AMA News Release (09/06/22) Murphy, Brendan
The American Medical Association (AMA) and partner programs in the AMA Reimaging Residency initiative are attempting to give the physical exam greater focus in residency training. AMA Chief Academic Officer Sanjay V. Desai, MD, describes the physical exam as a core element of patient care, both for measuring diagnostic accuracy and reducing diagnostic error. "The physical connection [to patients] that you are able to nurture through the practice of a physical exam is invaluable and I think facilitates those connections that are so important to healing," he explains. Desai cites regulatory shifts, operational changes within training institutions, and the onus of documentation on residents as contributors that de-emphasize the physical exam in residency training. He highlights AMA partner institutions' efforts to retool resident training to reverse this trend. Stanford University has formulated a framework to perform an exam in five minutes, while Johns Hopkins University found residents spend about 13% of their ward rounds on direct patient care, which Desai calls "inadequate." He says the ultimate goal is "to learn what interventions, practices, processes will allow us to cultivate the skills that we think are most important to learn in physical examination. And then bring that evidence to demonstrate that, in fact, these skills improve the clinical care a physician can provide, improve the well-being a physician can provide, and then ultimately improve patient outcomes."