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A physical examination, as the name suggests, is based on a physical examination of the patient. Such a survey cannot be fully carried out during an e-visit, but it is not always necessary. What are the possibilities of assessing the patient’s condition during the e-visit? What does a physical examination under teleconsultation look like?
What is a physical examination?
Physical examination, also known as physical examination, is used for an overall assessment of the patient’s condition. In order to conduct it, the doctor or nurse conducts viewing, palpation, percussion and auscultation of the patient. Therefore, physical examinations include activities such as the assessment of external appearance, body composition and proportions, as well as measuring the heart rate, pressure and temperature. If indicated, a physical examination of specific areas of the body (abdominal cavity, chest), organs (e.g. thyroid) and systems is also performed.
Although the physical examination is largely based on direct interaction with the patient, an important part of it is also observation, drawing attention to the behavior and appearance of the examined person. Some deviations from this range also provide useful information for the physician.
Doctors use the physical examination as one of the basic tools of work, but in practice not every medical consultation requires a physical examination. This applies, inter alia, to follow-up visits, when information obtained in the patient’s history or the tests performed is often sufficient. Due to this, a physical examination is not a limitation that affects the course of a telemedicine visit in any situation.
Check it out: 6 situations when an e-visit with an internist is better than a traditional one
Is physical examination during e-visit possible?
Telemedicine opens the door for patients and doctors to extend the diagnostic or treatment process to remote visits, i.e. e-visits. Contact with a specialist via electronic devices is associated with certain limitations, so it should not be treated as an alternative to every visit to the doctor’s office. One of the aspects influencing the usefulness of telemedicine consultations is physical examination, which is sometimes necessary.
During an e-visit, it is usually not possible to perform a complete physical examination.
Although the physical examination can only be fully performed when the patient and doctor meet face to face, some of its components can also be realized during an e-visit. Partial observation of the patient is possible thanks to an e-visit in the form of a video call, which may prove useful in the case of e.g. a neurological or dermatological e-visit.
During the conversation with the neurologist, the patient may receive instructions on the basis of which the specialist will be able to gather clues about the patient’s condition. This way, however, he would not be able to examine his reflexes. Visual analysis during an e-visit is also useful for a dermatologist – in this case, it is also possible to photograph the lesion and forward the photo to the doctor via the selected communication channel. However, this form of symptom recognition has a limited diagnostic value and may sometimes turn out to be insufficient.
See: Telemedicine visits – what problems can be solved thanks to them?
Execution is also possible under certain circumstances telemedicine physical examinationwhich is based on the use of telemedicine devices. These are devices that allow remote monitoring of medical parameters. In this way, it is possible to remotely inform the doctor about:
- body weight;
- body temperature;
- blood pressure and pulse;
- heart rate;
- glycemia in diabetes;
- parameters related to the functions of the respiratory system.
As for the parameters that require the use of specialized equipment, such data is usually collected from undergoing patients telemedical monitoring health condition.
What telemedicine devices are used in remote physical examinations?
In order to obtain at least some information about the patient’s health, which the doctor collects during traditional consultation in the office, appropriate medical equipment is used during e-visit. Certified devices that allow the collection of reliable data are preferred. The patient can use, among others:
- pressure gauge;
- thermometer;
- glucometer;
- weight or weight with body weight analysis;
- electronic stethoscope;
- spirometr;
- dermatoskop?
- device for CTG examination;
- mobile ECG recorder.
The collection of data on the patient’s health is facilitated by diagnostic applications.
When it comes to specialized devices, they are not always available as part of telemonitoring in individual telemedicine facilities. Telemedicine continues to develop, and over time, there may be more and more opportunities to remotely collect data about the patient’s health.
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Do the limitations of physical examination affect the legitimacy of e-visits?
An e-visit is a form of contact with a doctor that prevents full implementation traditional physical examination. During the e-visit, the doctor is not able to perform a palpation examination that would allow to assess the size, shape, mobility, warmth, cohesiveness or soreness of various structures by touch. These elements of the physical examination are important when checking the condition of tissues, swellings, lumps or lymph nodes. The physician cannot auscultate the patient in the traditional way or perform activities such as tapping and tapping.
Despite the limitations resulting from the remote nature of telemedicine visits, in many cases the doctor is able to collect the necessary information, guided by the interview, test results or measurements made telemedicine equipment. In some situations, a physical examination is not necessary, and even without it, a specialist is able to provide the patient with recommendations, suggest treatment, prescribe an e-prescription or issue an e-referral.
Check it out: Myths about telemedicine. We debunk the most repeated ones!
If the inability to conduct a complete physical examination makes it impossible to make a diagnosis, the doctor will inform the patient about the need to arrange a traditional medical visit.
Do you have questions about telemedicine? Send them to the following address: [email protected]. All the most important information on telemedicine can be found HERE: Telemedicine – frequently asked questions and answers
Read also:
- How do I find an e-visit doctor?
- How to prepare for a telemedicine visit?
- When is it worth deciding on telemedicine advice?