This article proposes that the history and physical exam, which is the standard initial record for each patient, includes the category of “chief concern” to complement the category of “chief complaint.” Such inclusion would necessitate close attention to narrative features of the patient's history of present illness, with particular attention to the “end” and “point” of the patient's story and to the patient's own sense of what constitutes health. Discernment of the ends of moral action is the key feature of Aristotle's ethical category of phronesis or “practical reason,” the chief example of which is the seasoned, successful physician. To this end, the article advocates the inclusion of the study of narrative and narrative knowledge in the training and practices of physicians.

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