Physical exams still important for patient safety.

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Posted on May 23, 2014

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Listen to this: A woman comes into the hospital with sky-high blood pressure and confusion. The doctors believed these symptoms were caused by a blood clot so they ordered a CT scan. When the scan came back, the doctors found that this woman had cancer in both breasts that had spread throughout her body.  A physical exam would have detected the tumors.

Now listen to this: A man repeatedly comes into the ER for what looks like the classic signs of cirrhosis--which he has been treated for many times. Only when a different doctor conducts a physical exam and considers the signs of a different disease, do they determine the problem is not actually his liver, but his heart.

Both of these cases are examples of a trend that has been becoming all too commonplace in medicine--doctors not being able to use a physical exam to make and accurate diagnosis, or not considering a physical exam as important information. The Washington Post reported that over the past few decades physical diagnosis skills---which were once a cornerstone of doctoring--have declined. These physical exams have been replaced with sophisticated, expensive tests.

Internal medicine physician, Salvatore Mangione, M.D. told the Washington Post, "A lot of people downplay the physical exam and [wrongly] say it's fluff". Dr. Mangione reports he has seen "many cases in which technology, unguided by bedside skills, took physicians down a path where tests begot tests and where, at the end, there was usually a surgeon, and often a lawyer and sometimes and undertaker" as he wrote in the Cleveland Clinic Journal of Medicine in 2012.

To remedy the problem, there have been programs put in place to teach physical diagnosis in many medical schools. These skills are an essential adjunct to technology and should boost diagnostic accuracy.  Physicians and nurses should always use all available information to form a differential diagnosis.

Technology is obviously a good thing and is critical in many different healthcare and hospital settings, but should not replace a physical exam.  Test results need to be considered in connection with the results of the physical exam and other available information. 

Proper medical care - the standard of care - and basic patient safety means preventing mistakes using a variety or systems, guidelines, protocols and checks.

So don't let a doctor, nurse practitioner hurry through an appointment without taking the time to get a thorough history and perform a physical exam - it could be the difference between the correct diagnosis and misdiagnosis.

Want more information on your rights if you've experienced a preventable medical mistake in the healthcare system? Call us today or send us an email - it's confidential, of course.  We can help with the problems you and your family are dealing with if you've been affected by medical malpractice.

Frank R. Kearney, Attorney-at-Law
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