The lost art of physical examination

Issue: BCMJ, vol. 63 , No. 3 , April 2021 , Pages 102 Letters

As we rush enthusiastically into the new age of virtual medicine, I am wondering what we are losing. I hear stories of patients receiving a telephoned prescription for penicillin, for a sore throat, unseen and unswabbed. Or for something that “sounds like” bronchitis. Another patient with right upper quadrant discomfort was treated with liver function tests and an ultrasound, but no examination. A tender breast lump? How about mammography plus or minus ultrasound?

I know I’m a dinosaur—a throwback to past generations of family medicine—but I foresee perils. It’s not enough for the MOA at the end of the line to ask, “Do think you need an appointment?” Neither the patient nor the MOA should be held responsible to answer that question. I can only hope that most GP offices are finding better ways of dealing with this issue.
—Lorne Walton, MD
Maple Ridge

Lorne Walton, MD. The lost art of physical examination. BCMJ, Vol. 63, No. 3, April, 2021, Page(s) 102 - Letters.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply