The Slim Book of Health Pearls: The Complete Medical Examination. Sheldon Cohen M.D. M.D.

by the wayside for the average patient. Hence, the cornerstone of early detection and prevention, the complete medical examination and risk factor analysis, is often incomplete. In a medical office where the physician is so busy with acute and follow up care, here is where the well-educated nurse and physician assistant can be of great help.

      As part of the complete medical examination, there are a large number of initial screening tests ordered. Invasive testing puts the patient at some risk. Therefore, the benefit to risk ratio test must be acceptable before performing these tests.

      The complete medical examination does include some risk factor questions, however there is not enough information provided to allow correlation of the risk factor with the disease. Patients can take their own risk factor analysis (see The Slim Book of Health Pearls: Am I at Risk?) This book allows patients to take their own risk factor analysis, which then can be shared with their physician.

      The best a physician can tell anyone after successful completion of the full examination is that, “The examination is normal in all its aspects.” There is a certain amount of reassurance in that statement, but inherent within it is that there is no guarantee. It is impossible to predict what the future holds, but following preventive and treatment recommendations will minimize the risks for death or disability. Patients understand this and are appreciative of the assurance that can come from a complete medical examination—if one can get a thorough one. This book will tell what it entails.

      So, let us now go through a medical history and a complete physical examination just as an average physician does with medical students and patients in their private offices and in the hospital. The book will give clinical examples after each section. These examples, illustrating the history or physical examination point discussed, are from my own and colleagues experiences. There will also be some examples of unusual cases of great clinical and human interest.

      Patients need to have a better understanding of:

      The art and science of history taking

      The technique of performing a thorough physical examination

      Basic laboratory studies.

      Risk factor analysis

      The capturing of vital important written patient information kept in an accurate and understandable format available for instant recall.