The Future of Medicine

The physical exam is the backbone of medical practice and goes back thousands of years to the Chinese. It has evolved over time—and modern technology is bringing yet more changes to the age-old assessment.

In basic terms, the physical examination is the physician’s way of evaluating a patient using minimal invasiveness and the physician’s five senses: sight, smell, touch, hearing, and even taste.

Yes, even taste. Did you know that years ago, physicians would actually taste urine to check for diabetes? It’s true! Fortunately, things like tasting urine are no longer done. But the physical exam remains integral to the practice of medicine. This is because the traditional physical examination is inexpensive, non-invasive, and potentially revealing. And besides all these things, the traditional physical exam serves the function of helping to establish the patient-doctor relationship.

I remember my first years as a medical student, when I began to learn how much effective medicine depends on the physician’s keen sense of observation. Of course, there are additional tools at a physician’s disposal. For example, there’s the stethoscope—an instrument as ubiquitous as the physician’s long white coat.

As a medical student, when I first started to learn how to use the stethoscope. One of my attending physicians informed us that in the near future, the landscape of medicine would see interesting changes. He also joked that in the future, whenever someone needed medical assessment, they’d probably just come to the clinic, bypassing the nurse, doctor, stethoscope or blood pressure cuff. They’d instead step into a futuristic, walk-in scanner, a la Star Trek. This Star Trek wonder would scan their body from head to toe, immediately offering precise screening and diagnostic information.

As a Trekkie, I marveled at the thought of people on conveyer-belt apparatuses being scanned, but I never thought my attending physician was being completely serious about people bypassing their doctor or all the components of the traditional physical exam. I don’t think we’ll ever get to a point where health professionals will be replaced by machines.

Either way, my attending was right in a few ways. Since my time as a medical student, the landscape of medicine has definitely evolved. We haven’t come as far as Star Trek, but we have seen some great technological advances. One such advancement is the virtual physical exam.

The virtual physical exam is an impressive, comprehensive screening and diagnostic procedure. Screening is a method used to detect a disease in individuals without clinical signs or symptoms of that disease. Screening is used to identify disease early, thus enabling earlier intervention and management in the hope of reducing death and suffering from disease. Mammograms are a common example of screening tests. A diagnostic test is performed to give a more precise diagnosis or detection of disease. Skin biopsies, in the case of suspected skin cancer, are an example of a diagnostic test. Thus, a screening test may show an abnormality, but not exactly what that abnormality is. Diagnostic tests can tell you exactly what the abnormality is.

The virtual physical is a non-invasive procedure that uses state of the art technology to take a global look at the body and identify abnormalities or disease. During this procedure, precise images are made of the body and organs to screen for things like cancer and a host of other conditions. Radiologists review the results of these exams, noting any problems that may require further evaluation by a physician.

Now back to the traditional physical exam. An annual physical exam is an important component to sound preventive care. The current medical standard of care is to recommend and offer a patient at least one physical examination per year. Still there are obvious limitations to the traditional physical exam, and this is where the virtual physical picks up the slack. The virtual physical exam is can uncover asymptomatic and often life-threatening diseases generally not detectable by traditional physical exam or standard screening tests.

Ultimately, the virtual physical exam is a great advancement of preventive and wellness medicine. It allows doctors to manage any diseases detected in the earliest stages, where medical costs are cheaper and procedures are less invasive and more effective. In addition, once the virtual physical is completed and the doctor has reviewed it, patients not only receive a printed copy of the analysis, but a CD-Rom with pictures of the exam. You have to admit that it’s a bit cool that you can take this CD with you, pop it into your computer, and review the results again from the comfort of your own home. And besides just being cool, this gives patients the opportunity to thoroughly review their own results, learn more about their bodies and even make a list of questions to ask their doctor.

Though it is not currently the standard of care in the United States, the virtual physical exam may well become an integral component to comprehensive and holistic care. I’ve heard praise and criticism of the virtual physical exam—but I am all for anything that is best for the patient. Still, I do not believe the virtual physical should completely replace the traditional physician-patient interaction, which aids patients and medical professionals in establishing a positive, collaborative relationship.