Key Points

The History and Physical (H&P) remains a way of gathering information when you do and Integrative Health assessment, but it deepens as you focus more on a person’s values and self-care, and it broadens as you use a team-based approach.

Each section of the H&P expands to include additional questions and details that can take patient encounters in new directions.

Introduction

The H&P forms the backbone of a medical visit.  When you use an Integrative Health approach, it remains important, but as the conversation expands, you might note that in some ways, your H&P changes too.  Some examples are as follows:

1. Richer information.  As you cover the different areas of the Circle of Health over time, you will learn more about your patients’ lives than you knew before—their strengths, struggles, dreams, and unique stories.  A yearly visit can seem like an opportunity to catch up with an old friend.
2. More prevention.  You may find that you focus more on prevention than before, especially as it relates to empowering patients to do self-care.
3. More meaning to your work.  You will likely remember information from visits more clearly.  If you move beyond “just the facts” to the realm of narrative, documentation becomes more of an exercise in “telling the story.”  Humans are better at remembering stories than lists of facts.  You become more invested in the outcome, when you know what their goals and aspirations are, as opposed to just knowing their problems. 

In clinical training, we were taught to let the outline for the H&P be our anchor as we have conversations with patients.  For Integrative Health visits, it still can be, but there are ways to expand it.  

What follows is a breakdown of how the parts of the H&P can change, section by section, during an Integrative Health visit.  As you review, ask yourself how you would organize an Integrative Health H&P with your own patients.  Of course, leave room for spontaneity, but it helps to have a general template in mind.