The Hidden Value of a Patient's Social History

Greg A. Hood, MD

Disclosures

June 22, 2016

The 'Good Old Days' of Paper Charts

Cynics and neo-techno luddites will forever lament the loss of the elegance and availability of the written word, particularly when it comes to the paper medical chart. There are some things to be said for this position. But, to be fair, there have been opportunities that were missed or not taken advantage of in both the eras of the written chart and the electronic health record (EHR).

In particular, the social history section has long been misunderstood and underutilized. No, I'm not going to enter into the old axiomatic debate of whether substance use belongs in the medical history or social history. Instead, I'm speaking of taking full advantage of the "social" aspect of the social history.

Throughout my more than 20-year career, I've used the social history to keep track of notes that help personalize my relationship with patients and provide them with good service. I'm talking about such things as weddings, births, anniversaries, recent vacations, and anything else that might be important or represent a milestone in a patient's life.

Thankfully, I've been able to maintain my methods with our current office system. However, between the "usability"/ease of interface of some EHR systems, and the ever-increasing time pressures that the system and its documentation requirements exert, the social history is becoming more of an anticlimactic social history. But I digress.

Providing good service should be a priority for all physicians. Patients, of course, hope to receive good service. Old and well-cited studies have shown that patients can't always accurately judge the quality of the care that they receive. However, they can recognize personalized service, be it from a hotel, a restaurant, or a physician's office. They also often equate personalization of care with quality of care.

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