Getting physical: is the physical exam becoming obsolete?
You may consider the physical exam an essential part of any visit to the doctor’s office, but its role in health care has seen a general decline over recent years due to improved technology, questions regarding the necessity of the exam, and the dearth of time that doctors have to properly evaluate each patient.
This week on “Take Care,” Dr. Danielle Ofri talks about the importance of the physical exam and its role in providing effective health care. Ofri is an internist at Bellevue Hospital in Manhattan and writes about medicine and the doctor-patient connection in The New York Times.
Before any visit to the doctor, a health history must be completed by the patient. The health history asks questions regarding any conditions or concerns that the patient has or may have developed since their last visit.
“The health history is really primary,” Ofri says.
The physical exam serves a supplementary role to the health history, either confirming or challenging the information included in the history.
Ofri says that one of the benefits of the physical is the connection created between the patient and doctor, which often makes patients feel more comfortable relating more personal health conditions that they may have been disinclined to include on the health history.
“Being close and touching and making a different kind of connection allows the history to flower in a way that it didn’t at the desk.”
Because of advancements in computer technology, doctors are now regularly using computers to enter patient information and view test results.
While computers are very useful in medicine, they remove some of the human connection between patients and their doctor that previously existed. Ofri believes that the physical can help take down this barrier.
Although any physical has the potential to reveal a medical problem, some types of physicals are more effective than others. Physicals that target specific areas and physicals that are administered to sick hospital patients are more useful than annual physicals because they involve looking for a specific problem rather than many.
“The data [does] not support much value of the physical exam in the general checkup,” Ofri says.
The future of physicals remains uncertain, but Ofri says that it would be a mistake to remove them from medical practices.
“I think we stand to lose a lot.”