The Physical Exam as Refuge
by Danielle Ofri
There are few situations where we expect to disrobe and have our bodies touched by relative strangers. The physical exam is one of the unique characteristics of the doctor-patient encounter; a visit to a doctor doesn’t seem the same without one. Yet, increasingly, there’s less and less of it. Visits are shorter and doctors have to spend most of their time at the computer filling out the endless electronic medical records that have come to define the modern medical transaction.
Often, it boils down to a half-hearted plop of the stethoscope on the fully clothed patient. For the medical students who are learning to become doctors, this can be perplexing: they have spent two years exhaustively learning the detailed physical exam, and then when they get to the practical years of medical school, they see doctors all around them hardly examining patients at all.
But the reality of the time-crunch cannot be ignored. Patients come to a typical 15-minute office visit with several chronic conditions, plus their acute concerns for that day. There are lab results to review and screening tests to discuss. There are medications to renew and drug interactions to check. There is the education and counseling that is crucial to any visit. All this must then be dutifully documented in the voracious electronic medical record. (And heaven forfend that the doctor run over time or skip steps; she will be duly dinged on efficiency and productivity reports.)
To read the full article in New York Times, click here
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