Though medicine continues to advance with new technologies and innovations, one invaluable tool has withstood the test of time: the medical interview. The medical interview continues to be the foundation for diagnosis and it is important that we are able to communicate with all of our patients. If you find yourself struggling to connect with your patients born between the 1980s and 2000s, consider the following suggestions.
I. Chief Complaint
Ideally, you want to understand the chief complaint in the patient’s own words i.e. “it feels like a bird is fluttering in my chest”, “it feels like someone is sitting on my chest”, or “it feels like my heart grew three sizes after I witnessed the miracle of Christmas”. To encourage succinctness, politely suggest that millennial patients describe their complaint in 140 characters or less.
II. History of Presenting Illness
The patient will likely have a meticulous log of the details of their progressing symptoms on some form of social media. If not, you can ask any one of their close friends or coworkers to explain the symptoms in disturbing detail. A specific note on assessing severity: instead of a 1-10 scale, ask the patient to describe their pain on a scale from “your Uber being two minutes late” to “the Yelp reviews were wrong and now you’re stuck at a very mediocre café with nothing to Instagram.”
III. Past Medical History
To show the patient that you are hip, cool, “woke” (“socially aware”), and actively trying to smash the patriarchy, correct your language and ask for their past medical HERstory, not history. Give the patient some space and time to text their mom, who will describe every cold since birth.
IV. Family History
The patient will likely have access to Facebook at the time of the appointment, although they have not actually posted anything in years as the site’s been infiltrated by their older relatives. This presents the perfect opportunity to gather important detailed medical complaints on older relatives’ facebook pages, where you will also find a series of inspirational quotes to get you through the rest of the interview. You may want to skip over never-attempted Tasty recipes and minute-by-minute political updates also prevalent on the site.
V. Social History
You may be able to use the patient’s LinkedIn page to get an understanding of their education and occupation while past Tinder conversations may be used for sexual history queries. Unfortunately, drug and alcohol use will be less accessible as that information is typically not kept for more than 24 hours in Snapchat stories.
VI. Review of Systems
a. General
If the patient reports having fevers and chills, ask the patient if the symptoms persist even when they take off their Patagonia fleece.
b. Skin
When examining the patient’s skin, resist the patient’s urge to only show you their good side and/or filtered photos.
c. Head, ears, eyes, nose, throat
Wear a surgical mask in anticipation of $5 artisanal ethically-sourced pour over coffee breath. You may notice a slight nystagmus as the patient frantically searches for their phone, an item they are used to focusing on at all times.
d. Respiratory system
After listening to the patient breathe, give the patient a life participation award.
e. Cardiovascular system
Instead of asking about “palpitations”, ask about “that feeling you get when the restaurant’s buzzer goes off and it’s your turn for brunch.”
f. Gastrointestinal system
Recognize that there is a new addition to the alimentary tract, through which every food item must pass before proper digestion can occur. As such, the patient’s Instagram page should be assessed.
g. Genitourinary system
If a male patient complains that it burns when they go to the bathroom, ask if any recipients of their dick pics have noted any lesions.
h. Musculoskeletal system
You can easily screen for muscle weakness by asking how long of a concert the patient can record on their phone before their arms get tired.
i. Nervous system
Try to assess the severity of the patient’s FOMO by seeing if it interferes with their daily activities, which paradoxically include avoiding social events to stay home.
With these suggestions, we hope you are better able to communicate with millennial patients. Most importantly, we ask that you never ever let the patient witness you struggling to use the Electronic Medical Record system as this will be perceived as incompetence and will result in poor Yelp reviews.
