By Apostolos “Paul” I. Hiotellis, MD
Technological advancement is an essential ingredient for progress in medicine. New testing, equipment, and information have made it easier than ever to diagnose and treat patients; however, despite the wide range of tools available, we can’t forget the basics when it comes to patient care. Patient history and thorough physical examination are crucial to the diagnostic process.
Patient history can often help providers catch dangerous conditions before they become harmful. We learn valuable information from just having a conversation with our patients. A patient whose mother had colon cancer at 40 years old should signal that we start screening earlier than normal. The best histories come from patients who develop relationships with their providers based on honesty and trust. Taking the time to connect and share dialogue with a patient about their past, family, children and other life events is more than just socialization. These conversations provide us with the insight needed to tailor care to our patient’s unique needs. Patient history is similar to world history. If we don’t remain vigilant, history will repeat itself. If you don’t have a healthy respect for what came before, how can you prepare for what comes after?
Like patient history, a thorough physical exam can often tell you much more than a simple test. A physical examination will fill in the gaps of incomplete patient history. For some patients, it can be challenging to disclose certain health information, whether from guilt or shame. Physical examination removes some of that ambiguity. Additionally, physical exam findings should often take priority over test results. If a patient comes back with a negative strep test, but their throat is strawberry red and indicative of strep, it’s generally better to rely on your physical exam than the test results.
In some ways, COVID-19 forced us to rely on technology for patient care. While telehealth and remote monitoring equipment are helpful for the treatment of patients, they can never take precedence over the regular physical examination. It’s important to understand that no tests can replace a physical exam.
The physical exam and patient history are two of the most important things anyone in the medical field can learn. It’s something we practice daily and, if done improperly, can lead to mistakes. If you’re unable to have a conversation with your patient or give them a thorough physical exam, it can lead to unnecessary testing, treatment and even premature death. Educating the next generation of medical students about these ordinary medical skills is crucial for minimizing diagnostic errors and saving our patients time and money.
Dr. Hiotellis is a Board certified family medicine physician in Newport News providing care to patients of all ages at TPMG City Center Family Medicine. In his clinical practice, Dr. Hiotellis takes a special interest in the treatment and management of diabetes, cardiovascular disease and preventative medicine. mytpmg.com