MD Podiatrist Discusses the Lost Art and Science of the Physical Exam  

According to Dan Michaels, DPM, “No matter the specialty, there has been an obvious trend in modern medicine: the physical exam is rarely performed. We have come to rely on tests and studies, providing as they occasionally do a definitive answer. Even specialties considered extremely “physical,” like psychiatry, orthopedics, as well as podiatry, no longer stress the physical exam in school or clinical rotations. If the problem can’t be tested by some form of technology, then it doesn’t exist. But there is none that can evaluate the quality of motion of a diseased joint. No machine which can appreciate the subtle coloration in the early stages of a developing infection in the foot of a diabetic.”

“Part of this trend away from a hands-on approach has been the development of new and better technologies. These allow doctors to examine structures inside the body never before visualized. Still, they can’t give the whole picture, they can’t feel a tender abdomen, test carefully a healing sprain. Admittedly, a physical exam isn’t necessary for every problem or by every specialist. But for most problems, a hands-on exam should begin the investigative process of evaluation for any medical condition,” says Dr. Michaels.