Family Physicians’ Experiences of Physical Examination

Martina Ann Kelly; Lisa Kathryn Freeman; Tim Dornan

doi:10.1370/afm.2420

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Table 1

Themes, Subthemes, and Codes

Theme	Explanation^22,36	Subtheme	Code
Gnostic experience	From the Greek gnostikos, meaning “one who knows,” as related to the mind, reason, and judgment.	Doctor as detective Being thorough	Following clues Planning next steps Old-school doctor What if?
Pathic experience	From pathos, meaning “suffering or passion.” Relates to personal presence, relational perceptiveness, emotional awareness, and embodied experience of the senses.	Relational experience Actional experience Temporal experience Corporeal experience	Expected by patients Reassured patients Contributed to the relationship Doing Routines and personal style Laying on of hands Slowing of time Physical reactions Never leave you Knowing normal

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Table 2
Description of Participants
Years in Practice N (%) Male Female Urban Rural Teaching Practice
<5 years 4 (25) 3 1 3 1 0
6-19 years 4 (25) 0 4 2 2 2
>20 years 8 (50) 4 4 6 2 5
Total 16 (100) 7 9 11 5 7

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The Article in Brief

Family Physicians' Experiences of Physical Examination

Martina Ann Kelly , and colleagues

Background The increased availability of reliable diagnostic technologies has stimulated debate about the utility of physical examination in contemporary clinical practice. To reappraise its utility, this study explored family physicians' experiences.

What This Study Found As Affordable Care technology has gained ground in medicine and critics have called into question the diagnostic accuracy of physical examinations, what place does the practice of the physical exam have in today's clinic? In depth, qualitative interviews with 16 family physicians in Canada revealed a common view that physical examinations help promote a healthy patient-physician relationship and constitute an integral part of being a good doctor. Guided by principles of phenomenology, which considers how human beings experience a certain phenomenon--in this case, the physical examination itself--the research found that in addition to diagnostic information gained in physical examinations, the empathic benefits of "laying on hands" served as an important reminder of the physician's role as healer.

Implications

At a time when contemporary clinical practice is grappling with the influx of emerging diagnostic technology, the physical exam is seen by many doctors as a grounding and centering element of the time-honored art of family medicine.