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Tuesday, July 31, 2012

The Fading Art Of The Physical Exam

Internist Nesli Basgoz examines patient Barry Arcangeli who has a leaky heart valve. Basgoz discovered Arcangeli's heart condition during a routine physical examination.

"I sometimes joke that if you come to our hospital missing a finger, no one will believe you until we get a CAT scan, an MRI and an orthopedic consult. We just don't trust our senses." - Dr. Abraham Verghese

Would you prefer your doctor to take the time talk with you, give you a physical exam that includes touch, make judgements based on experience and physical touch? I do, that's why I go to 82 year old Dr. Pepe in Boulder City. But other physicians say that the time spent to practice the art of medicine takes away from the efficiency, documentation and physicall evidence of tests, scans and almost CSI or detective deductive evidence. After all we live in a modern world with modern things.

Insurance company demands that doctors spend less than fifteen minutes per patient  (in some cases ten) have taken from face time and physical touch. The family doctor is more likely a family clinic, where doctors who are contract employees come and go based on how much they are paid as much as how much they can help people.

Some med schools are never taught to "lay hands" or how to properly interview a patient, as their instructors come from the world of technology and large medical institutions.

NPR 's Morning Edition spent time yesterday morning looking at the "fading art of the physical exam."


Lydia Scherr said...

I find this extremely interesting!

of all the countless times spent in a doctors office i have never been told that insurance companies have doctors spend a fixed amount of time for each patient...which is annoying in my opinion, because you still have to wait forever to be seen.

How can the medical field really improve, or maintain respect if the doctors know more about reading results from a machine than reading the human body

Kayla Geale said...

I think it's quite sad that the medical world has taken such a drastic turn. I believe that people would like doctors more if they connected on a more personal level. It'd also make spending so much money a little more worth while. When it comes to money, people want their dollars worth. How can they get that, when the doctor spends less than 15 minutes diagnosing them?

Anonymous said...

R Caruthers bc550
I work in the health field and i have seen this done where dr's are in and out of the room in less then 15 mins and on to the next. personally i hate feeling like "a number" i want quality time. it is my health and my life.

Ryan said...

I don't think insurance companies should be telling doctors how to do their jobs. They're not the professional. When I get sick I don't go to a customer service rep. at a insurance company to get medication. I go to a professional doctor.

Janael Macaraeg said...

I agree with Ryan because to a patient it is so important to feel comfortable with your doctor and to feel comfortable with them, you have to see them longer. I think that doctors will lose their "bedside manners" with a patient by not being able to get to know them personally and understand what is wrong with them. Insurance companies make me mad about topics like this.

Anonymous said...

For the past 10 years, I have worked in the healthy insurance field and have never heard of this 15 minute rule. I have, however, seen the extreme amounts of money that physicians charge for their services, so it makes more sense that doctors would spend as little time with a patient in order to move on to the next room where more money awaits. Also, these physicians spend less time examining and more time ordering tests because there is an additional charge that can be submitted on your medical claim, and will also require a follow up visit which puts another couple hundred bucks in your doctor's pocket.

-Jessica Pena