History and physical examination a commonsense approach pdf

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history and physical examination a commonsense approach pdf

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The medical profession today faces many problems. We march to bureaucratic drummers, we have lost our autonomy, our prestige has spiraled downward, and our professionalism is sagging. Lurking in the shadow of these ills is yet another medical malady, one for which we are solely responsible, and one that endangers the public we serve. It begins in medical school, where it almost never receives the attention it deserves. During residency training, it remains easy to spot, but efforts to spot it are not routine. And even when it becomes conspicuous, measures to correct it are often ignored, inadequate, or temporary at best. I call this malady hyposkillia —deficiency of clinical skills.
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Bates' Guide to Physical Examination and History Taking, 11E

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Although legal and medical definitions vary, rape is typically defined as oral, anal, or vaginal penetration that involves threats or force against a person who is unwilling ie, nonconsenting or incapacitated because of cognitive or physical disability or intoxication. Such penetration, whether wanted or not, is considered statutory rape if victims are younger than the age of consent. Typically, rape is an expression of aggression, anger, or need for power; psychologically, it is more violent than sexual. Sexual assault is rape or any other sexual contact that results from coercion, including seduction of a child through offers of affection or bribes; it also includes being touched, grabbed, kissed, or shown genitals. However, actual prevalence may be higher because rape and sexual assault tend to be underreported. Females are raped and sexually assaulted more often than males.

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When was the last time we as clinicians have performed a thorough physical examination on a patient who has walked into our clinic? The answer would surprise the best of clinicians amongst us.
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