Detection and Correction of House Staff Error in Physical Diagnosis

Abstract

To the Editor.— I congratulate Drs Wray and Friedland for their excellent study of the quality of physical examination performed by house staff and interns (1983;249:1035). Their work highlights the concept of teaching the art of medicine at the bedside, which was preached in 1883 by Oliver Wendell Holmes on this side of the Atlantic when he wrote the following: The most essential part of a student's instruction is obtained, as I believe, not in the lecture room, but at the bedside. Nothing seen there is lost; the rhythms of disease are learned by frequent repetition, its unforeseen occurrences stamp themselves indelibly in the memory. 1 Their estimates of the time needed to review findings at the bedside ranged between 12 and 12 1/2 minutes per patient. Lack of time, therefore, should not be an excuse by too busy physicians for not performing a sound physical examination. Kampmeier wrote that