Do you ever stare at a virtual patient on Shadow Health and wonder, “What am I really supposed to ask?”
You’re not alone. Which means the first time I logged into the program I spent ten minutes scrolling through the chart, then another ten trying to remember the exact phrasing for a past‑medical‑history question. Turns out, the way you phrase those questions can make—or break—the whole encounter Small thing, real impact..
What Is a Past Medical History Question in Shadow Health?
In Shadow Health you’re not just ticking boxes; you’re conducting an interview that mirrors a real‑world assessment. A past medical history (PMH) question is any prompt you use to draw out a patient’s previous illnesses, surgeries, hospital stays, chronic conditions, and even lifestyle factors that could influence their current problem.
Think of it as a conversation starter that opens the door to the patient’s health timeline. Instead of a sterile “Do you have any past illnesses?” you might ask, “Can you tell me about any health issues you’ve dealt with in the past that still affect you today?” The nuance matters because the virtual patient is programmed to respond based on how you ask.
The Three Core Types
- Disease‑specific – “Have you ever been diagnosed with hypertension?”
- Procedure‑specific – “Did you ever have surgery on your abdomen?”
- General health‑history – “Are there any health problems that run in your family?”
Each type serves a different purpose, and mastering them gives you a smoother flow and a higher score.
Why It Matters / Why People Care
If you skip or botch a PMH question, the virtual patient’s chart stays incomplete. In practice that means you might miss a crucial risk factor—like a prior myocardial infarction that would change your differential diagnosis.
Real‑world clinicians rely on a solid PMH to decide whether a headache is just tension or a sign of something more sinister. In Shadow Health, the same principle applies: a thorough PMH can open up clues that push you toward the right lab orders, medication choices, or patient education points.
And let’s be honest—your grade hinges on it. The program’s scoring algorithm rewards depth, relevance, and appropriate follow‑up. So the better your questions, the higher your score, and the more confidence you’ll carry into the actual clinic.
How It Works (or How to Do It)
Below is the step‑by‑step workflow I use every time I sit down with a virtual patient. Feel free to adapt it, but keep the core ideas intact.
1. Scan the Chief Complaint First
Before you even think about PMH, read the chief complaint (CC). If the patient says, “I’ve been coughing for three weeks,” you’ll want to focus on respiratory‑related history—COPD, asthma, prior pneumonia, smoking status, etc.
2. Open With a Broad, Open‑Ended Prompt
Start with something that invites the patient to narrate Worth keeping that in mind..
- “Can you tell me about any health problems you’ve had in the past?”
- “What illnesses have you dealt with before that still affect you now?”
The virtual patient will usually give a short answer, then wait for you to dig deeper Most people skip this — try not to. Simple as that..
3. Use the “S‑O‑A‑P” Drill‑Down
S – Symptoms: “When you had that asthma attack, what symptoms did you notice?”
O – Onset: “When was the first time you were diagnosed with diabetes?”
A – Actions/Treatment: “What medication were you put on after the surgery?”
P – Progress: “How has your hypertension been controlled over the years?”
Each mini‑question helps you fill a specific field in the chart Turns out it matters..
4. Prioritize Relevance
Not every past condition deserves equal weight. Use the “rule of three”: focus on the three most relevant past issues for the current CC. For a cardiac‑related CC, prioritize hypertension, hyperlipidemia, and prior MI.
5. Document as You Go
Shadow Health lets you type directly into the chart. That's why as soon as the patient mentions a condition, click “Add” and fill in the details (date, treatment, outcomes). This prevents you from forgetting later.
6. Confirm and Clarify
After you’ve gathered the list, summarize:
- “So you’ve had asthma since childhood, a gallbladder removal two years ago, and you’re currently on lisinopril for hypertension, correct?”
The virtual patient will nod (or type “yes”) and you’ll lock those entries in That's the part that actually makes a difference..
7. Follow Up With Family History
A quick “Do any of these conditions run in your family?” can reveal genetic risks that the patient might not have mentioned under PMH alone.
Common Mistakes / What Most People Get Wrong
Mistake #1: Jumping Straight to Yes/No Questions
“Did you ever have surgery?” sounds efficient, but it shuts down the chance for the patient to elaborate on complications, anesthesia reactions, or postoperative issues. The virtual patient often responds with a single word, leaving you with a half‑filled chart.
Mistake #2: Ignoring Time Frames
Asking “Do you have diabetes?” can cause you to miss the duration, which influences disease severity. ” without probing “When were you diagnosed?Shadow Health expects you to note the year or at least the decade Surprisingly effective..
Mistake #3: Over‑loading the Patient
Throwing a rapid‑fire list—“Any heart disease, lung disease, kidney disease, liver disease?”—makes the encounter feel robotic. The virtual patient may give a generic “no” or get confused, and you lose points for poor communication.
Mistake #4: Forgetting to Ask About Medications
A past condition is only useful if you know how it’s being managed. Skipping “What medication are you taking for that condition?” leaves a gap in the chart and can affect your treatment plan.
Mistake #5: Not Using Follow‑Up Prompts
If the patient says, “I had a surgery,” you need to ask what kind of surgery, when, and why. Failing to follow up signals a superficial interview That's the part that actually makes a difference..
Practical Tips / What Actually Works
- Mirror the Patient’s Language – If they say “the doc told me I have high blood pressure,” respond with “high blood pressure” rather than “hypertension.” The virtual patient’s algorithm is keyed to those exact phrases.
- Use the “5‑W1‑H” Framework – Who, What, When, Where, Why, How. It forces you to cover every angle without sounding scripted.
- Keep a Mental Checklist – Before you move on from PMH, run through: chronic illnesses, surgeries, hospitalizations, allergies, immunizations, and ongoing treatments.
- apply the “If‑Then” Technique – “If you’ve ever had a heart attack, then I’ll need to know the date and any procedures you had.” This signals to the virtual patient that you’re prepared to dig deeper.
- Practice the “Pause and Prompt” – After the patient answers, pause for a beat, then ask a clarifying question. It feels natural and gives the system time to register your query.
- Record Dates Even If Approximate – “Around the early 2000s” is better than “I don’t remember.” The system accepts approximations and still awards points.
FAQ
Q: How many past medical history questions should I ask?
A: Aim for 5–7 focused questions that cover chronic disease, surgeries, hospitalizations, and medications. Quality beats quantity Turns out it matters..
Q: What if the virtual patient says “I don’t know” to a question?
A: Follow up with, “That’s okay. Can you tell me if you ever had any tests or treatments related to that condition?” Sometimes a different angle jogs their memory.
Q: Do I need to ask about childhood illnesses?
A: Only if they’re relevant to the current complaint. For a respiratory issue, childhood asthma is worth noting; for a skin rash, it’s probably not.
Q: How do I handle multiple past conditions that seem unrelated?
A: Group them by system (cardiovascular, respiratory, etc.) and prioritize the ones that could impact the present problem.
Q: Is it okay to use lay terms like “high blood pressure” instead of “hypertension”?
A: Absolutely. The virtual patient responds to the language you use, and the system will map lay terms to the correct medical entry.
That’s the short version: ask open‑ended, follow up with specifics, keep relevance front and center, and never rush past a “yes.”
When you treat the virtual patient like a real person—listening, clarifying, and documenting as you go—you’ll not only boost your Shadow Health score, you’ll build habits that stick when you step into the actual clinic. Happy interviewing!
Putting It All Together – A Sample Walk‑Through
Below is a quick, “real‑time” transcript that demonstrates how the tips above translate into a fluid interview. Notice the natural pauses, the strategic use of the 5‑W1‑H framework, and the way each response feeds directly into the next question.
| Interviewer | Virtual Patient Response |
|---|---|
| You: “Can you tell me a little about any medical problems you’ve had in the past?I’m on lisinopril 10 mg daily now.Here's the thing — ” | “Sure, I’ve had high blood pressure for a few years and I had my gallbladder removed when I was 38. Even so, i was back to work in a week. ” |
| You (Final Confirmation): “Great, thank you. ” | “I had a mild case of pneumonia two years ago, but I’m fully recovered now.Practically speaking, ” |
| You (If‑Then): “If you’ve been on lisinopril, then I’ll need to know if you’ve ever had any side effects, like a cough. Also, ” | |
| You (Wrap‑Up): “That covers the major points. ” | “No, I recovered pretty quickly. ” |
| You (Pause + Prompt): “When were you first diagnosed with high blood pressure, and what treatment have you been on since then?Still, ” | |
| You (5‑W1‑H – When/Where): “When was the gallbladder surgery, and where did it take place? Is there anything else you think is important for me to know about your health history?Also, ” | “It was in March 2012 at St. ” |
| You (Systematic Checklist – Allergies): “Do you have any allergies to medications, foods, or environmental triggers?” | “I did get a dry cough a few months after starting it, but it went away on its own.” |
| You (Medication Review): “Besides lisinopril, are you taking any other prescription or over‑the‑counter meds, vitamins, or supplements? ” | |
| You (Clarify): “Did you have any complications after the surgery—like infection or prolonged pain?Luke’s Hospital.I’ll document all of that and we can move on to your current concern. |
Why this works
- Open‑ended starter gives the patient control and yields a concise list of conditions.
- Targeted follow‑ups (date, treatment, side effects) hit the exact keywords the algorithm looks for.
- If‑Then statements keep the flow logical and signal to the system that you’re drilling deeper.
- Systematic checklist ensures you haven’t missed a category (allergies, meds, surgeries).
- Closing prompt gives the patient a chance to disclose anything you might have missed, capturing those low‑frequency points that often carry high points.
Common Pitfalls and How to Avoid Them
| Pitfall | Why It Costs Points | Quick Fix |
|---|---|---|
| Rushing through PMH | The algorithm flags incomplete sections and deducts points. In practice, | Ask “Why were you started on that medication? Worth adding: |
| Skipping the “why” | Without a rationale, the system assumes the information isn’t clinically relevant. Which means | Mirror the patient’s language; if they say “high blood pressure,” repeat that phrase before adding the clinical term in parentheses if needed. Even so, |
| Using only medical jargon | The virtual patient may not recognize the term, leading to a mismatch. ” to capture the indication. Practically speaking, | |
| Neglecting approximate dates | “I don’t remember” registers as a missed data point. ” | |
| Forgetting to document allergies | Allergies are a high‑value data point; omission = lost points. | Insert a dedicated allergy question early in the PMH sequence. |
The Bottom Line for Your Shadow Health Score
| Component | Weight in Score | What the System Rewards |
|---|---|---|
| Completeness of PMH | 30 % | All relevant chronic conditions, surgeries, hospitalizations, and allergies documented. In practice, , “high blood pressure” → “hypertension”). g. |
| Chronology & Dates | 20 % | Precise or approximate dates for each event. Now, |
| Accuracy of Terminology | 25 % | Exact phrase matches (e. |
| Medication Details | 15 % | Drug name, dose, frequency, and indication. |
| Patient‑Centric Communication | 10 % | Use of lay language, active listening cues, and appropriate follow‑ups. |
By internalizing the strategies above, you’ll be consistently hitting the high‑value items in each category, which translates directly into a higher overall percentage And that's really what it comes down to. Which is the point..
Final Thoughts
Mastering the past medical history interview in a virtual environment is less about memorizing a checklist and more about adopting a structured, patient‑first mindset. When you:
- Start broad, then narrow with purposeful follow‑ups,
- Speak the patient’s language while still capturing the clinical term,
- Systematically cover every organ system using the 5‑W1‑H framework, and
- Pause, reflect, and prompt to give the system a moment to register your query,
you’ll not only ace the Shadow Health assessment but also develop a habit that will serve you throughout your clinical career. The virtual patient is a safe sandbox—use it to rehearse, refine, and perfect the art of history‑taking. When the real bedside calls, you’ll already have the rhythm, the language, and the confidence to gather a comprehensive, high‑scoring past medical history every single time.
Counterintuitive, but true.
Happy interviewing, and may your scores be as strong as your future patient relationships!
Putting It All Together: A Sample Walk‑Through
Below is a concise, end‑to‑end script that demonstrates every tip we’ve discussed. Notice how each question is phrased in lay terms, how the “why” is always asked, and how the interviewer subtly nudges the virtual patient to supply the exact clinical terminology the system is looking for.
| Step | What You Say | Why It Works |
|---|---|---|
| **1. | ||
| **2. ” | A safety net that prompts the patient to disclose any forgotten items, boosting the completeness score. When were you first told you had it?” | Captures drug name, dose, frequency, and indication—all high‑value data points. Day to day, was there a particular test or symptom that prompted it? |
| **7. So lee. ” | Adds the rationale, which the system flags as clinically relevant. | |
| 3. Here's the thing — , cholelithiasis) and sets up the next set of follow‑ups. Can you tell me a little about why you needed it?Drill Down on Details | “What medication are you taking for that, and how often do you take it?In practice, verify Completeness** | “Just to make sure I haven’t missed anything, do you have any other chronic conditions, past hospital stays, or surgeries you haven’t mentioned yet? Now, |
| 8. Opening | “Hi Ms. Now, pinpoint Timing** | “Was the surgery before or after you turned 35? Because of that, patel, I’m Dr. ” |
| 6. But move to the Next System | “You also said you had gallbladder surgery. | |
| 4. Clarify the First Issue | “You mentioned you’ve had ‘high blood pressure.On the flip side, before we get started, could you tell me a little about any health problems you’ve had in the past? Also, ” | Places the allergy question at the top of the PMH segment, ensuring it isn’t overlooked. That's why |
| **9. Day to day, ” | Opens the conversation with a friendly tone and a broad invitation, giving the patient freedom to mention the most salient issues first. g.Summarize & Close** | “Thanks, Ms. Also, patel. Explore the “Why”** |
| 5. Consider this: capture Allergies Early | “Do you have any medication or food allergies that we should know about? So ” | Again, the “why” pulls out the indication (e. ” |
By following a script like this, you’ll naturally hit the high‑value items in each scoring category without having to think about a separate checklist. The key is flow—the conversation should feel like a genuine dialogue, not a rapid‑fire interrogation.
Common Pitfalls & Quick Fixes
| Mistake | What It Looks Like in the System | One‑Sentence Remedy |
|---|---|---|
| Jumping straight to medications without establishing the diagnosis | “You’re on metformin.So ” → No disease captured, low accuracy score. Still, | First ask, “What condition is metformin treating for you? ” |
| Using only medical jargon | “You present with dyspnea on exertion.” → Patient says “I get short‑of‑breath when I climb stairs,” and the system doesn’t register the symptom. | Mirror the patient’s words, then add the clinical term in parentheses. |
| Ignoring “I’m not sure” responses | System logs a blank field for the date. Even so, | Prompt for a relative time frame (“Was it before or after you started college? ”). In practice, |
| Forgetting to close the loop | No summary → The system may treat the last entry as incomplete. | End with a brief recap and ask for confirmation. |
A Final Checklist (For the Busy Learner)
- [ ] Begin with a broad, patient‑centered opener.
- [ ] Translate lay descriptions into clinical terms (parentheses optional).
- [ ] Ask “why” for every condition, medication, and procedure.
- [ ] Capture dates—exact if known, approximate if not.
- [ ] Document allergies early and explicitly.
- [ ] Summarize and obtain patient confirmation.
Keep this list on a sticky note or in your digital notes app; a quick glance before you click “Submit” can be the difference between a 78 % and a 94 % score.
Conclusion
The Shadow Health past‑medical‑history module is designed to mirror real‑world documentation challenges while rewarding precision, completeness, and patient‑centric communication. By structuring your interview with the 5‑W1‑H framework, mirroring the patient’s language while inserting the correct clinical terminology, and systematically probing for dates, indications, and allergies, you’ll consistently achieve high percentages across all scoring dimensions.
Counterintuitive, but true That's the part that actually makes a difference..
Remember, the virtual patient is a rehearsal space—not a shortcut. Consider this: the habits you build here—clarifying lay terms, asking “why,” and double‑checking for completeness—will travel with you into every bedside encounter, every charting session, and every multidisciplinary hand‑off. Master the virtual interview, and you’ll enter the clinic already armed with a polished, patient‑focused history‑taking technique that translates into better documentation, higher grades, and ultimately, safer, more effective patient care.
Happy interviewing, and may your future charts be as thorough as they are compassionate!
Putting It All Together – A Sample Walk‑Through
Below is a concise, end‑to‑end example that demonstrates how each of the checklist items can be woven into a single, fluid interview. Notice how the clinician:
- Opens broad and patient‑centered
- Mirrors the patient’s language while adding clinical terminology in parentheses
- Uses the 5‑W1‑H prompts for every new piece of information
- Secures dates (exact or relative)
- Confirms allergies early
- Closes the loop with a clear summary
1. Opening the Encounter
Clinician: “Hi Maria, I’m Dr. Patel. Before we get started, could you tell me a little about why you’re here today?”
Why this works: The opener is warm, open‑ended, and signals that the patient’s story will drive the interview The details matter here..
2. Capturing the Presenting Problem
Patient: “I’ve been feeling really tired lately, especially after work.”
Clinician (mirroring + clinical term): “You’re experiencing fatigue (persistent tiredness) after your shift. Is that right?”
Why this works: The patient’s phrase is repeated verbatim, then the clinical term is added in parentheses, satisfying the system’s language‑matching algorithm.
3. Digging Deeper with 5‑W1‑H
| Prompt | Example Question | What It Captures |
|---|---|---|
| Who | “Who else in your household has noticed the same fatigue?” | Triggers, severity |
| When | “When did you first notice this change?” | Contextual clues |
| Why | “Why do you think it started now?So naturally, ” | Onset |
| Where | “Where do you usually feel the fatigue most—at work, at home, or both? ” | Family pattern, possible environmental exposure |
| What | “What activities make the fatigue worse?” | Patient’s hypothesis, potential risk factors |
| How | “How would you describe the fatigue—like you can’t get out of bed, or just a low‑energy feeling? |
System tip: For each answer, record the exact date if the patient knows it (e.g., “June 3, 2024”) or a relative marker (“about three weeks ago, after I started night shifts”).
4. Exploring Past Medical History
Clinician: “Let’s talk about any past health conditions you’ve been diagnosed with. Do you have any chronic illnesses, surgeries, or hospitalizations?”
Patient: “I was diagnosed with hypertension a few years back, and I had my gallbladder removed in 2019.”
Clinician (mirroring + parentheses): “You have hypertension (high blood pressure) diagnosed in 2021, and you underwent a cholecystectomy in 2019.”
Why this works: The clinician repeats the patient’s words, adds the clinical term in parentheses, and captures both the condition and the date.
5. Medications and Indications
Clinician: “What medications are you currently taking, and what are they for?”
Patient: “I take Lisinopril, and I started it after my blood pressure got high.”
Clinician: “Lisinopril – prescribed for hypertension. When did you start it?”
Patient: “Around March 2022.”
Clinician (record): “Lisinopril for hypertension, started March 2022.”
Key point: Asking the “why” (indication) prevents the system from logging a medication without a linked diagnosis, which would otherwise lower the accuracy score Turns out it matters..
6. Allergies – Capture Early
Clinician: “Do you have any medication, food, or environmental allergies?”
Patient: “I’m allergic to penicillin; I get a rash.”
Clinician: “Penicillin allergy – rash. Noted.”
Why this works: Early placement of allergies satisfies the checklist item and avoids a blank field later in the module Which is the point..
7. Social History & Lifestyle (Brief)
Clinician: “Do you smoke, drink alcohol, or use any recreational drugs?”
Patient: “I smoke about a pack a day, and I have a glass of wine with dinner.”
Clinician (mirroring): “You smoke a pack daily and have one glass of wine each evening.”
Note: Even brief social data earns points for completeness when documented with the patient’s own phrasing.
8. Closing the Loop
Clinician: “To make sure I’ve captured everything correctly, here’s a quick summary:
- Chief concern: Fatigue after work, started three weeks ago.
- Past conditions: Hypertension (diagnosed 2021), cholecystectomy (2019).
- Medications: Lisinopril for hypertension, started March 2022.
- Allergies: Penicillin (rash).
- Social history: Tobacco use – 1 pack/day; alcohol – 1 glass wine nightly.
Is anything missing or inaccurate?”
Patient: “No, that’s right.”
Clinician: “Great, thank you. I’ll move forward with a physical exam and some labs.”
Why this works: The summary mirrors the patient’s language, includes all required fields, and explicitly asks for confirmation, satisfying the “close the loop” requirement But it adds up..
Quick Reference Card (Print‑Ready)
| Step | Action | Example Phrase |
|---|---|---|
| 1️⃣ | Warm opener | “Hi [Name], I’m Dr. And ” |
| 4️⃣ | Capture dates | Exact (MM/DD/YYYY) or relative (“about 2 months ago”) |
| 5️⃣ | Ask “why” for meds/procedures | “Why were you prescribed metformin? ” |
| 3️⃣ | 5‑W1‑H for each new item | “When did the symptom start?What brings you in today?[Last]. ” |
| 6️⃣ | Document allergies early | “Any allergies to meds, foods, or environment?” |
| 2️⃣ | Mirror + parentheses | “You feel shortness of breath (dyspnea) when climbing stairs?” |
| 7️⃣ | Summarize & confirm | “Here’s what I have… Is everything correct? |
Not the most exciting part, but easily the most useful.
Print this on a 3‑by‑5 card and keep it beside your computer during the module; the visual cue alone can boost your score by 5‑10 %.
Final Thoughts
The Shadow Health past‑medical‑history exercise is more than a grading tool—it’s a rehearsal for the real‑world documentation challenges that clinicians face daily. By mirroring patients, embedding clinical terminology, systematically applying the 5‑W1‑H framework, and closing each encounter with a concise recap, you not only meet the software’s scoring algorithm but also cultivate a habit of thorough, patient‑centered charting Most people skip this — try not to. Took long enough..
Every time you step away from the virtual patient and into the clinic, these habits translate into:
- Higher-quality notes that reduce ambiguity for the entire care team.
- Improved patient safety because every medication has a documented indication and every allergy is visible.
- Better communication with patients, who feel heard when their own words are reflected back.
Take the checklist, the sample walk‑through, and the quick‑reference card as your launchpad. Practice them until they become second nature, and you’ll find that the “Submit” button feels less like a test and more like the natural conclusion of a well‑conducted interview.
In short: master the structure, respect the patient’s voice, and always verify. Do that, and you’ll consistently turn a 78 % score into a 94 %+—and, more importantly, you’ll be delivering the kind of comprehensive, compassionate care that every clinician strives for.
Happy interviewing, and may every chart you write be as complete as it is compassionate.
A Few Final Tweaks Before the “Submit” Button
| Tweaking Tip | Why It Matters |
|---|---|
| Use the patient’s exact phrasing – even if it’s a bit informal – and then translate it into the required medical shorthand. | Keeps the patient’s narrative intact while satisfying the software’s strict field‑requirements. In real terms, |
| When you’re stuck on a date, ask for the month and year only – the system will auto‑populate the day if you’re sure it’s not critical. | Saves keystrokes and reduces the chance of a wrong date entry. |
| If the patient mentions a symptom that isn’t on the form, add it as a free‑text note and circle it in the “Other” field. In practice, | The evaluator checks for completeness; a free‑text note shows you didn’t ignore the issue. |
| Re‑listen to the audio clip once before you finish – you’ll catch a missed “yes” or a subtle change in tone that signals a new concern. | A quick second pass can turn a 78 % into a 92 %. |
Putting It All Together: A One‑Minute Flow
- Greeting & rapport – 5 s
- Mirrored symptom check – 10 s
- 5‑W1‑H for each new item – 30 s
- Medication & allergy confirmation – 15 s
- Summarize & confirm – 10 s
Total: ≈1 min – the sweet spot for a concise, complete history that satisfies the evaluator and respects the patient’s time Worth keeping that in mind..
The Bottom Line
The Shadow Health past‑medical‑history module is a microcosm of the real‑world electronic health record. It forces you to:
- Listen actively – capture what the patient truly says.
- Translate precisely – convert vernacular into clinical data that other providers can instantly understand.
- Verify relentlessly – never assume a field is correct until the patient confirms it.
Mastering these steps doesn’t just boost your score; it builds a foundation for accurate, patient‑centered documentation that will serve you throughout your career.
Final Checklist Before You Hit “Submit”
- [ ] All required fields populated (date, medication, allergies, etc.).
- [ ] Every symptom addressed with a 5‑W1‑H sentence.
- [ ] Patient’s own words mirrored in the summary.
- [ ] One clear, concise recap sent to the patient.
- [ ] Final listening pass to catch any missed details.
If you tick all of these, you’re ready Easy to understand, harder to ignore..
Takeaway
Structure, empathy, and verification are the three pillars of great charting. Use the 5‑W1‑H framework as your scaffolding, mirror the patient’s voice to build rapport, and always close the loop with a confirmation. When you do, the “Submit” button will feel less like a hurdle and more like the natural ending of a well‑conducted encounter Which is the point..
Good luck, and may every chart you write be as thorough as it is thoughtful That's the part that actually makes a difference..
