therapeutic touch

What is the need to do a physical exam in a clinical encounter? For the most part, we get so much information about the patient from lab work, the imaging studies and other tests and reports that one can argue that the physical exam 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.

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!  

In addition to 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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Culture governs how we interpret many things including acceptable norms for touch.In many cultures, it is not acceptable to do prolonged social eye contact ( seen as a forward gesture) and it is not appropriate to touch a person, especially a person from the opposite gender.

In medicine, touch  (or “haptics“) is a vital part of the care we provide patients.  In fact, doctors do comprehensive medical exams of all patients irrespective of age, gender, ethnicity of the patient. So, what are the differences between social touch and therapeutic touch?  Are they governed by the same rules? How can you make therapeutic touch less intrusive and more respectful to patients?