The unreliable historian

There are two rules in medicine - believe everything the patient says, don't believe anything the patient says

Sometimes it is obvious that a patient's history cannot be relied upon and we need to take a health skepticism about anything they say.

Sometimes the best historian is NOT the patient.

Why do we get the wrong information

If there are concerns about the patient's mental function then perform a quick mini-mental exam.  If they score poorly then it is not worthwhile persisting with a detailed history.  Perform a quick review of current symptoms then obtain the information from an independent source.

 Words that might mean different things to the doctor and patient

Questions that might get different responses

How we can improve the history

When all else fails