Not long ago the internet was captivated by the video clip of a physician using a wine glass to teach percussion. The display elicited a sense of nostalgia and long-lost wisdom. The clip put 20th and 21st century medicine into stark contrast. But when was the last time you used percussion to make a diagnosis? Predictably, every smartypants in the audience has ... Continue Reading about Percussion – An Obsolete Physician Skill?
Butterfly iQ Moments – Should Med Students Have a POCUS?
During its revered white coat ceremony last week The University of California Irvine School of Medicine gave Butterfly iQ pocket ultrasound devices to its medical students. The future, it seems, belongs to POCUS (point of care ultrasound). Twitter lit up. Social sentiment pinned the Butterfly iQ as the new stethoscope. Every armchair futurist was over the ... Continue Reading about Butterfly iQ Moments – Should Med Students Have a POCUS?
Touch | Beyond the Physical Examination
I read recently about a patient who spent 4 hours in an ER but was never experienced touch by a human. Not surprising, really. Technology is doing a lot of what we used to do with our eyes, ears and hands. For better or worse. While physicians often associate touch with the physical exam, it can facilitate more powerful things. Here are a few things the hand can ... Continue Reading about Touch | Beyond the Physical Examination
What Did the Rectal Examination Show?
When I was a medical student I had an attending who would fail medical students who failed to universally perform the rectal examination. He would gloat on rounds when reviewing admissions with the trainees. Stopping dramatically during the middle of the presentation of the physical exam, he would smile broadly, look around at the team and ask, “So what did the ... Continue Reading about What Did the Rectal Examination Show?
Within Normal Limits
If you poke around old medical records you’ll find WNL written in parts of the physical exam. Neurological: WNL. It means within normal limits. It’s the pen and ink dotphrase used through most of paper record history by physicians to indicate that the organ or system under exam was unremarkable. One of medicine’s most versatile and open-ended acronyms, within ... Continue Reading about Within Normal Limits
The Stethoscope’s Quiet Eclipse
My concerns about the stethoscope’s future began at lunch recently among a group of doctors where it was suggested that the revered icon had evolved as an ornament of clinical medicine – an iconic relic of medicine’s past. Others around the table held firmly to the idea of the stethoscope as a critical diagnostic tool. The contrast was striking. The more I looked ... Continue Reading about The Stethoscope’s Quiet Eclipse