The ideal purpose of the physical examination is to determine what or if a problem exists. The results should be used to establish a diagnostic plan, prepare a therapeutic approach, and develop a prognosis as rapidly and efficiently as possible.

The nature of an internal medicine problem does not always allow for each objective of the physical examination to spontane­ously or quickly generate either a diagnosis or a prognosis.

More realistically, the examination process dictates the specific laboratory tests or procedures to be performed that support the diagnostic or therapeutic effort. The clinician’s self-discipline regarding the extent of the physical examination should be guided by experience, efficiency of time, and judicious selection of the ancillary diagnostic aids that are available. A complete and extensive examination of each patient may not always be practical, especially in busy private or academic practice situ­ations. In these cases the clinician should provide for the client’s concerns with an expedient history and a pertinent physical examination process that addresses the client’s complaint (e.g., a rectal examination is not required for an evaluation of a pneumonia patient).

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