Why don’t doctors touch patients anymore? Richard Horton editor @TheLancet

Why don’t doctors touch patients anymore? Having had the privilege of attending clinics in the UK’s National Health Service almost every week since March this year, I can honestly say that at no stage has any physician, surgeon, or anaesthetist ever completed anything approaching a physical examination. (Even taking a history by a doctor has been an astonishingly cursory exercise.

Nurses are more thorough, albeit by using a checklist.) These observations are not meant to be criticisms. You might fairly argue that since my “presenting complaint” did not concern the heart, lungs, abdomen, or neurological system a full physical examination was unnecessary. But as someone who went to medical school in the 1980s, I had the importance of inspection, palpation, percussion, and auscultation burned into my emerging clinical soul.

The pages and pages of findings we wrote based on extensive histories and physical examinations conformed to a pattern of extraordinary detail that we were exhorted, indeed required, to describe. But not today. Or, at least, not in the contemporary day-to-day practice of medicine. The physical examination seems to have become an anachronism, a vestigial remnant, of clinical care. Should we mourn or celebrate the demise of the laying on of hands?

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