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Thursday, January 19, 2017

The Value of Physical Examination


As the medical community seeks remedies to the problems of medical misdiagnosis, escalating healthcare costs, the sputtering doctor–patient relationship, and physician burnout, it is tempting to suggest that one part of all of these problems—and perhaps a component of the solutions—lies in bedside skills. These skills once characterized the best clinicians, both as a symbol of respect and a factor in referrals, but they have apparently waned in modern medicine. PE is not a panacea, however; many other aspects of our approach to patients and their care also must be addressed if we are to improve their, and our own, lots.

But we must start somewhere and we suggest that that is with the next generation of doctors, in our medical schools and residency programs.[27] We hope that the value of the PE, the value of history taking, and the ability to gather information and derive conclusions through talk and touch can be re-emphasized. We have highlighted ways in which the benefit of PE is expressed beyond its contribution to diagnosis alone and believe these mixed qualitative and quantitative indices will provide a truer notion of its value.

The value of the PE extends far beyond diagnostic accuracy alone, far beyond a single figure such an odds or a likelihood ratio. We hope that our attempt to create a broader metric stimulates others to think further about its place in their practice.

http://www.medscape.com/viewarticle/873768_3

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