The adult screening physical examination: what physicians do

Patients expect a thorough physical examination. However, there is debate on the utility of the physical examination, and students are deficient in many common maneuvers.

(1) To estimate physician perceived utility of physical examination maneuvers in a routine adult screening examination. (2) To promote teaching of core physical examination competencies in student and resident education.

Primary care physicians at 2 academic medical centers were surveyed. Using a 5-category frequency scale, physicians estimated how often they perform and document 90 common physical examination maneuvers in a routine adult screening examination.

Survey response rate was 56%. Physicians reported significant variation in frequency of use for individual physical examination maneuvers. Both common (blood pressure) and rarely performed (visual acuity) maneuvers were identified.

This study helps define the adult screening physical examination by estimating which individual physical examination maneuvers physicians typically utilize. Educational resources and clinical research should focus on identifying an evidence-based approach to the physical examination.