Physical Exam Obsolete?

by chelseajin

Before I had my physical exam class, I was really excited to be the best House-like med student ever. I thought, if I can master this, I can be with a person for 15 minutes and tell what they have without needing to order any imaging.

It still amazes me how stupidly idealistic I can be.

The practicals for that class were probably the most irritating ones I’ve ever had, and then getting a glimpse of how patients are seem in the hospital showed me that a lot of the maneuvers are useless. For one, you need to get good documentation of everything and double check your work (mostly in case you get sued), so you can’t just rely on physical exam techniques. They’re more to just give you a sense of security in your guess of what’s going on.

So things like whispered petrioloqy, fremitus, jugular venous pulse, estimating diaphragm descent (written in Bates as extremely inaccurate compared to an x-ray) etc, etc, seem like silly things to be teaching students.

In this day and age, I’d say that a person extremely skilled in physical exam would only be used to their full capacity in a place with almost no medical equipment. I’m talking about a place with a stethoscope, bandages, and just a pharmacy.