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Table of Contents
LETTER TO EDITOR
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 610

COVID-19 pandemic: Another nail in the coffin of the “dying art” of the physical examination


1 Department of Pediatrics, AIIMS, Mangalagiri, Andhra Pradesh, India
2 Department of Obstetrics and Gynecology, AIIMS, Mangalagiri, Andhra Pradesh, India

Date of Submission10-Aug-2020
Date of Decision14-Aug-2020
Date of Acceptance15-Aug-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Vijayan Sharmila
Department of Obstetrics & Gynecology, AIIMS, Mangalagiri, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_274_20

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How to cite this article:
Babu TA, Sharmila V. COVID-19 pandemic: Another nail in the coffin of the “dying art” of the physical examination. Cancer Res Stat Treat 2020;3:610

How to cite this URL:
Babu TA, Sharmila V. COVID-19 pandemic: Another nail in the coffin of the “dying art” of the physical examination. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Oct 25];3:610. Available from: https://www.crstonline.com/text.asp?2020/3/3/610/295517



History taking, physical examination, and investigations have been the three main pillars of the medical evaluation of patients since ancient times. A good clinician can arrive at the correct diagnosis in the majority of cases merely by taking the history and performing a physical examination, even before conducting investigations. Although detailed history taking is still widely practiced, there has been a significant decline in the utility of the physical examination in the last two decades. This has resulted from the advancement in science and technology that has led to a surge of several sophisticated investigations that can be performed rapidly and accurately. Doctors have now become increasingly dependent on blood investigations and imaging modalities such as ultrasonography, computed tomography, and magnetic resonance imaging to diagnose and treat patients. Physical examination has already been replaced with investigational tools in several clinical settings and is now rightly referred to as a “dying art.”[1] The dependence on technology has led to a decline in the clinical skill set among medical professionals. The ongoing coronavirus disease 2019 (COVID-19) pandemic is yet another nail in the coffin of the already dying art of the physical examination. Telemedicine has revolutionized the field of health care during this pandemic, and medical consultations have transformed from “in-person” to virtual visits to contain the spread of the pandemic.[2] Doctors are advised to optimize the use of telephone technologies to communicate with patients.[3] With telemedicine, the major elements of the medical evaluation, namely history taking and performing investigations, remain the same, except for the physical examination component, which cannot be performed without physical contact with the patient. As physical examination is considered a “high-risk exposure” for the spread of infection, health-care providers have almost dropped the component of physical examination of patients and prefer to evaluate them with a standard set of investigations aimed at understanding the clinical condition and to arrive at a diagnosis. The lack of a physical examination can have grave consequences, such as missing or delaying the diagnosis in all branches of medicine and surgery. For instance, carcinomas of the cervix and oral cavity require mandatory physical examination for arriving at an accurate clinical diagnosis. In addition, medical schools have started virtual medical training, making it difficult for students to learn and perform physical examination, thereby compromising the acquisition of the skill set that is already shrinking.[4],[5],[6] The COVID-19 pandemic has sidelined the physical examination component of the medical evaluation, and only time will tell the effects of this significant change in the provision of health care caused by the pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Puri B, Shankar Raman V. Physical examination: The dying art. Med J Armed Forces India 2017;73:110-1.  Back to cited text no. 1
    
2.
Portnoy J, Waller M, Elliott T. Telemedicine in the Era of COVID-19. J Allergy Clin Immunol Pract 2020;8:1489-91.  Back to cited text no. 2
    
3.
Au SC. Blindness during the coronavirus outbreak. Cancer Res Stat Treat 2020;3 Suppl S1:90-1.  Back to cited text no. 3
    
4.
Atreya A, Acharya J. Distant virtual medical education during COVID-19: Half a loaf of bread. Clin Teach 2020;17:418-9.  Back to cited text no. 4
    
5.
Malapati S, Singh SR. Life and training in the time of corona. Cancer Res Stat Treat 2020;3 Suppl S1:92-3.  Back to cited text no. 5
    
6.
Jaiswal R. Impact of the coronavirus disease 2019 pandemic on resident doctors in India. Cancer Res Stat Treat 2020;3 Suppl S1:87-9.  Back to cited text no. 6
    




 

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