The Physical Exam as Refuge

July 10, 2014

(New York Times) – In the frenetic world of daily clinical practice, doctors struggle to keep all the balls in the air in the limited time allotted. I find that I focus mostly on history, because the words of the patient are the most sensitive diagnostic tool I’ve yet come across. The physical exam primarily serves as an adjunct, to confirm or rule out a diagnosis that was suggested in the history. Once in a while, though, something completely unprompted from the history will arise from the physical — an unexpectedly enlarged liver, a nodular thyroid, an unnoticed skin lesion. Though this doesn’t happen often, it is a good reminder of the utility of the physical exam.