May 12th, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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A common problem in healthcare is the number of times that small adjustments are needed in a person’s care. Often for these little changes, a physical exam and face-to-face time have nothing to do with good medical decision making.
Yet the patient and doctor are locked in a legacy-industrialized business model that requires the patient to pay a co-pay and waste at least half of their day driving to and from the office, logging time in a waiting room, and then visiting five minutes with their practitioner for the needed medical information or advice.
Today I’d like to visit the case of a patient I’ll call “DD,” who I easily diagnosed with temporal arteritis (TA) through a 15-minute phone call after she’d spent four weeks as the healthcare system fumbled her time with delays and misdirection via several doctors without establishing a firm diagnosis. Read more »
April 27th, 2010 by Edwin Leap, M.D. in Better Health Network, Humor, Opinion
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Our relatively new electronic medical record (EMR) product has prompts and clicks for everything imaginable. One of them, which we can use during the physical exam, is the long list of “constitutional” findings that we perceive on generally looking over the patient.
They include things like: Obviously ill, comfortable, uncomfortable, pale, well-nourished, well-hydrated, well-dressed, alert, chronically ill, contracted, emaciated — and so on.
But these descriptors don’t always cut it. I mean, people are both amazing and annoying, so why not add a few more to the list? Read more »
*This blog post was originally published at edwinleap.com*
March 2nd, 2010 by DrRob in Better Health Network, Humor
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People are asking for more physical exam posts.
People asked for more Millli Vanilli too. People aren’t always smart.
But you ask, I give. I am just that kind of guy. It’s been a long time (since October) since I have done a post on this subject. So for all of you “newbies” out there (I just wanted to use that word and sound like a nerd), I want to give you a recap of what I have already done on the physical exam. That way people who have not inflicted upon themselves read the old ones can get all caught up. To be honest, this is one of my favorite series as well. Or is that “serieses?” Where’s Grammar Girl when you need her? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
March 1st, 2010 by DrWes in Better Health Network, Opinion
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It’s out there. It makes a cool picture, but I wonder how many medical students realize how unimportant apps like this have become to today’s cardiovascular care. Don’t get me wrong, it’s good to hear the difference between a systolic and diastolic murmur, or for the really talented, a diastolic rumble on physical exam. Recognizing the difference between mild and severe aortic stenosis is also very helpful. After all, the physical exam remains the most cost-effective instrument in medicine. Read more »
*This blog post was originally published at Dr. Wes*
November 24th, 2009 by DrRob in Better Health Network, True Stories
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It’s that part of the job that I’ve never gotten used to. I hope I never do.
I saw a man recently with an unexpected finding on his exam – a “lesion” that should not have been there. I was seeing him for his diabetes and blood pressure, and was doing my “ritual” physical exam, when the “lesion” blared into my vision.
I say “ritual” exam because the exam itself had little to do with his medical problems. It is just my practice to do a cursory exam of the head, neck, chest, and lungs of most everyone who comes to the office. I guess it’s the “laying on of hands” part of the practice of medicine that makes me do this; there is something about the human touch that makes a doctor’s visit different from a visit to the accountant. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
