Doctor Curmudgeon: Wait! Wait! Don’t Touch That Patient!

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By Diane Batshaw-Eisman, M.D. FAAFP

What the heck is going on?

It was a trickle, now I see it more and more.

I began to notice this trend while answering multiple choice questions as part of doing continuing medical education.

And then, I saw an actual, real, authentic editorial in one of the throwaways, titled something like: “Is the History and Physical Worth doing Anymore?”

As I recall, it involved a study in an emergency room investigating which modalities were of greatest value in coming to a correct diagnosis. Ye Olde History and Physical came out very well. The physician/author presented the study, asking readers for comments.
But why even study this?

We are all familiar with multiple choice questions. My heart lurches when I see choices like these:

A. Order stat CT of all toes.

B. Get serum chocolate level.

C. Immediate neurosurgery consult

D. Do a history and physical.

Now of course, A, B, and C are not actual choices that I have seen, but D! I have seen it many times.

How can that possibly be an “option?”

Doing a history and physical? Well…forgive me…I cannot stop sputtering.

History and Physical? It’s like breathing. Like having your daily chocolate.

If you don’t do a careful History and Physical, how on earth do you know what to order?

Why even waste time with a study like this?

Two prime directives of Medicine:

HISTORY AND PHYSICAL

PRIMUM NON NOCERE

The Curmudgeon will now resume normal respiration.

Doctor Curmudgeon® is Diane Batshaw Eisman, M.D., a physician-satirist. This column originally appeared on SERMO, the leading global social network for doctors.

SERMO www.sermo.com “talk real world medicine”

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