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Medical Clinics of North America

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https://www.readbyqxmd.com/read/29650078/the-clinical-examination-in-twenty-first-century-medicine
#1
EDITORIAL
Brian T Garibaldi
No abstract text is available yet for this article.
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650077/recapturing-the-lost-art
#2
EDITORIAL
Bimal H Ashar
No abstract text is available yet for this article.
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650076/digital-tools-to-enhance-clinical-reasoning
#3
REVIEW
Reza Manesh, Gurpreet Dhaliwal
Physicians can improve their diagnostic acumen by adopting a simulation-based approach to analyzing published cases. The tight coupling of clinical problems and their solutions affords physicians the opportunity to efficiently upgrade their illness scripts (structured knowledge of a specific disease) and schemas (structured frameworks for common problems). The more times clinicians practice accessing and applying those knowledge structures through published cases, the greater the odds that they will have an enhanced approach to similar patient-cases in the future...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650075/clinical-skills-assessment-in-the-twenty-first-century
#4
REVIEW
Andrew Elder
Clinical skills remain fundamental to the practice of medicine and form a core component of the professional identity of the physician. However, evidence exists to suggest that the practice of some clinical skills is declining, particularly in the United States. A decline in practice of any skill can lead to a decline in its teaching and assessment, with further decline in practice as a result. Consequently, assessment not only drives learning of clinical skills, but their practice. This article summarizes contemporary approaches to clinical skills assessment that, if more widely adopted, could support the maintenance and reinvigoration of bedside clinical skills...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650074/clinical-examination-component-of-telemedicine-telehealth-mhealth-and-connected-health-medical-practices
#5
REVIEW
Ronald S Weinstein, Elizabeth A Krupinski, Charles R Doarn
Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth)...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650073/the-clinical-examination-and-socially-at-risk-populations-the-examination-matters-for-health-disparities
#6
REVIEW
Karly A Murphy, Alejandra Ellison-Barnes, Erica N Johnson, Lisa A Cooper
Data from the United States show that persons from low socioeconomic backgrounds, those who are socially isolated, belong to racial or ethnic minority groups, or identify as lesbian, gay, bisexual, or transgender experience health disparities at a higher rate. Clinicians must transition from a biomedical to a biopsychosocial framework within the clinical examination to better address social determinants of health that contribute to health disparities. We review the characteristics of successful patient-clinician interactions...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650072/patient-centered-bedside-rounds-and-the-clinical-examination
#7
REVIEW
Peter R Lichstein, Hal H Atkinson
Bedside hospital rounds promote patient-centered care in teaching and nonteaching settings. Patients and families prefer bedside rounds and provider acceptance is increasing. Efficient bedside rounds with an interprofessional team or with learners requires preparation of the patient and the rounding team. Bedside "choreography" provides structure and sets expectations for time spent in the room. By using relationship-centered communication, rounds can be both patient proximate and patient centered...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650071/improving-observational-skills-to-enhance-the-clinical-examination
#8
REVIEW
Stephen W Russell
For much of the 20th century, educators lacked evidence that teaching observational skills could benefit modern medicine. But in 2001, a statistical model emerged that supported the effectiveness of teaching observational skills to medical students using a museum-based curriculum. The story that led to that ground-breaking study, and the consequences that sprung from it, is retold here, traveling from the darkened caves in the foothills of France to the brightly lit galleries of the Yale center for British art...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650070/communication-and-ethics-in-the-clinical-examination
#9
REVIEW
Sharon Onguti, Sherine Mathew, Christine Todd
At the heart of every effective patient-physician interaction is a relationship that is built on trust. Cultivating sound communication skills coupled with the awareness and application of ethical principles is integral to this process. One of the foremost challenges in competent practice is negotiating situations that arise at the bedside when such issues as patient autonomy, differing world views, honesty, and cost stewardship come into conflict. It is essential for health care providers to consider how to detect and prioritize these issues as they advocate for high-quality and patient-centered care...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650069/the-electronic-health-record-and-the-clinical-examination
#10
REVIEW
Helene F Hedian, Jeremy A Greene, Timothy M Niessen
This review examines how the adoption of the electronic health record (EHR) has changed the most fundamental unit of medicine: the clinical examination. The impact of the EHR on the clinical history, physical examination, documentation, and the doctor-patient relationship is described. The EHR now has a dominant role in clinical care and will be a central factor in clinical work of the future. Conversation needs to be shifted toward defining best practices with current EHRs inside and outside of the examination room...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650068/the-outpatient-physical-examination
#11
REVIEW
Maja K Artandi, Rosalyn W Stewart
The physical examination in the outpatient setting is a valuable tool. Even in settings where there is lack of evidence, such as the annual physical examination of an asymptomatic adult, the physical examination is beneficial for the physician-patient relationship. When a patient has specific symptoms, the physical examination-in addition to a thorough history-can help narrow down, or in many cases establish, a diagnosis. In a time where imaging and laboratory tests are easily available, but are expensive and can be invasive, a skilled physical examination remains an important component of patient evaluation...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650067/diagnostic-errors-and-the-bedside-clinical-examination
#12
REVIEW
Bennett W Clark, Arsalan Derakhshan, Sanjay V Desai
Diagnostic errors are common in clinical practice and lead to adverse patient outcomes. Systematic reviews have shown that inadequate history taking and physical examination lead to a plurality, if not a majority, of diagnostic errors. Recent advances in cognitive science have also shown that unconscious biases likely contribute to many diagnostic errors. Research into diagnostic error has been hampered by methodologic inconsistency and a paucity of studies in real-world clinical settings. The best evidence indicates that educational interventions to reduce diagnostic error should give physicians feedback about clinical outcomes and enhance their ability to recognize signs and symptoms of specific diseases at the bedside...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650066/the-role-of-technology-in-the-bedside-encounter
#13
REVIEW
Andre Kumar, Gigi Liu, Jeff Chi, John Kugler
Technology has the potential to both distract and reconnect providers with their patients. The widespread adoption of electronic medical records in recent years pulls physicians away from time at the bedside. However, when used in conjunction with patients, technology has the potential to bring patients and physicians together. The increasing use of point-of-care ultrasound by physicians is changing the bedside encounter by allowing for real-time diagnosis with the treating physician. It is a powerful example of the way technology can be a force for refocusing on the bedside encounter...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650065/the-hypothesis-driven-physical-examination
#14
REVIEW
Brian T Garibaldi, Andrew P J Olson
The physical examination remains a vital part of the clinical encounter. However, physical examination skills have declined in recent years, in part because of decreased time at the bedside. Many clinicians question the relevance of physical examinations in the age of technology. A hypothesis-driven approach to teaching and practicing the physical examination emphasizes the performance of maneuvers that can alter the likelihood of disease. Likelihood ratios are diagnostic weights that allow clinicians to estimate the post-probability of disease...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650064/the-physical-examination-as-ritual-social-sciences-and-embodiment-in-the-context-of-the-physical-examination
#15
REVIEW
Cari Costanzo, Abraham Verghese
The privilege of examining a patient is a skill of value beyond its diagnostic utility. A thorough physical examination is an important ritual that benefits patients and physicians. The concept of embodiment helps one understand how illness and pain further define and shape the lived experiences of individuals in the context of their race, gender, sexuality, and socioeconomic status. Understanding ritual in medicine, including the placebo effects of such rituals, reaffirms the centrality of the physical examination to the process of building strong physician-patient relationships...
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29650063/the-enduring-value-of-the-physical-examination
#16
REVIEW
Junaid A B Zaman
This article focuses exclusively on physical examination (PE) in the context of clinical medicine, that is, the interaction between a health care provider and patient. In essence, there is not only benefit (value) to PE but also that it will last (endure) for some time. Both "enduring" and "value" are explored in more depth with respect to the future integration of PE into the clinical assessment of a patient and how its value extends well beyond current diagnostic/cost-based metrics.
May 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29406074/urology-and-medicine
#17
EDITORIAL
Robert E Brannigan
No abstract text is available yet for this article.
March 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29406073/go-with-the-flow
#18
EDITORIAL
Bimal H Ashar
No abstract text is available yet for this article.
March 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29406068/urology
#19
Robert E Brannigan
No abstract text is available yet for this article.
March 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29406067/the-intersection-of-medicine-and-urology-an-emerging-paradigm-of-sexual-function-cardiometabolic-risk-bone-health-and-men-s-health-centers
#20
REVIEW
Martin M Miner, Joel Heidelbaugh, Mark Paulos, Allen D Seftel, Jason Jameson, Steven A Kaplan
Men's mental health and how they think about their health are critical to the future of men's health. Poor health choice patterns are established under age 50, when men are twice as likely to die than women. As the future of medicine focuses on quality and value, a better understanding of the social determinants of men's health will identify areas for improvement. The presentation of a man to a clinician's office with a sexual health complaint presents an opportunity for more complete evaluation. The future of men's health will be well served by integrated men's health centers that focus on the entire man...
March 2018: Medical Clinics of North America
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