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Eye to Eye Communication and Laying On of Hands: Anachronistic Medicine?
It is clear that there have been
and will be important changes in the way medical care of patients is being and
will be practiced in the future. With
the technological developments both in terms of communication by healthcare
providers with patients by way of the internet, the use of the internet for
patient self-diagnosis, the use of electronic medical record devices in the
medical office and hospital to store text and graphics, the diagnosis and
treatment with devices never anticipated generations ago and the continuing
systems of care which tend to limit the time physicians can take with their
patients, there is a real question as to whether the teaching of history taking
and physical examination to the students in the first years of medical school
is really anachronistic. Is the current
teaching of methods for developing the doctor-patient relationship that can
become emotionally supportive and therapeutic for the patient and in addition
lead to diagnosis and hopefully effective treatment becoming outdated?
We currently teach our students
to take time with the patient, to take a medical history or discuss the
patient's case sitting face to face, eye to eye and the importance of the hands
of the physician actually on the patient's body performing the classic
procedures of the physical examination.
But some may argue that much of this is unneeded, unnecessary,
impractical in this current age of medical practice. It is said that in this age of patient
autonomy and the patient's now access to medical information beyond that coming
from the doctor's office and with the limited time available with the doctor,
detailed sit-down history taking is unnecessary.
And, as far as the physical
examination is concerned, will modern technical devices such as ultrasound, CAT
scan and MRIs amongst others provide better sensitivity and specificity to the making
of a diagnosis than anything that hands or stethoscope on the patient's body
Dr. Abraham Verghese, physician
and professor at Stanford University School of Medicine and recorded in an 18
minute video TED talk "A Doctor's Touch" , available through thislink, presents the contrary view that what we are currently teaching our students
is still what we should be teaching.
Watch and listen to the talk and then come back here and tell us your
view as to whether we should continue to teach the medical students in the way
Dr. Verghese finds is the right way or should we modernize to something
else. How do you want your doctor to
treat you? ..Maurice.
Graphic: GIF image by ANTHONY ANTONELLIS via Google Images