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