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Limited value of physical examinations in upper respiratory illness: account of personal experience and survey of doctors’ views
Author(s) -
Kiderman A.,
Dratva D.,
EverHadani P.,
Cohen R.,
Brezis M.
Publication year - 2009
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/j.1365-2753.2008.00980.x
Subject(s) - respiratory illness , value (mathematics) , medicine , family medicine , psychology , nursing , respiratory system , psychiatry , statistics , mathematics
Medical tradition considers a physical examination (PE) an essential part of the clinical encounter. In real medical practice, however, a full PE may not be necessary when the diagnosis is clear after anamnesis and general impression. We assessed the value of PEs in 500 diagnoses of upper respiratory infection (URI) and the attitudes of 123 doctors regarding the utility of PEs in virtual cases. Methods Computerized files of consecutive cases with a diagnosis of URI over 8 months in two practices were reviewed and correlation studies between the extent of PE and clinical outcomes were performed. In addition, doctors’ attitudes and declarations about PEs were compared. Results Five hundred paediatric and adult patients were included. Less than one‐fifth underwent a full PE. More patients who underwent a full PE returned because they still felt unwell or their parents felt they were unwell. Fewer doctors declared actually having performed PEs than supported giving one in two virtual cases of URI. Specialized doctors were less inclined to perform PEs than doctors without a specialization. Conclusions Our study suggests that in many cases presenting as URI, doctors may conduct limited PEs or even omit them entirely.