A Practical & Evidence-Based Physical Exam (Strong Exam)
Вставка
- Опубліковано 25 лис 2023
- An introduction to a physical exam course for medical professionals and medical professionals in training. This course highlights maneuvers and findings which are supported by the scientific literature, and deemphasizes those which are historic relics no longer used in practice. The course incorporates demonstrations on patients, examples of pathology, pointers about documentation and classic pitfalls, and a discussion of the evidence.
Central References for the Series:
Evidence-Based Physical Diagnosis by Steven McGee, 5th Edition
The Rational Clinical Exam series in JAMA, 1998 - ongoing
Additional Resources:
Stanford 25 (stanfordmedicine25.stanford.edu/)
Physical Diagnosis PDX (physicaldiagnosispdx.com/)
I'm excited to finally bring to you the most requested topic I receive and the biggest project I've undertaken for the channel to date: The Physical Exam. Thanks for your patience over the preceding three months while I've been working on this. This is the introduction to the series, the first batch of which will consist of 20 videos. Although many of them are finished and ready to be published, as to not overwhelm the almighty UA-cam algorithm, I've been advised to not literally post them all at once. I'm tentatively planning on posting one a day, Sunday-Wednesday for the next 4 weeks, take a 1-2 week break for the winter holidays, and then post the remaining in the beginning of January. However, that plan is subject to change based on how analytics and engagement looks as the series is rolled out. I hope you enjoy!
This is a dream come true!! Finally!! As a long time fan of the chanell and physical exam enthusiast I cant tell you how excited I am!
How to access this course? Can’t seem to find. Does this cost money? Very excited to watch.
The course will be posted here. Nothing on Strong Medicine will ever cost viewers money.
soo excited! thanks, Dr Strong
Awesome! Thank you Dr. Strong! Honestly, release them in the way that is most profitable for you. You're already providing arguably one of the best resources for young physicians as it is for free. There is nothing wrong with working the youtube algorithim for all its worth.
I'm curious as to what you have to say on liver percussion. In my experience, if I feel hepatomegaly on palpation but am not 100% sure, I'll percuss to estimate liver size. If I then send those patients for an abdominal ultrasound I'll often successfully corroborate my physical exam findings. That's how I use it and I'm pretty happy about its success rate. I think I can kind of get a guesstimate of how big the liver is with liver percussion. I once was able to go back and uncover an underlying alcohol substance use disorder thanks to this approach. To be fair, I am in a specialty that only sporadically involves head-to-toe physical examinations, so I'm never really sure about any of my exam findings... that's why I'm quite looking forward to your new series!
You, sir, are a pioneer in medical education for the upcoming generations of doctors. Finally, someone has taken on the challenge of critically evaluating the physical examination as it is taught today (outdated) AND found a convenient format to present it to his audience (videos>textbook). Thank you!
It's so frustating to study things that are completely useless in real practice! The amount of things we study is already huge, there is no need to add useless stuff. Thank you for taking the time to make this INCREDIBLE series!! All doctors and nurses will benefit from this!! I'm so grateful to be part of this family! Hats off to you Sir! Finally, finally, finally!!
Having all this material for free is just amazing, thank you so much
You’re doing an amazing job and I can’t thank you enough for this.
This is fantastic and very compelling for bringing change to our approach to physical exams, thank you!
really stoked for this series!
Thank you so much for doing this! Can't wait to see all the videos!
As a young doctor, I must say your videos really help me! You made me a better professional and I thank you for that. Everytime I feel insecure about a subject, the first thing I do is check if you already have a video about it. Please keep on the excelent work, Dr. Strong.
Kudos, from a portuguese fan
Perfect timing, Dr. Strong! I was literally teaching and demonstrating the Homan sign to pre-meds yesterday, and I told them that they might be asked about it on medical school exams, but the sensitivity and specificity is pretty low and can maybe even cause more harm than good. I'm super excited for this series!
Can't wait! Thanks for your work and teachings!
I am about to start my journey as an educator in medicine and have you as my biggest role model! I love the physical exam and all your other videos! This is such an exciting time, it is such a privilege to have such good knowledge at your fingertips!
Looking forward to it! I am sure it will be another excellent series just like your other ones. Thank you for the work that you do w/ FOAM!
Looking forward to it. From being a medical student in Nepal to now an attending in a US hospital, Dr. Strong has been my virtual mentor. Thank you so much!
I miss your super informative lectures! the ones I depend on! I go back to your old lectures regularly and thank god for your existence everytime! I'd consider myself a strong (pun intended) follower. I hope you never sell out! (more fairly: I hope you never are always compensated enough to continue for free) you are a a real Mensch!
Great to hear from you , I am looking forward to learn this . Thank you Doctor.
Thank you very much! Much appreciated. I will carry this forward to my future practice and teaching.
I can already tell that it's going to be a great video series. It's exactly what we need. Thank you ❤
Whoa!!!! Seems like quite the undertaking. Excited to be following along.
Thank you for doing this, the physical exam should always be revised and updated, it's perception as an old tool does a diservice to it's potential, so an evidence based selection is the best tool to make it legitimate in our modern era, making it speak the same language that the rest of the diagnostic tests doñ
I am about to start my journey as an educator in medicine and have you as my biggest role model! I love the physical exam and all your other videos! How exciting!
Thank you for your courage to promote patient centred meducation.
So excited for this course. Even at a well respected medical school, I still feel like my physical exam education has been awful at best. Looking forward to sharing these upcoming videos with all my classmates. Thanks again!!
Looking forward to this series!
Thank you doctor for all the things you do
Looking forward to this series!!!
I'm very much looking forward to this course!
Have been so excited for this. I hope to incorporate this with my students.
Thank you! Really needed a good video on this topic.
The goat with another amazing resource for free
Look forward to it!!! Thanks in advance 😊
THANK YOU VERY MUCH, DOCTOR STRONG, THIS INFORMATION IS VERY VALUABLE TO UPDATE MY STRATEGIES IN CLINICAL PRACTICE, I WILL BE VERY ATTENTION TO EACH VIDEO. GREETINGS FROM COLOMBIA
Sounds amazing, looking forward to seeing it.
so excited for this course, thank you
Very excited for this!
Can't wait for the next video - thank you Dr Strong
Looking forward to it!
The information we need !
Can’t wait!
So happy!
Dr. Strong, I'm writing this from Ukraine and can't overestimate how exited I am about future videos, and also how sad and frustrated about the fact that we can't enjoy them now or like... yesterday😅. Thanx soo much for creating one of the best content out there!!!
Thank-you!
Greetings from India,🙏🙏🙏🙏,You are the best teacher I have ever seen since I started my med school in 1990.LEGENDARY 😂
The best teacher and person 😊
Thank you very much
Woo, I've been waiting for this for a while. This is probably the aspect of clinical medicine that simultaneously most fascinates and aggravates me. I'm supposed to present some form of didactic for my Internal Medicine service some time from now maybe next year, would it be okay to base myself on your materials? Most of the attendings are nearing retirement age and they as well as the med students may profit greatly from hearing this. :)
we look forward to learning from you Sir.
Thank you Dr Strong , i am glad to hear from you . I heard in one of your video before that you eluded to thi smatter. i am looking forward to learn from you . i was instinctively recoqnize these before as a student, i got a very very hard time from teachers , this was few decades ago.
Yep, I self-plagiarized a bit about the textbook vs. evidence-based vs. practical exam types from a video rant I posted a few years ago. I hope you'll enjoy the series!
Great content
Thanks Dr
Perfect video.
Very excited! 😍
The most student empathetic proctor ever,
You mentioned that we might get negative score for using u r method and not their more like this situation happened
The guide book is Bates clinical exam so once I used that method to present my PHYSICAL EXAMINATION case but they got disappointed for not using their Method
Minor incordination with what we use and what they lecture yet big impact on grades
great teacher. may Allah pak gives long life
Sounds like an interesting topic!
I‘m looking foward to it!
Personally, if I have access, I use the ultrasound more and more during seeing patients; portable ultra sounds seem to get more and more momentum, I haven’t tried them yet but would use them too:
nevertheless I am excited to see which exams are really helpful; personally I actually try to percutate pleural effusions if ultrasound is not available, for example
Time is now and looking forward to the teaching
Eagerly awaiting sir..!! ❤❤
Very excited 😌
can't wait ❤🔥
Thank u ❤
Wonderful news!!
you're the greatest
You are great 😃😃
EXCITEDDDDD
this is just what the doctor ordered🫡
Legend!
Always loved the brevity and clarity each video provides better than many textbooks and teachers in medical schools. Thank you for all that your doing Dr.Strong. Eagerly awaiting these videos !
I wonder if you can incorporate POCUS w/ the classic physical exam
Keen!!
❤️❤️❤️
❤❤
❤❤❤❤
I also wonder if you can bring other experts in regional Dx and POCUS to add value to the regional exam
I appreciate the suggestions. I considered incorporating POCUS into this series, but showing people's ultrasounds on social media - even those of paid actors - has a few extra barriers over that of a physical exam. Also POCUS isn't widely available for trainees (yet) across the world. I'd like for future updates of the series to include a POCUS video for each major exam component, but that's a long way away.
Regarding bringing in specialists, a challenge with that is that, in my experience here in the US, opinions on the place of the exam in modern medicine are very polarized with relatively few of us in "the middle". Many specialists virtually ignore the exam, while a small number approach it with an excessive reverence that ignores the evidence and relevant practicalities. The only clinicians who I personally know whose philosophy to the exam is similar to the one on which this series is based are a handful of other hospitalists, primary care docs, rheumatologists, and ID docs. That's not shade at the cardiologists, pulmonologists, and gastroenterologists of the world, but rather acknowledges that at a place like Stanford, where echocardiograms, CT scans, MRIs, endoscopy, and PFTs are all very readily available, there is a natural tendency to gravitate to technology, even in situations in which it is unnecessary.
Thank you for the quick response.
Will there be comments for pediatrics (example: this maneuver is not applicable for pediatrics)
Unfortunately, while many of the principles and findings can be applied to pediatrics, the series is currently designed only for an adult patient population. As alluded to in this introductory video, I am anticipating updates with additional information, and depending on interest and my ability to recruit a pediatrician, I can imagine an update covering core pediatric exam maneuvers and findings. FWIW, my colleagues with the Stanford 25 group have posted a few videos on the neonatal exam here: ua-cam.com/users/stanfordmedicine25
Where can we access this course?
The course will be posted right here, one video a day. (If I post the whole thing at once, it risks being deprioritized by the UA-cam algorithm)
Christmas came early.
Thank… god….
As lame as it sounds, I am incredibly hyped for this series 😭
Please how can I make you my primary doctor? I believe you will take time to examine me and help me with a diagnosis because I have been to many doctors and specialist and none has take time to examine me or even listen to me. I am desperately looking for a good doctor out there that really cares about patients and I don't mind traveling to a different state to see the doctor. So please do you see patients? Because I would like to come and see you at your clinic or hospital. Thanks
I'm sorry about the challenges you've had with finding a doctor to listen to you and examine you. I know it can be difficult to find someone trusted with whom you can establish a good long-term doctor-patient relationship. Unfortunately, I'm a hospitalist, meaning that I specialize in the care of patients in the hospital. I haven't worked in primary care for many years. The best source of information about good primary care providers near you is honestly word-of-mouth from friends who have similar medical conditions (or at least who have a similarly complex medical history). Stanford does have several clinics which specialize in making challenging diagnoses. One is the Center for Undiagnosed Diseases focuses on suspected genetic diseases; although it's not required, most of their patients are children. Another is the Online Second Opinion Program: stanfordhealthcare.org/second-opinion/overview.html
wow, as a resident who is just going through the motions of physical exams because that is what i was taught even though i know a lot of the stuff is useless, i am excited to watch this course!
Do you work in Stanford hospital at all?
Yes, I'm an employee of the medical school and hospital. Today will be day 10 of a 10 day stretch...
@@StrongMed only asking because I saw someone that looks like you around the hospital twice already and I want to say hi 😅
It's totally cool to say hi. (I don't think I have a doppelganger at the hospital!)
Really hyped for this
❤❤❤