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4. General Approach to Treating Patients
Pages 43-50

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From page 43...
... . For Gulf War veterans, the first step in evaluating persons deployed to the Gulf War is to construct an accurate history through a careful interview.
From page 44...
... (1995) reported that information giving, time spent in discussion of preventive care by the doctor, and greater interview length were positively associated with patient satisfaction while a dominant, controlling style of communication on the part of the physician produced less satisfaction.
From page 45...
... This will involve recording detailed information about current and past medical illnesses, medications used, surgical procedures, typical allergies, previous diagnostic workups and treatments, and the patient's pattern of medical care utilization. Obtaining past medical records is especially helpful, particularly when the patient is a poor historian or the past history is confusing.
From page 46...
... Neuropsychological testing may be useful in some patients, particularly when the predominant complaint involves memory impairment or poor concentration. Results of the physical examination and laboratory testing may well be within normal limits for most patients and will help to exclude the presence of well-defined illness.
From page 47...
... It is then possible to address misconceptions, reinforce accurate understanding, and provide reassurance to patients through education and advice that address the patient's beliefs.
From page 48...
... Patient-centered care may require more initial time spent with the patient but may, in the end, decrease the total amount of time required for effective treatment, especially for those patients with difficultto-diagnose or unexplained conditions. As an example, patient-centered care has been used to clinically manage patients with somatization disorder.
From page 49...
... RECOMMENDATION The committee recommends that the VA provide specific training to health care providers caring for Gulf War veterans to ensure that they are skilled in the principles and practice of patient-centered care. Further, the committee recommends that the VA ensure that health care practitioners serving Gulf War veterans are allowed sufficient time with patients to provide patient-centered care.


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