Physician viewpoint: The value of a physical exam in a socially distant world

The uptick in telehealth adoption, spurred by the COVID-19 pandemic, has many physicians questioning whether the physical patient examination is unnecessary in today's healthcare landscape — but one primary care physician still finds value in these exams.

In a perspective article for JAMA Internal Medicine, Paul Hyman, MD, grapples with the question: "What is a physical examination worth?"

Today, physicians have so much information about their patients before they even meet in person that it can be tempting to perform the exam quickly. In addition, the pandemic has led to a rise in telehealth adoption, where no physical exam is conducted. But there is value in conducting these exams.

For one, it allows physicians to discover unexpected diagnoses that may not be apparent in otherwise healthy patients — a mole or a soft tissue mass, he writes. The physical exam also provides physicians with a "measure of objectivity," so physicians are not dependent on the word of their patient, who might downplay certain symptoms.

Also, when patients disagree about treatment plans, the exam provides data that can help settle disputes.

It can help physicians center and focus in the midst of their busy schedules.

"The examination, though, is more than a tool that informs diagnosis and treatment," writes Dr. Hyman. "I now realize its value to me. The quiet moments when I am listening to a patient's heartbeat and breath can be centering, similar to the part of a meditation where one refocuses on one's own breathing."

And finally, it's a part of a physician's routine. Not being able to perform the exam as frequently as prior to the pandemic, after nearly 15 years of it being an integral part of how he practices medicine, has left Dr. Hyman on uncertain ground.

"In attempting to keep patients at a distance, I am losing touch with a part of my professional identity," he concluded.

Read the full article here.

More articles on physicians:
The new physician training environment: How medical schools are navigating students' return
Texas Medical Board warns physicians touting deceptive COVID-19 treatments
UC San Diego faced 'serious morale problems' among physicians before targeted changes, report finds 



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