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the key to medical and surgical diagnosis is to have the same orderly approach to every patient it is well known that 70% of diagnosis can be made by excellent history taking physical exam and labs make about 30% of diagnosis when taking a history I recommend using a quotes 3 paragraph approach to ensure you dont miss anything the chief complaint or presenting complaint is the key the first step in taking a great history is to make the patient decide what is the worst of all symptoms and then allow a description in his or her own words without interrupting if the patient strays from describing the chief complaint get the patient back to it no other symptom descriptions are allowed at this point when the physician has a complete understanding of this chief complaint that completes paragraph 1 of the history template in paragraph 2 the patient may now describe all symptoms associated with the chief complaint in their own words the physician should now have a reasonable idea of the organ