Why Physicians Must Not Skimp On The Physical Exam

Like most physicians, I feel extremely rushed during the course of my work day. And every day I am tempted to cut corners to get my documentation done. The “if you didn’t document it, it didn’t happen” mantra has been beaten into us, and we have become enslaved to the quantitative. It’s tempting to rush through physical exams, assuming that if there’s anything “really bad” going on with the patient, some lab test or imaging study will eventually uncover it. Just swoop in, listen to the anterior chest wall, ask if there’s any new pain, and dash off to the next hospital bed. Then we construct a 5-page progress note in the EMR, describing the encounter, our assessment, and plan of care. Focused physical exams have their place in follow up care, but I strongly urge us all to reconsider skimping on our exams. A fine-toothed comb should be used in any first-time meeting – because so much can be missed as we scurry about. Some examples of things I discovered during careful examination: 1. A pulsatile abdominal mass in a woman being worked up for dizziness. 2. New slurred speech in an edentulous gentleman with poorly controlled hypertension. 3. A stump abscess in a 2-year-old leg amputation. 4. A bullet lodged in the scrotum. 5. Countless stage 1 sacral decubitus and heel ulcers. 6. Melanoma. 7. Rashes that were bothering the patient for years but had not previously been addressed and cured. 8. Early cellulitis from IV site....
Source: Better Health - Category: American Health Authors: Tags: Health Tips True Stories Diagnosis Don't Skimp Patient Satisfaction Physical Exam quality healthcare Respect Winning Confidence Source Type: blogs