Veterinary Medicine - October 2008 - (Page 536)

Leading Off test is misinterpreted. And even ﬁnely tuned electronic instruments may not offer deﬁnitive results. Nevertheless, we highly value technology. Yet the physical exam has certain advantages over sophisticated tests and tools. For example, it is less expensive, and, unlike many high-tech diagnostic tools, it can be performed anywhere. In addition, the physical exam can be used more easily to make serial observations. And because it involves touch, the exam enhances the veterinarian-patientclient relationship. In addition, even in today’s technologic times, some practitioners still embrace the physical exam as something almost mystical. They see the true value in auscultating the chest or in palpating the abdomen before taking further diagnostic tests. These veterinarians remind themselves that some of the greatest achievements throughout medicine have been based on observation, thorough history taking, and a physical exam. For example, long before the invention of the electrocardiogram, Karel Wenckebach, an early 20th-century physician, discovered the heart block arrhythmia by timing a patient’s arterial and venous pulsation. tomography and MRI, will continue to rely on a patient’s history and physical exam results to correlate pathology with functional changes. Practitioners, too, must not lose touch with this central component of patient evaluation. As Sir William Osler said, “Learn to see, learn to hear, learn to feel, learn to smell and know that by practice alone can you become experts.”3 It is the fusion of the physical exam, the patient’s history, and technology that will help veterinarians become more accurate, quicker diagnosticians and healers while maintaining the crucial veterinarianpatient-client bond. REFERENCES CONCLUSION Without a doubt, the veterinary medicine of today is not the veterinary medicine of the last decade. However, despite the many advances in technology, the history and physical exam will remain constants in veterinary medicine. Dermatologists will continue to depend on observation and palpation to recognize skin problems. And neurologists, while greatly helped by computed 1. Phoon CK. Must doctors still examine patients? Perspect Biol Med 2000;43(4):548-561. 2. Flegel KM. Does the physical examination have a future? CMAJ. 1999;161(9):1117-1118. 3. Bean WB. Sir William Osler: aphorisms from his bedside teachings and writings. Spring eld, Ill: Charles C. Thomas Publisher, 1961;129.

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Veterinary Medicine - October 2008 Contents Leading Off Clinical Exposures Idea Exchange Stalking Stones Vaginitis in Dogs CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - October 2008

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