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. Edited by Brian Garibaldi, co-president of the Society of Bedside Medicine, the publication includes articles from many of the organization’s members and founders, including our own Abraham Verghese.

In his introduction to the May 2018 issue, Garibaldi says “Advances in technology are at the forefront of [many] exciting developments, but the clinical encounter between a patient and physician remains the cornerstone of medical practice. This time-honored ritual provides the basis for trust and healing for the patient. It is fundamental to accurate diagnosis and high-quality patient-centered care. It is also an important source of fulfillment and satisfaction for the physician.”

However, he also notes that the ritual is at risk due to a number of factors – such as EHRs and other operational constraints – in the modern hospital and clinic settings. As a result, he says, “Fundamental clinical skills such as the physical exam are in decline. As physical exam skills have declined, so too have the number of practitioners who are confident enough to teach the physical exam.” An important area of emphasis at Stanford – and the impetus for the Stanford Medicine 25 – is to improve those teaching skills.

Several of our faculty members contributed to this publication:

·       In his article, titled “The Enduring Value of the Physical Examination,” Stanford’s Junaid Zaman focuses on the interaction between a health care provider and a patient. This interaction is explored in depth to demonstrate the enduring value of the physical exam for diagnosis, prognosis and patient and physician satisfaction.

·       Verghese and Cari Costanzo, an academic director and lecturer with Stanford’s Department of Anthropology, co-authored an article titled “The Physical Examination as Ritual: Social Sciences and Embodiment in the Context of the Physical Examination.” It explores the physical examination from a social sciences perspective and as an important ritual that benefits both patients and physicians.

·       Andre Kumar, Jeffrey Chi and John Kugler are co-authors on “The Role of Technology in the Bedside Encounter,” which examines the ways in which technology can strengthen and weaken the patient-physician relationship and describes best practices to implement technology to bring physicians back to the beside.

·       Andrew Elder assesses the practice of clinical skills in the United States in his article “Clinical Skills Assessment in the 21st Century.” Though the practice of these skills seems to be declining, he says, contemporary approaches can be taken and widely adopted to reinvigorate bedside medicine skills.

The Society of Bedside Medicine is a global community of physician educators dedicated to bedside teaching and improving physical examination and diagnostic skills. Brian Garidbaldi, the organization’s co-president and editor of this edition of Medical Clinics of North America, will be a speaker at the Stanford Medicine 25 Skills Symposium in September. Follow the link to register!


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