A recent New York Times Well Blog post provided an insightful and valuable commentary on the importance of the physical exam for diagnosing illness. Dr. Danielle Orfi is right when she points out in her article, “The Physical Exam as Refuge,” that although the physical exam is a unique aspect of the patient-physician encounter, time constraints often do not allow healthcare providers what she calls a “luxury” — a comprehensive physical exam.
However, despite the limited time we have with our patients, we must not forget the power of the physical exam, especially as we work hard to improve and develop a more effective physician-patient relationships. If we fail to see tell-tale signs that something is amiss health-wise, such as joint pain or mouth sores, swollen limbs or abdomen, we miss opportunities for accurate diagnosis and quality patient care.
At DrossmanCare we value physical exam in our practice, and embrace it as an vital and important tool. Wealso applaud Dr. Orfi’s candid commentary on the physical exam and encourage clinicians and patients to read her words as true mind-body care depends on the physical exam.
So while the utility of the physical exam for diagnosing illness may not be quite as refined as it once was (though certainly still quite useful), it has become a tool of a different sort, a refuge from the intrusion of technology, a moment of only touching and talking. In the medical world — as in the world at large — there are precious few moments left of just touching and talking. As a diagnostic and therapeutic tool, it is irreplaceable. — Danielle Ofri, MD
Douglas A. Drossman, MD