Mastering the ART of MEDICINE

Reference books for Physical Diagnosis. Bates' Guide to Physical Examination and History Taking (left) and DeGowin's Diagnostic Examination (right).

Learn to see, learn to hear, learn to smell. Know that by practice alone you can become an expert.  ~ Sir William Osler ~

The Physical Diagnosis (PD) course is sometimes taken for granted by the medical students, but it is actually one of the most important courses we have in medical school.

What does PD teach us? 

It teaches us the clinical foundations of medicine.
It teaches us how to be doctors.
It teaches us the ART of medicine which is becoming a lost art in this technology-dependent age.

Basically, we learn three things in PD - (1) how to write a medical history, (2) how to perform a physical examination and (3) how to arrive at a clinical diagnosis through analysis and synthesis.

Why is it important to master PD?

Because it is very essential to clinical practice!

We were told that 80% of diagnosis depends on a good medical history and physical examination. If we were able to perform a good history and PE, we won't need additional diagnostic and laboratory tests which will only cost the patient more money and time.

How does one become a good clinician?

Let me just clarify first that I am not an expert on this. I am only a medical student trying to learn everything I can to be a good doctor.

Becoming a master clinician requires a lot of practice and experience to gain clinical skills and PE techniques. In medical school, we do several medical histories and physical examinations in almost every subject - Physical Diagnosis (Internal Medicine), Pediatrics, Surgery, Obstetrics and Gynecology, Psychiatry, Ophthalmology and Otorhinolaryngology among others. I'd like to believe that with each patient we encounter and with each history and physical exam we do, little by little, we become good clinicians, although I know that we still have so many things to master in order to be called good clinicians.

Here's a gem by Dr. Robert Manning on how to be a clinician shared to us by one of the best mentors in our med school:

• Study books to learn of diseases
• Study patients to learn of human nature and of illness
• Study your preceptors to develop clinical judgement

Remember, medicine is both an ART and a SCIENCE!