The Adult Screening Physical Examination: What Physicians Do

Background: 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. Purposes: (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. Methods: 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. Results: 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. Conclusion: 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.