Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians

By Robert H. Coombs; D. Scott May et al. | Go to book overview
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Teaching Physical Diagnosis-- Emotions and Privileges

Rich Davis

Although the primary purpose of any text or course in physical diagnosis is to enlighten the learner about successful methods of physical diagnosis, there should be an important, if somewhat secondary, purpose. That is to alert and educate the learner about the psychological process occurring and the emotions being stirred during a physical examination. The great majority of both texts and courses tend to ignore the emotional dimension engendered by one human physically and verbally probing another. Yet physician-- patient interaction is rarely more delicately experienced, at least by the patient, than during a physical examination.

All that a physician need do to refresh the intense personal significance of such an experience is to submit to it by a fellow physician. However sophisticated and educated he or she may be, there is a feeling, at times bordering on helplessness, as one submits to nakedness, cold instruments, and casual, if professional, disinterest in those exposures we have so preciously kept to our own discretion. A personal physical examination for the physician is an abrupt reminder for him of what every person experiences during any physical examination.

I still recall a woman (of what some call the world's oldest profession) fearfully and angrily clasping her clothes to her bare front (anterior) as I foolishly walked into the examining room without first knocking. "Get your ass (posterior) out of here until I'm dressed!" she shouted. And I did. She later reminded me that although this may have been my tenth examination that day, it was her first in a year. I have never forgotten her reminder that each patient's examination is unique, important, and highly personal (regardless of profession). Although one should not become preoccupied with patients' fears and anxieties, becoming so occupied with physical

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