Are physical examinations by family doctors still needed?

Are you wondering if an annual or regular physical examination is still necessary? A new study reveals that it’s an integral part of relationship-centered care and detection of diseases early on.

The increased availability of state-of-the-art and modern diagnostic technologies has sparked debate on whether the conventional physical examination is still needed in the clinical practice. One of the procedures done in clinics is physical examinations.

Physical examination is a requirement not only in school admission, employment opportunities, or sports activities but also, in families. Family doctors play an important role in the conduct of these examinations to diagnose and treat many diseases.

Otherwise known as medical examination or physical assessment, it’s a process that ensures that individuals stay in good health. Aside from this, it’s mainly a preventive process. Early detection and diagnosis of diseases will eventually lead to immediate treatment. Hence, it helps improve prognosis.

As technology has gained ground in medicine and critics have called into question the diagnostic accuracy of physical examinations. Image Credit: Zetar Infinity / Shutterstock
As technology has gained ground in medicine and critics have called into question the diagnostic accuracy of physical examinations. Image Credit: Zetar Infinity / Shutterstock

Physical examinations aid in early detection of disease

A team of researchers at Calgary, Alberta wanted to determine if physical examinations are still necessary in the modern world and what do family physicians think about the process.

To land to their findings, they conducted in-depth qualitative interviews with 16 family doctors in Canada. They include those who have 20 years of practice experience, a recent family medicine graduate, a public health doctor, and a retired internist.

The researchers explored the clinical experiences of doctors in conducting a physical examination. The respondents include 7 men and 9 women, whose clinical experience varied widely from both rural and urban locations.

The team recorded the interviews, transcribed, and determined initial themes using template analysis.

The study, which was published in the Annals of Family Medicine, revealed that physical examinations, according to physicians, is an important part of being a doctor. Moreover, they found that physical examinations gather data from patients, in addition to diagnostic laboratory procedures.

Physical examinations are important in the doctor-patient relationship

The participants were asked to describe two aspects of the physical examination – diagnosing and estimating prognosis and responding to patient’s illnesses. These procedures form relationships between the two parties, the doctor and the patient. The procedure allows doctors to use their bodies to experience their patients’ illnesses.

The doctors also said that aside from diagnostic data gathered during physical examinations, the process helps with empathy, as laying on hands during the procedure strengthens the role of doctors as healers. Physical examinations also strengthen the relationships between doctors and patients, developing trust and establishing rapport.

“Physical examination is part of the identity of family physicians. It not only contributes diagnostic information but is a therapeutic intervention in and of itself. Physical examination contributes to relationship-centered care in family practice,” the researchers concluded in the study.

However, the researchers also said the study has limitations.

“We do not know what patients experienced or what they expected. However, previous studies indicate that patients expect to be examined and are less satisfied when physicians do not examine them,” they explained.

“We did not directly observe participants’ physical examinations and relied on their self-reports, sometimes long after the events they described. A key feature of this type of work, its interpretive nature, limits its generalizability,” they added.

What happens during a physical assessment?

Physical assessment or examination involves many procedures. All these contribute to a diagnosis that can be confirmed through diagnostic tests. First off, the doctor may need to conduct an interview for updated health history.

The physician will ask certain questions related to healthy history, changes, and developments in health. These may include questions about the job, relationships, allergies, family history of illness, recent surgeries, supplements, and medicines.

During the physical examination, the doctor will also check the patient’s vital signs, including blood pressure, respiratory rate, pulse rate, and temperature. A visual exam will follow, which involves reviewing the patient’s appearance for any signs of possible conditions. A head-to-toe examination is done involving the head, eyes, beck, chest, abdomen, musculoskeletal system and nervous system functions.

Aside from a visual exam, the doctor conducts palpation or touching parts of the body such as the abdomen, to determine abnormalities. Motor functions and reflexes are also included in the examination.

Journal reference:

Kelly, M.A, Freeman, L.K., and Dornan, T. (2019). Family Physicians’ Experiences of Physical Examination. Annals of Family Medicine. http://www.annfammed.org/content/17/4/304.full

Angela Betsaida B. Laguipo

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Angela Betsaida B. Laguipo

Angela is a nurse by profession and a writer by heart. She graduated with honors (Cum Laude) for her Bachelor of Nursing degree at the University of Baguio, Philippines. She recently completed a Master's Degree where she specialized in Maternal and Child Nursing and is now working as a clinical instructor and educator in the School of Nursing at the University of Baguio.

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