Why the Art of Clinician is Dying? (Opinions and Judgements) : A Literature Review

Abstract

 Background  

The use of basic medical knowledge has been used since the time of Hippocrates by clinicians to manage patients. This medical knowledge is gained during the medical school years, by reading various course and reference books and further supplemented by learning clinical skills such as a  physical examination of the patient. All such skills get polished throughout the medical school by attending morning rounds, spending time at the patients’ bedside, performing a hands-on examination. But during recent years, there has been a decline in appropriate clinical skills acquired by clinicians due to many reasons and this interplay of several factors has resulted in the high dependence of medical professionals on modern medical technology.

Methods

 A literature search was carried out regarding the decline of physical examination and clinical skills in modern-day medical practice. 1566 articles were identified through Google Scholar, Pubmed, and ERIC by using the keywords, ‘Physical Examination’ and ‘Clinical Skills’ out of which 20 are included in this literature review.

 Results

 The gradual decline in optimal knowledge of clinical skills can be attributed to many factors, like sub-standard teaching practices being carried out during medical school and training programs. Clinicians fail to understand the therapeutic effect of a properly performed physical examination on the patient and its implication in the management plan. Moreover, the burden on a clinician is very high, leading to burn-out of the doctor making him/her incompetent to teach young doctors and trainees during ward rounds. Leading to the development of a low threshold of clinicians to prefer laboratory investigations to diagnose and manage patients. This all makes us in dire need of doctors with a humanitarian spirit, who use their senses to at least probe a diagnosis rather than ordering a test without any clinical knowledge of the patient at hand.

Discussion

Identification of these influencing factors on the clinical skills of doctors needs further evaluation to properly understand the precise reasons for the decline in physical examination practices by doctors. The significance of advancements in medical technology and their influence on a doctors’ clinical skills need further evaluation.