The Physician-Patient Relationship, Physical Examination, and New Procedures

Abstract

Gene Stollerman would like to see continuing medical education emphasize clinical skills. He deplores the growing gap between medical technology and clinical skills, in which advice based on the interview and examination is replaced by that based on results of laboratory studies and technical procedures. The development of clinical skills, he points out, enables physicians to obtain a better understanding of the patient’s problems and gain confidence in their own ability to determine what technologic tool is required to substantiate the clinical findings and what consultations would be to the patient’s advantage. Learning about new tests and procedures, unfortunately, is much easier than discovering how better to examine a patient. Richard Lewis emphasized the value of the clinical history: “The importance of the clinical history cannot be overestimated. The physical examination cannot be done in a vacuum; the history is critical to alert the examiner to possible abnormal physical findings. Subtle abnormalities are discovered only when specifically searched for as a result of the history”.