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The speaker emphasizes the importance of past medical history (PMH) in evaluating patients, stating that it informs both current and future health assessments. They argue that understanding a patient's medical history is crucial, as it helps predict present conditions and risk factors. For instance, knowing if a patient has a history of lung cancer allows the clinician to assess the likelihood that the cancer is related to their current complaint. The speaker highlights that knowledge of the cancer's stage—ranging from localized (stage 1) to advanced (stage 4)—significantly affects the patient's risk profile and informs treatment decisions. Therefore, a comprehensive understanding of the PMH is essential for effective patient care.