Curing Health Care by Adding Value: How About a Physical Examination?

Robert C. Goldszer, MD, MBA


South Med J. 2019;112(2):89-90. 

In This Article

Abstract and Introduction


New diagnostic technologies … telemedicine on your mobile phone … online portals for reviewing test results and scheduling appointments … electronic medical records … paperless physician's office—these are cornerstones of the modern healthcare experience in the United States today, but are we really getting what we want? To know the answer, we must first accept as a society what it is we really want from health care. My millennial daughters and others tell me they want "to live longer" and "for health care to be less expensive." Looking through the lens of some of health care's most exciting recent developments, these expectations are being addressed. Experts are exploring genetics for diagnoses and cures. We are practicing precision medicine for acute and ongoing treatment with minimal adverse effects. There are new imaging techniques providing insights never before available. The power of big data and artificial intelligence is being harnessed with the goal of achieving more positive patient outcomes. Although healthcare professionals should remain interested in these advancements, we must never lose sight of access to care, patient safety, patient satisfaction, maintenance of health, and expense.

Our goal is to add value for patients. So, what could we do to improve? I recommend we always include fundamental high-quality health care—beginning with an excellent patient history, a focused detailed physical examination at regular intervals that precedes imaging and diagnostic tests, and a strong relationship between patients and their primary care physicians. As the landscape of medical care continues to evolve, the patients' perception of the importance of having a focused and thorough history and examination has diminished. In addition, for many reasons, including reimbursements and payment models that pay for volume (number of visits), many medical professionals do not allocate time for a complete evaluation and do not provide the means for convenient access.