No physical exams! The following article comments on the fading focus on physical exams by many primary doctors in lieu of just ordering expensive tests. Just as the effort to move to evidence based medicine has traction, we seem to be losing sight of the goal. (See report attached. http://www.npr.org/templates/story/story.php?storyId=129931999).
The trend is evident to both patients and specialists and has raised some red flags. The specialty referral system for instance at Cook County requires community physicians to document what data they have that prompts the need for a referral. However, there is little communication between private specialists and primary care doctors that they are referring patients inappropriately without a proper work-up because of both culture and economic concerns tied to referrals.
Patients should demand complete examinations before being exposed to dangerous testing. CT scanning exposes patients to significant radiation and may be unnecessary for many patients. My guess is that the number of negative findings are high.
Primary care requires time for thorough physical exams and attentive listening. Speeding primary care patients through the system to a more expensive and less wholistic testing system is a old mindset that healthsystems should pay close attention to.
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