It’s Not a Chief Complaint

In medical school, doctors are trained to distill a patient’s narrative into something we call the “chief complaint.” It’s a shorthand, a tool to help us focus all the details of a patient’s history into a single lens, from which additional data can be gathered and a plan of care can be developed. It’s efficient, it’s concise, and it’s been the cornerstone of medical practice for generations.

But there’s something inherently dehumanizing about this framework. The term “complaint” implies that the patient’s voice is something to be managed, rather than something to be deeply listened to. It suggests that expressing one’s experience is a burden, something to be minimized or dismissed. This is not the relationship we want to cultivate with our patients.

Language matters. It shapes how we see the world and, in this case, how we see our patients. Referring to a patient’s experience as a “complaint” belies a fundamental misunderstanding of the doctor-patient relationship. It frames the patient as a problem to be solved, rather than as a person to be understood.

In reality, the patient’s story is the most important piece of the puzzle. It’s not just a prelude to the real work of diagnosing and treating; it is the real work. When a patient shares their concerns with us, they’re entrusting us with something deeply personal. It’s our job to listen—to truly listen—and to understand not just the symptoms they’re describing, but the impact those symptoms have on their life.

That’s why we’re so intentional about the language we use in our practice. Instead of asking, “What’s your chief complaint?” we ask, “What’s your concern?” A complaint suggests that the conversation is one-sided, that the patient is merely ticking off a box on a form. A concern, on the other hand, invites dialogue. It’s open-ended. It acknowledges that the patient is the expert on their own experience and that our role is to help them make sense of that experience.

This shift in language isn’t just a matter of semantics; it reflects a deeper philosophy about how we approach patient care. In our practice, we believe that healing happens when two people sit down, take the time, and have a real conversation. That’s why our follow-up visits are typically an hour long. It’s not just about checking off boxes; it’s about peeling back the layers, exploring the nuances, and getting to the heart of what’s really going on.

In medical school, we’re taught that 90% of medicine is the history and physical. This isn’t just a nostalgic nod to a bygone era when technology was limited. Even today, with all the advanced diagnostics at our disposal, the patient’s story remains the cornerstone of accurate diagnosis and effective treatment. Every test has its limitations, its false positives and false negatives. Our interpretation of data is always colored by the context provided by the patient’s narrative.

So, we don’t ask for complaints. We ask for concerns. Because concerns are where the real work begins. They’re the raw material from which we can sculpt a diagnosis, develop a treatment plan, and most importantly, build a relationship based on trust and mutual respect.

In the end, it’s not about solving problems. It’s about caring for people. And that starts with how we listen, how we speak, and how we honor the stories our patients share with us.