ABSTRACT
Even once they have described and been questioned about their symptoms, the patient still has useful diagnostic data to offer in terms of their previous healthcare, health behaviours, social, occupational and family history. Back pain is a common problem presenting to primary care clinicians. Patients are often concerned about the cause of the pain but there is a persisting controversy regarding the initial evaluation of such patients. Lumbar-spine films are frequently obtained but have a low yield, may be misleading, represent a significant dose of radiation and are expensive. Palpitations are another symptom where information from the previous healthcare history can be useful in distinguishing patients with clinically significant arrhythmias from those without. There is particularly a strong tradition within British general practice that patients who visit their general practitioner with a new problem after a long period of non-attendance are more likely to have a cancer.
