My colleague, Prof. Abraham Verghese, (a big proponent of the physical exam) jokingly told me once that the modern-day doctor needs an X-ray to diagnose an amputation!
What is the need to do a physical exam in a clinical encounter? After all, we get so much information about the patient from lab work, imaging studies, and other tests and reports that one can argue that the physical exam may not be required or at best it plays a minor part in the clinical encounter.
I firmly believe that the physical exam forms the bedrock of the doctor-patient relationship. Firstly, if we did a focused physical exam, we might not need to subject the patient to so many lab tests and procedures. Secondly, beyond the obvious diagnostic value of the physical exam, it has a more subtle and deeper therapeutic significance. A careful physical examination, done respectfully, strengthens the doctor-patient bond and improves patient engagement with their own wellness and health.
VJ Periyakoil, MD, Stanford University School of Medicine.
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