes so we all learn that our fancy, expensive tests have many, many limitations - such as false positives - especially, when we use them indiscriminately. Are the concepts of sensitivity and specificity any harder to teach than, say, algebra?

And heck, maybe this doesn't need to be a political football. Maybe education that teaches personal medical encounter responsibility can unify progressive and conservative alike?