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doctor gives a physical examination of a patient

The Five-Minute Moment

In today’s hospital and clinic environment, the obstacles to bedside teaching for both faculty and trainees are considerable. As electronic health record systems become increasingly prevalent, trainees are spending more time performing patient care tasks from computer workstations, limiting opportunities to learn at the bedside. Physical examination skills rarely are emphasized, and low confidence levels, […]

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A Diagnosis at Hand: Pulmonary Arterial Hypertension

A classic physical examination finding pointed to underlying disease in a 43-year-old Hispanic woman. On presenting to the Emergency Department, she reported progressive shortness of breath, fatigue, and chest pressure. One month earlier, she could exercise without limitation. However, in the ensuing interval, she developed increasing dyspnea and constant, nonexertional, left-sided chest pressure. A review […]

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An Evidence-based Guide for Obesity Treatment in Primary Care

Primary care physicians can assist their patients with weight management by using the 5As counseling framework (Assess, Advise, Agree, Assist, and Arrange). Primary care physicians can use the 5As framework to build and coordinate a multidisciplinary team that: 1) addresses patients’ psychosocial issues and medical and psychiatric comorbidities associated with obesity treatment failure; 2) delivers […]

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physical exam with stethoscope

Inadequacies of Physical Examination as a Cause of Medical Errors & Adverse Events

This meta-analysis describes the incidence and outcomes of ischemic hepatitis, with additional focus on patients with ischemic hepatitis who have documented precedent hypotension, acute cardiac events, or sepsis. Background Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or […]

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Palm Reading, Observation, and Intuition

At a recent dinner party here in Tucson, an 80-year-old Chinese woman from Nanjing read the palms of each dinner guest. Her readings were surprisingly accurate and included ages at which individuals had had a serious illness, as well as the number of children that the various women present had delivered in their youth. She […]

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