Physically examining your patient takes time and cannot be rushed. Having a methodical approach will help you make accurate assessments when examining patients.
“Dr. Mathur, will I ever reach to the point where I can perform the whole physical exam more quickly?” My student asked during our debriefing session after completing a bedside exam on a standardized patient.
“You finished the exam in half the time given, why would you want to go faster than that?” I asked.
This was a learning opportunity to discuss the importance of gracefully completing bedside physical exams in a timely manner while being mindful of the patient’s needs. The need to be seen and to have your full attention and presence.
Dr. William Osler made patients active participants in the diagnostic process. He spent a lot of time at the bedside teaching students how a patient’s history and physical examine can give key clinical information.
3 things to keep in mind while giving a bedside exam:
1. Slow down.
If we rush through the exam without sufficiently acknowledging the patient’s humanity, it contradicts the reason why we entered the field of medicine. After all, we’re committed to helping others, and one of the simplest ways to show this is through human interaction during the bedside exam. It’s an opportunity to give kind and compassionate care.
2. Give the patient your full attention and presence.
Be truly present to cultivate the patient-doctor relationship. If there’s no connection between patient and clinician on a human level, it impacts everything from the development of trust and rapport to medication compliance and treatment outcome.
3. Listen and engage with your patient during the exam and use proper exam techniques.
If we’re distracted or rushing through the exam by palpating or auscultating over their gown, patients may feel as though their concerns are being overlooked. Simple steps like preserving patient dignity by being mindful of maintaining proper draping and utilizing footrests can go far. Engage patients by asking them to show you where it hurts while still looking at their facial expressions. We should always share our findings with patients and ask if they have any questions or other concerns.
We must remember that there’s so much more to what we do than just diagnose an illness and provide a cure as quickly as possible. We must lean on our compassion within our interactions and fuse it with all of our medical knowledge. In essence, aligning head, heart, and hands.
This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.