Source: Jaideep S. Talwalkar, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

The examination of the body is fundamental to the practice of medicine. Since the Roman Empire, physicians have described the connection between alterations in function of specific parts of the body and specific disease states and have sought to further scientific understanding to improve bedside diagnosis. However, in this modern age of increasing technology within medical diagnostics, it is important to consider the role that physical examination plays today. It is misguided to believe that physical examination holds all the answers, and much has been written about the questionable utility of certain maneuvers previously held in high regard. It is equally misguided to suggest that physical examination plays little role in the modern patient encounter.

Physical examination remains a valuable diagnostic tool; there are many diagnoses that can only be made by physical examination. A diagnosis made by labs or imaging is rarely done in the absence of findings detectable at the bedside. As the provider conducts a history and physical, they are actively generating and testing hypotheses to explain the patient's condition. The information one gathers may not replace the need for testing, but having firm hypotheses in place allows the provider to order tests more judiciously and ask better questions of those tests. This, in turn, has the potential to reduce risk to the patient and save cost for the health care system. Finally, physical examination plays a critical role in the therapeutic relationship. By engaging in the time-honored ritual of physical examination, the clinician has the opportunity to develop rapport (by demonstrating attention and sensitivity) and promote healing through the deliberate and responsible use of touch.

1. Before patient encounter

1. Prepare the exam room for the patient by disinfecting surfaces touched by the previous patient (e.g., exam table); this is typically done by support staff.
2. Disinfect any equipment you plan to use during the encounter (e.g., stethoscope, reflex hammer).
3. Wash your hands with soap and water or topical disinfectant solution.
4. Determine if any specific infection control precautions are needed for the clinical encounter (e.g., conta

This video demonstrates the role that physical examination plays in the modern patient encounter and has reviewed some critical steps to ensure the exam is carried out in a safe and sensitive manner. Important preparatory steps before the examination help to reduce risk of infection as well as patient and provider anxiety. Ensuring patient privacy and using gowns and drapes in a sensitive manner also makes patients feel more comfortable. A deliberate approach to the examination that is grounded in clinical reasoning is v