News + Issues

Does a “chief complaint” change patient care?

Dentist and Patient Examining X-ray

A new class is settling into clinic and treatment planning seems to be happening in every other chair. An intake interview is happening next to me and I hear, “Um… What’s your chief complaint?” I cringe. I see the patient’s head tilt slightly. His brows furrow revealing confusion. I take a guess at what he’s thinking, “What in the world is this kid asking me?!”

There are a couple things wrong with this scenario. First of all, we should always be cautious when using dental/medical jargon with patients, as it may undermine their understanding and overall experience. Secondly – and what I’ll focus on here– is the concept of “chief complaint” and its arguably inappropriate prominence in dentistry and medicine.

When I first heard the term “chief complaint” as a D1, I was baffled. My first professional experience in health care was at the National Center for Medical Home Implementation. The buzzwords we lived by were “continuous,” “comprehensive” and “coordinated,” among many other optimistic terms (even some that don’t begin with “C”). The idea that a patient would only come in if they had a problem was exactly what we were trying to combat. The goal for every patient was to address their needs and move toward preventive care. In the dental world, they become a “recall” patient.

The U.S. Department of Health and Human Services, Health Resources and Services Administration defines chief complaint as “a concise statement in the patient’s own words describing the symptom, problem, condition, diagnosis or other factor that is the reason for the encounter.” It goes without saying that our priority should always be to address our patient’s primary concern. However, we mustn’t focus too heavily on the term itself. By doing so, we may inadvertently be suggesting to our patients that they should only be presenting when they have a specific problem to address, rather than coming in for check-ups.

As students, we’re at a critical phase in learning how to communicate effectively in health care. We’re on the cusp of truly understanding these terms, yet not so far from when we shared the average layperson’s comprehension of dentistry.

Perhaps say something along the lines of, “It’s great that you’re here starting/continuing your dental treatment, but I’d just like to check. Is there anything in particular that’s been bothering you lately?” This allows us to gather the information we need while still approaching oral health care as a comprehensive, ongoing process. For the sake of our patients and in an effort to become better communicators and providers, let’s form good communication habits now.

Are there other dental/medical terms that you hear thrown around with patients that may cause confusion? If so, share your stories below!

Chelsea Rajagopalan, Rutgers ’17

Chelsea Rajagopalan

Chelsea F. Rajagopalan is a fourth year student at Rutgers School of Dental Medicine. She serves as chair on the ASDA Council on Professional Issues and is Immediate Past President of the Rutgers ASDA Chapter. When she’s not in class or clinic, she enjoys visiting her friends and family in Michigan and Texas, exploring NYC, and running with her dog Mack.

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  1. Awesome read! Communication is not to be underestimated in our profession! Many times during my clinical hygiene career I’ve reviewed the health history with my patient. The one sentence … do you like your smile … with following options if answered no .. being whiten, straighten, etc. THIS is confusing as the patient will focus on whitening their teeth! Forget that their breath is blowing you away from xerostomia, periodontal disease, untreated caries, or a coating on the tongue as thick as a fit bit! Until WE focus our questions health … it’s relation in simplicity to their current oral health I say remove the smile concern to health history. Because without teeth, there’s nothing to smile about and isn’t that really a smile concern question? 🙂 #AmericasDentalHygienist

    1. Chelsea Rajagopalan says:

      Thanks so much, Anastasia! Love that alternative — simply “Are you happy with your smile?” — to help us dig deep and figure out the patient’s true concerns and hopes for their time and money spent with us. As with most things in life, communication is key! Thanks again for reading!

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  3. Thanks for sharing most valuable blog.

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