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Stanford Medicine 25 Blog

  • Medscape Article Highlights Need for Physical Exam Training & Assessment

    A new Medscape commentary, authored by Stanford 25 faculty Abraham Verghese, Jeff Chi, Poonam Hosamani, & colleague Andrew Elder, explains that "in clinical practice, recognizing something abnormal in the physical examination … is vital to patient safety & outcomes."…

  • The Resurgence of Bedside Teaching During the Pandemic

    Authored by Danielle Miller of the Stanford School of Medicine, “Not Quite Bedside” Teaching During the COVID-19 Pandemic examines the teaching of bedside medicine in the midst of the pandemic.

  • Registration is Now Open for the 2021 Stanford Medicine 25 Skills Symposium

    This year, the 6th annual Stanford 25 Skills Symposium will take place virtually on March 25 and 26, 2021. Registration is now open!…

  • Teaching Empathy in Medical Education

    In addition to physical exam skills, we believe instruction on empathy is an essential aspect of physician training, but it’s often overlooked in medical school curriculum.

  • The Presence 5 for Racial Justice: Promoting Anti-Racism in Clinical Interactions

    Stanford Medicine 25’s Donna Zulman, Abraham Verghese and their Stanford Medicine colleagues evolved the Presence 5 practices into The Presence 5 for Racial Justice to address a longstanding history of racial bias in medicine.

  • Announcing the Stanford 25 Skills Symposium

    Join John Kugler and Abraham Verghese and our core Stanford 25 team with guest faculty Dr. Steve McGee and Dr. Andrew Elder as we provide a 2-day course for physicians who teach or are interested in teaching at the bedside. Attendees will return to their institutions more confident at the bedside teaching students and residents...

  • Stanford Medicine 25 Skills Symposium 2015

    This week, the Stanford Medicine 25 hosted its first skills symposium for educators by educators focusing on clinical skills in a effort to bring together some of the world’s leaders and educators in medicine. Doctors from various specialties, who have a passion for medicine at the bedside and teaching the physical exam, came together for a 2-day conference that focused on exam technique and practice....

  • Stanford 25 Skills Symposium 2016 Announced!

    The Program for Bedside Medicine at Stanford is proud to announce registration is open for the Stanford 25 Skills Symposium 2016! Date: August 27th and 28th 2016 (Saturday & Sunday) Location: Stanford University School of Medicine Visit this link for registration. You can also learn more about last year’s symposium and our upcoming event here. The Symposium is designed for early...

  • Abraham Verghese Asks: Why Are We Doing This Teaching?

    We teach bedside medicine. We emphasize the importance of the physical exam and how it can help care for your patient and also create an environment where the person you are caring for develops trust. We have taught this now for over 6 years (when the Stanford Medicine 25 was first created). But sometimes it’s important to ask why. In a recent blog post, “Will the Healing Touch Go Out the Door With the Stethoscope?”, we look at the how some think that ultrasound is replacing any need for a stethoscope...

  • What is rhinophyma?

    This 42 year old male give a history of a chronic “skin rash” of his face. He notes he’s had it for many years and never sought treatment. While it comes and goes on its own, it seems to get worse with alcohol consumption...

  • Stanford Medicine 25 Launches New Website

    The Stanford Medicine 25 is proud to announce the launch of our new website with the new year! Since the start of our website, we’ve had millions of visitors and look forward to improving and adding more content! The new site is now mobile-friendly and share’s more about what we do, including our Stanford 25...

  • Medical Errors and Adverse Events from a Missed or Inadequate Physical Exam

    In the last 20 years the knowledge base for a physician has grown exponentially. Meanwhile technological advances, combined with a growing healthcare system and greater demands on the physician have left the need to find more ways to overcome these challenges. The physical exam, once regarded in the medical profession and the litmus test to...

  • Teaching the teachers… Our methods.

    As we begin a new year at Stanford, we’re taking time to reassess our methods of teaching the physical exam. Yesterday we had a session with some wonderful faculty from the VA in Palo Alto who are committed to teaching the physical exam.

  • Stanford Medicine 25 Clinical Pearl Award

    This year, the medical student interest group created a “Clinical Pearl Award” that challenged medical students to create a clinical pearl through an essay, a step-by-step photo guide or a video demonstration.

  • Abraham-Verghese’s-TED-Talk:-Over-one-million-views!

    Dr. Verghese was invited to speak at the TED Global in Edinburgh, Scotland in 2011. He spoke about the importance of the physical exam and how we physicians are in danger of losing the connection with our patients as we focus more on technology and the electronic medical record.

  • Welcome New Stanford Interns!!!!

    The Stanford Medicine 25 would like to welcome our new internal medicine interns! They have just been included to our list of subscribers, along with our seasoned residents and other subscribers throughout the world!…

  • Stanford ENT Free Oral Screening November 2nd

    Oral cancer affects 40,000 new people each year and kills one life every hour in the United States. Many cases are preventable and can be linked to tobacco use, alcohol, HPV, and lack of oral hygiene. Early detection of oral cavity lesions through a quick, painless, and noninvasive screening is the most effective way to counter this harsh reality.

  • This-Week’s-Stanford-25-Session

    This finding is seen in people with low albumin such as in patients with liver failure and severe malnutrition. This finding is called Terry’s nails.

  • Congratulations to our ACP Winners!

    This past weekend our Stanford residents took first place in the medical jeopardy contest and clinical vignette poster contest! We finished second in the research & quality improvement poster contest!…

  • An interesting illustration of the physical exam

    An article was recently published in the Annals of Internal Medicine using a cartoon to illustrate a doctor’s haunting history of misdiagnosis in a patient with respiratory distress. The article highlights the cause of this misdiagnosis from missing the physical exam finding.

  • Website Reaches Half a Million Visitors!

    The Stanford Medicine 25 website recently passed 500,000 total visits and 375,000 unique visits since our initial launch in February, 2012. We just wanted to thank everyone for all the support!…

  • Stanford 25 in Okinawa: 10 things learned about this beautiful island

    The residency program (called the Muribushi Okinawa Project) consists of 8 hospitals throughout Okinawa. This Stanford-Japan exchange program is organized by Dr. Haruko Akatsu (Stanford Department of Endocrinology)…

  • Cultural Competence at the Bedside

    A clinician will encounter patients from all socio-economic strata, who speak foreign tongues and understand disease in ways that stand apart from the clinician’s own conceptions of disease etiology.

  • Dr. Singh Teaches the Exam of Low Back Pain and Hip Pain

    Dr. Singh is the Clinical Chief of the Stanford Internal Medicine Clinic. Below are some take-home points for the session.

  • Abraham Verghese Interviews with Medscape’s Eric Topol

    The leader of our Stanford 25 program, Abraham Verghese, recently sat down with Medscape’s Editor-In-Chief, Eric Topol. This interview was part a number of popular videos for a Medscape’s One-On-One series that is newly published today.

  • Stanford Medicine 25 Faculty Training session at Western SGIM

    In this session, we shared our experiences with teaching the physical exam at the bedside. Our participants got into groups and came up with their own bedside teaching example to share with everyone.

  • Dr. Ahuja Leads a Stanford 25 Session on the Oral Exam

    In our last Stanford 25 session, Dr. Neera Ahuja led a session on the oral exam. In this session, she talked about important findings of the oral exam for the internist that include abnormal findings of the tongue, buccal mucosa and salivary glands.

  • Interview with Dr. Eric Topol (editor-in-chief of Medscape)

    The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series.

  • What’s in Doctor Verghese’s Lab Coat?

    We’re sure you must be wondering: what does Dr. Verghese carry in his white coat when attending on rounds?…

  • Abraham Verghese wins the Heinz Award

    Congratulations to our own Dr. Abraham Verghese for receiving the 2013 Heinz Award for the Category of Arts and Humanities. The Heinz Award is widely considered to be one of the largest individual achievements in the world and includes an prize of $250,000.

  • The Flipped Patient

    Many of us in the Program in Bedside Medicine are deeply involved in the medical students pre-clerkship curriculum. Each week the students interview hospitalized patients, perform physical exams, give presentations, followed by a written H&P note. These students enter the patient room with only pen and paper, as they have not yet gained access to the Electronic Health Record (EHR). By the end of the year, our students are able to obtain medical history from patients with complex medical problems on their own and able to communicate their findings concisely and effectively.

  • Art and Observation: Stanford 25 Trip to the Cantor Art Museum on Stanford Campus

    Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.

  • Dr. Barry Teaches the Exam of the Foot and Ankle

    Dr. Barry trained in Rheumatology at Yale and now serves as the Director of the Johnson & Johnson Global Health Scholars Program at Stanford. Please read below for some take-home points of the foot and ankle exam from Dr. Barry.

  • Stanford-25-Website-Passes-One-Million-Visitors!

    With over one million unique visitors (and over 1,360,000 total visits) to our website alone, we want to thank everyone for their support.

  • Artificial Intelligence and the Gift of Physician Time

    In a new book Eric Topol explores his belief that AI will go beyond enhancing diagnoses and treatments and “transform almost everything that doctors do.”…

  • Four Physicians Describe the Synergy Between Technology and Bedside Medicine

    Four physicians (Abraham Verghese, Eric Topol, Christopher Maiona and Caesar Djavaherian) are outlining similar solutions that leverage technology to nurture the doctor-patient relationship.

  • The Art and Science of Patient Care

    In a perspective piece published in Wiley Online Library, author Robert Truog conveys the importance of the physical exam, writing that “from the beginning, touching has been integral to doctoring.”…

  • Bedside Teaching is a Powerful Learning Tool in the ICU

    An analysis by Christopher Cheney in HealthLeaders discusses the importance of teaching at the bedside in the ICU--it's a challenging and unique environment due to “the medical complexity of the patients [and] the time pressure.”…

  • The Physical Exam Remains an Effective Tool for Physicians

    A new study published in the Annals of Family Medicine highlights the necessity of the physical exam in medicine concluding that “it not only contributes diagnostic information but is a therapeutic intervention in and of itself.”…

  • Compassion: A Powerful Tool for Improving Patient Outcomes

    The release of Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference has ignited a conversation on the relationship between physician compassion and patient outcomes.

  • A Diagnosis of Nelson's Syndrome

    At age 15, Gillian noticed changes in her body that did not feel typical of a young adolescent woman.

  • Register Now for the 5th Annual Stanford 25 Skills Symposium

    This year, the 5th annual Stanford 25 Skills Symposium will take place on November 1 and 2, 2019. Registration is now open!…

  • Thoughtful Implementation of Machine Learning Can Help Physicians Improve Patient Care

    As outlined in a PLOS Medicine editorial, artificial intelligence, specifically machine learning, is transforming medicine.

  • How AI Can Improve the EHR and Bedside Medicine

    In a recent JAMA Network Viewpoint feature, Stanford Medicine 25’s Abraham Verghese and Sonoo Thadaney readily endorse artificial intelligence (AI) in medicine, describing its promise as “undeniable.” But they also emphasize an overlooked opportunity, specifically how AI can “help clinicians deliver better and more humanistic care.”…

  • Cultivating The “Golden Minute” at the Bedside

    A Scientific American article authored by Claudia Wallis, explains how the adoption of technology in medicine has “reshaped the doctor-patient relationship.”…

  • Humanizing the EHR

    In a recent CLOSLER feature, Jeffery Millstein of Penn Medicine reinforces a sentiment frequently shared by Stanford Medicine 25, writing that “the clinically excellent clinician makes an effort to know each patient’s unique story, moving beyond the confines of the content within the [electronic health record] EHR.”…

  • Five Practices to Strengthen the Physician-Patient Relationship

    A new study authored by Stanford Medicine 25’s Donna Zulman and Abraham Verghese shares five practices they say can “enhance physician presence and meaningful connection with patients in the clinical encounter.”…

  • Announcing the 2017 Stanford 25 Skills Symposium

    The Program for Bedside Medicine at Stanford is excited to announce that registration is open for the 3rd annual Stanford 25 Skills Symposium.

  • Conversation About Bedside Medicine Gains Momentum

    Abraham Verghese’s passion for patient care and physician wellbeing is contagious. It’s also attracting national attention, as with this recent Medscape article: Abraham Verghese: ‘Revolution’ Starts at Bedside.

  • Abraham Verghese Interviews Jerome Kassirer on New Book

    In a career that spans more than five decades, Jerome P. Kassirer, M.D. has been an acclaimed kidney specialist, clinical researcher, administrator, author, creator of new medical disciplines and, during the decade of the 1990s, editor-in-chief of the prestigious New England Journal of Medicine.

  • Artificial Intelligence as a Partner in Patient Care

    Abraham Verghese and fellow Department of Medicine faculty Nigam Shah and Robert Harrington have authored an opinion piece on humanism and artificial intelligence which insists that “the two cultures – computer and the physician – must work together.”…

  • The Tradition of Daily Bedside Clinical Care

    Brian Garibaldi, co-president of the Society of Bedside Medicine and contributor to Stanford Bedside Teaching Symposium, and his colleagues at Johns Hopkins University (JHU) are reinvigorating beside medicine in the university’s residency training program.

  • UMKC Case Highlights the Importance of a Thorough Physical Exam

    A recent case presented by the Department of Internal Medicine at the University of Missouri Kansas City (UMKC) demonstrates the importance of physical exam skills and provides a clear example that lack of thorough history and complete physical exam can lead to diagnostic errors.

  • Empathy and the Physical Exam Remain Essential Components of Medicine

    A recent article in Quartz says that while machine-learning technology is becoming more “pervasive in the health system,” empathy may be becoming obsolete… even though “it’s one of the reasons why people trust doctors."…

  • Register Now for the 4th Annual Bedside Teaching Symposium

    This year, the 4th annual Stanford 25 Bedside Teaching Symposium will take place on September 7 and 8, 2018. Registration is now open!…

  • The Benefits of Bringing Doctors Back to the Bedside

    The first two episodes of a new podcast from Johns Hopkins Medicine focus on “bringing doctors back to the bedside,” and both feature members of the Society of Bedside Medicine, where Stanford Medicine 25’s Abraham Verghese serves as an Advisory Council member.

  • Physical Exam Can Sort Out - And Treat - Common Type of Vertigo

    Some older patients with dizziness undergo thousands of dollars of tests that often turn up nothing. Others are told it’s just a part of aging. But with the most common kind of vertigo, there’s actually an easy fix.

  • Medical Students Recognize Importance of Bedside Manner

    Truly caring for the patient begins at the bedside with observation, examination and connection. An article in In Training – “Why is Bedside Manner Important” – describes the value of taking time to engage with patients at the bedside because a “chart can only reveal so much.”…

  • The Spine Sign

    Point-of-care ultrasound (POCUS) has a sensitivity and specificity for pleural effusions of 93% and out performs chest x-ray in detecting and characterizing pleural effusions. Using POCUS physicians are able to detect as little as 5ml of pleural fluid.

  • Finding Joy in Physical Exam Skills

    In an interview with hospitalist, Twitter personality and “Incident Report” host Zubin Damania, Abraham Verghese discusses the movement to bring physicians back to the bedside.

  • How Technology May Lead to Greater Human Connection at the Bedside

    Could the machine be the catalyst that brings us back to the bedside? It may sound counter-intuitive, but it’s one theory Stanford Medicine 25’s John Kugler shared in this Medscape interview.

  • Journal Dedicates Entire Issue to “Enduring Value” of Bedside Medicine

    The latest issue of Medical Clinics of North America focuses entirely on a topic very important to us at Stanford Medicine 25 – the physical examination. The issue “explores the enduring value of the clinical encounter” and contains 14 articles related to bedside medicine and the physical exam.

  • Bedside Medicine Training Helps Both New and Established Physicians

    A recent blog post on the Daily Nurse highlights the different ways nursing students, medical students and residents are being taught good bedside manner. This training builds clinicians’ communications skills and offers real-life experience.

  • Compassion, Patience and Bedside Manner Improve Patient Satisfaction

    A study from Healthgrades and Medical Group Management Association (MGMA) analyzed seven million patient reviews and comments about health care providers. This Patient Sentiment Report found that over 52 percent of patients stated that they wanted their doctor to have at least one of the following qualities: compassion, comfort, patience, personality and bedside manner.

  • AI is Doing More to Help Keep Doctors at the Bedside

    Prompted by the release of Sense.ly’s “Molly,” a new artificial intelligence (AI)-powered avatar, a Forbes article examined “how humans and machines can work together to improve and transform” health care.

  • As Prices Drop, Point-of-Care Ultrasound May Spark Evolution of Physical Exam

    In a commentary for JAMA Cardiology, John Kugler writes, “The ‘wow’ factor is powerful with the latest generation of pocket ultrasound machines.

  • The Miracle of a Patient’s Recovery

    If it was a movie script, you wouldn’t believe it. A 28-year-old woman has a miscarriage while on vacation in Mexico. When she goes to the doctor, a nightmare begins. She ends up spending the next five years in and out of hospitals. At one point, she’s told she’s going to die. She takes chemotherapy, sees a naturopath, sees doctors in her native Ukiah and at Stanford, even goes to Philadelphia and Boston to see experts on the disease. They all agree that nothing can be done.

  • Technology Doesn’t Have to Be the Antithesis of Humanity

    In a commentary for Modern Healthcare, North Carolina physician Chris DeRienzo asks a question that we’ve also been exploring with great interest and passion: “Could technology actually return some humanity to healthcare?” DeRienzo believes it can, and we agree, of course.

  • Abraham Verghese Shares Story of the EHR’s Negative Consequences With Broader Audience

    In a recent feature piece for The New York Times, Abraham Verghese, MD, MACP addresses “the threat that electronic health records (EHRs) and machine learning pose to physicians’ clinical judgment – and their well-being.”…

  • Using Riddles as Medical Teaching Tools

    In a recent article in The American Journal of Medicine (AMjMED), Stanford Medicine 25’s Abraham Verghese advocates for riddles as a teaching tactic.

  • An Emphasis on the Bedside May Prevent Physician Burnout

    Physician burnout is a very real job hazard. However, according to a 2016 article in Consumer Affairs, “being present and mindful” with patients may be able to prevent burnout.

  • What Stands in the Way of Bedside Teaching?

    An opinion piece from The BMJ made the rounds a while ago on Twitter. The column, provocatively titled “The death of bedside teaching,” originally appeared in December 2016, but the points made by physician Mark Mikhail continue to reverberate. Is bedside teaching really dying?…

  • Teaching the “Intangibles” of Medicine

    An editorial on Healio.com highlights the importance of “intangibles” in medicine, primarily the connection between patient and provider. In the commentary, Leonard H. Calabrese, a rheumatologist and course director at the Cleveland Clinic Lerner College of Medicine, shares concern that empathy and mindfulness are pieces of medicine “we know very little about.”…

  • AI to Complement – Not Compete With –Physicians’ Diagnostic Skills

    It was big news earlier this summer. As reported by Forbes, “This AI Just Beat Human Doctors On A Clinical Exam.” The story unfolded on a stage in London where Babylon Health demonstrated its artificial intelligence software.

  • Using Art to Teach the Human Side of Medicine

    In Spokane’s Providence Internal Medicine Residency rotation, students and residents study more than patient charts. Each morning, reports The Spokesman-Review, they also gather to chat briefly about a painting, image, piece of music or poem that one of them has brought in for discussion.

  • The Basics vs. Technology Debate: When They Work Together, Everyone Wins

    A recent discussion on Medscape between two physicians posed the question, “Are Physicians--Let's Face It--Getting Clinically Lazy?” This bold question has prompted many responses from clinicians that has become an ongoing conversation on “The Basics Versus Technology: Which Wins?”…

  • Dr. Verghese’s Rules for the Bedside Exam

    Abraham Verghese says he’s learned key lessons at the patient bedside over the course of his career, all of which can be applied to enhance physical exam skills and foster the physician-patient connection.

  • Bringing Human Connection to the Forefront of Medicine in a Technological Era

    At Stanford Medicine 25, we believe human connection plays a critical role in patient care. But as the medical world becomes increasingly reliant on technology, how can we keep this approach in focus?…

  • Through a Patient’s Eyes: Physicians Reflect on Personal Illness

    A few recently published articles shed light on how physicians’ own experiences with illness offered lessons on the importance of humanity, connection and comfort.

  • Communication Strategies to Help Physicians Lead Meaningful Patient Conversations

    Let’s take a closer look at how physicians can transition into substantive discussions through simple yet effective communication strategies that encourage conversation, transparency and partnership.

  • Bringing Tidings of Comfort and Joy to the Patient Bedside

    The ability to conjure feelings of comfort and joy plays an important role at the patient bedside, especially during difficult times.

  • How Physicians Can Help Promote Early Detection of Prostate Cancer

    In honor of Prostate Cancer Awareness Month, we’ve gathered resources to help physicians identify signs of prostate cancer at the bedside.

  • 7th Time's a Charm: The 2022 Stanford 25 Skills Symposium

    On September 30-Oct 1, Stanford 25 hosted its 7th Annual Skills Symposium, an event that brings together medical educators from around the world to foster clinical teaching skills.

  • How Physicians Go Above and Beyond to Promote Patient Healing

    Simple acts like holding a patient’s hand or offering a warm blanket can elevate the patient experience in immeasurable ways.

  • How to Address Monumental Patient Conversations

    At some point, every physician will need to share difficult news with a patient. We provide tips and resources to aid physicians as they help patients process bad news.

  • The Importance of Cultural Competence in Bedside Medicine

    Providing quality care at the bedside relies not only on a physician’s medical knowledge, technical skills and compassionate demeanor, but also on respect for a patient’s cultural, racial and ethnic background.

  • Cardiovascular Physical Exams

    In honor of American Heart Month, we’ve gathered resources for medical educators and learners to spread knowledge of the cardiovascular system.

  • Combat Physician Burnout with the Joy of Bedside Medicine

    Ongoing research has shed light on various tactics to prevent and address physician burnout, including rediscovering the joys of bedside medicine.

  • Physical Exam Techniques to Support and Promote Women’s Health

    In honor of Women's Health Week, we’ve compiled resources and information related to women’s health for physicians and medical learners.

  • Promoting Inclusive Care at the Patient Bedside

    Creating a clinical environment that is inclusive, welcoming and comfortable for individuals of all backgrounds is an important component of the patient experience.

  • Janet Tillman's Life as SP and GTA

    In her roles as a standardized patient (SP) and gynecological teaching associate (GTA), Janet Tillman has helped medical students learn how to conduct exams as well as master other basic skills including patient interaction, diagnoses, and more.

  • The 4th Annual Stanford 25 Bedside Teaching Symposium

    On September 7 and 8, Stanford 25 hosted its 4th Annual Bedside Teaching Symposium, an event that brings together medical educators from around the world to foster clinical teaching skills.

  • The Significance of Small Gestures at the Patient Bedside

    Textbooks rightly emphasize the importance of diagnostic and treatment skills, but we also believe it’s vital not to lose sight of the big impact that small gestures can have.

  • Balancing Technology and Human Connection in Patient Care

    As the broad-reaching capabilities of Artificial Intelligence (AI) gain momentum, we see enormous potential to advance human health. However, as we look forward to this progress, we also believe it's more important than ever to preserve the physical exam and humanistic aspects of medicine.

  • How the ‘Privilege of Physicianhood’ Inspires Best-Selling Author Abraham Verghese

    Verghese embodies Stanford Medicine 25’s ideals of channeling humanity & empathy in patient interactions, and this interest in the human story is part of his magic as an author. A closer look at his philosophy on writing reveals important lessons for physicians and medical learners!…

  • Stanford Medicine 25’s Resources to Help Physicians Promote Skin Health

    Skin health is always a relevant topic in the clinical setting, but it’s particularly worthwhile to revisit after the summer season, during which many people are exposed to high levels of sun damage.

  • Honoring Breast Cancer Awareness Month Through Physical Exam Knowledge

    Each fall, Breast Cancer Awareness Month aims to promote education about the disease that impacts roughly one in eight women. In this post, we’ve outlined useful information and key resources to help physicians identify signs of breast cancer and other abnormalities at the patient bedside.

  • Healing: A Journey, Not a Destination

    Although healing and curing are often used interchangeably, we think of these two terms in different ways and believe the distinction is important when it comes to our outlook on patient care and bedside medicine.

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