Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Doctor accepting new patients
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

A connection is lost when we outsource the physical exam

Suzanne Koven, MD
Physician
August 27, 2012
Share
Tweet
Share

I remember my first visit home at the end of my second year of medical school. I’d just received my black doctor’s bag loaded with medical equipment. Like a 16-year-old with a new driver’s license, begging to do the very errands she’ll soon groan about, I went around my parents’ living room and took everyone’s blood pressure, looked in their ears and throats — and then made my “rounds” again.

While I never got tired of doing physical exams, they did, of course, lose some of that initial thrill.

But now that parts of the exam are being outsourced to other caregivers, I miss them. And I find myself feeling not so different than I did on that spring day so long ago when I asked, “Can I take your blood pressure, please?”

Nurse practitioners and physicians’ assistants do annual physicals, hospital admissions, and preoperative medical clearances. Medical assistants take blood pressures and perform other tasks previously done routinely by physicians.

There are good reasons for a team approach, including current and projected physician shortages, especially in primary care, and pressures on physicians to crowd many patients onto their schedules because of low Medicare and other reimbursements. Many argue, reasonably, that some jobs must be offloaded to give doctors more time to be doctors — to diagnose patients’ problems, formulate treatment plans, and offer counseling about how to prevent illness.

But I sometimes worry that we could be losing something important.

For example, measuring blood pressure offers an opportunity to touch a patient, one I’m not sure we doctors should be so quick to abandon. Many times I have seen a patient for a consultation — say, to discuss birth control or assisted living or an imminent divorce — and capped the visit by taking the patient’s blood pressure and listening to their heart and lungs.

In over 20 years in practice I have never yet had a patient ask me why I was examining them when their problem wasn’t “physical.” Touching a patient is part of paying attention to them, of caring for them.

The physical exam has another, harder to define but no less important benefit: It makes me feel more connected and attuned to the patient.

Recently, my practice adopted the common procedure of having a medical assistant take the patient’s blood pressure after escorting him or her into an exam room.

But I keep forgetting about the new procedure, and start my exam by taking the patient’s blood pressure.

Last week, as I wrapped the cuff around her arm, a patient said: “Oh, someone already did that.”

I said, “I know, but somehow I can’t stop taking blood pressures myself.”

ADVERTISEMENT

The patient, a thoughtful young woman, asked, “So it’s like a ritual for you? Like breathing before yoga?”

And I answered, “Exactly!”

Suzanne Koven is an internal medicine physician who blogs at In Practice at Boston.com, where this article originally appeared. She is the author of Say Hello To A Better Body: Weight Loss and Fitness For Women Over 50. 

Prev

When politicians decide a woman's fate

August 27, 2012 Kevin 6
…
Next

I cherish the relationships I’m able to build with my patients

August 27, 2012 Kevin 2
…

Tagged as: Cardiology, Primary Care

< Previous Post
When politicians decide a woman's fate
Next Post >
I cherish the relationships I’m able to build with my patients

ADVERTISEMENT

More by Suzanne Koven, MD

  • A hospital leader speaks out against the transgender military ban

    Suzanne Koven, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Don’t hesitate to talk to your doctor about work

    Suzanne Koven, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Patients should silence their phones in the exam room

    Suzanne Koven, MD

More in Physician

  • Physician wellness theater: Why pizza parties do not fix burnout

    Patrick Hudson, MD
  • Moral injury in medicine: When silence becomes a survival strategy

    Timothy Lesaca, MD
  • Medical misinformation: Navigating vaccine hesitancy with empathy

    Christine J. Ko, MD
  • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

    Brian Hudes, MD
  • Physician weight loss strategy: Why willpower isn’t enough in 2026

    Archana Reddy Shrestha, MD
  • Demedicalize dying: Why end-of-life care needs a spiritual reset

    Kevin Haselhorst, MD
  • Most Popular

  • Past Week

    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Physician wellness theater: Why pizza parties do not fix burnout

      Patrick Hudson, MD | Physician
    • Celiac disease psychiatric symptoms: When anxiety is autoimmune

      Carrie Friedman, NP | Conditions
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • Physician wellness theater: Why pizza parties do not fix burnout

      Patrick Hudson, MD | Physician
    • Antimicrobial resistance causes: Why social factors matter more than drugs

      Maureen Oluwaseun Adeboye | Conditions
    • Immigrant caregiver burden: the hidden cost of the five-year Medicaid wait

      Ranjita Suresh | Policy
    • Connected health care workflows: From chore to core patient care

      Grace E. Terrell, MD, MMM | Tech
    • Business literacy empowers physicians to lead sustainable health systems [PODCAST]

      The Podcast by KevinMD | Podcast
    • The necessity of getting lost to find yourself

      Michele Luckenbaugh | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why Medicare must cover atrial fibrillation screening to prevent strokes

      Radhesh K. Gupta | Conditions
    • Why medical school DEI mission statements matter for future physicians

      Aditi Mahajan, MEd, Laura Malmut, MD, MEd, Jared Stowers, MD, and Khaleel Atkinson | Education
    • The American Board of Internal Medicine maintenance of certification lawsuit: What physicians need to know

      Brian Hudes, MD | Physician
    • Teaching joy transforms the future of medical practice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Physician wellness theater: Why pizza parties do not fix burnout

      Patrick Hudson, MD | Physician
    • Celiac disease psychiatric symptoms: When anxiety is autoimmune

      Carrie Friedman, NP | Conditions
  • Past 6 Months

    • Will AI replace primary care physicians?

      P. Dileep Kumar, MD, MBA | Tech
    • What is the minority tax in medicine?

      Tharini Nagarkar and Maranda C. Ward, EdD, MPH | Education
    • Why the U.S. health care system is failing patients and physicians

      John C. Hagan III, MD | Policy
    • Alex Pretti: a physician’s open letter defending his legacy

      Mousson Berrouet, DO | Physician
    • Health care as a human right vs. commodity: Resolving the paradox

      Timothy Lesaca, MD | Physician
    • Why voicemail in outpatient care is failing patients and staff

      Dan Ouellet | Tech
  • Recent Posts

    • Physician wellness theater: Why pizza parties do not fix burnout

      Patrick Hudson, MD | Physician
    • Antimicrobial resistance causes: Why social factors matter more than drugs

      Maureen Oluwaseun Adeboye | Conditions
    • Immigrant caregiver burden: the hidden cost of the five-year Medicaid wait

      Ranjita Suresh | Policy
    • Connected health care workflows: From chore to core patient care

      Grace E. Terrell, MD, MMM | Tech
    • Business literacy empowers physicians to lead sustainable health systems [PODCAST]

      The Podcast by KevinMD | Podcast
    • The necessity of getting lost to find yourself

      Michele Luckenbaugh | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A connection is lost when we outsource the physical exam
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...