Department of Medicine–

Bedside Medicine Revisited


There was no shortage of ideas and opinions among the intimate gathering of physicians who participated in Stanford’s First Symposium on Bedside Medicine.  Organized by senior associate chair, and professor of the theory and practice of medicine, Abraham Verghese, MD, the two day

bedsidegroup

Stanford Symposium on Bedside Medicine

event was attended by master clinicians from universities across the country, representatives from the National Board of Medical Examiners, the American Board of Internal Medicine and other agencies, and authors of the leading physical diagnosis texts used in America. 

Designed with short presentations and panel discussions, the workshop program left ample time for spirited dialogue. According to Verghese, who has had a long interest in the significance of bedside skills as one part of the art and craft of medicine, “there is some urgency to the decline and absence of bedside skills and over reliance on technology, but even more importantly, it diminishes and short changes the ritual of the patient-physician relationship.”

Value in Experience

Richard LeBlond, MD, professor of internal medicine at the University of Iowa, attended the symposium. LeBlond (editor of the famed DeGowin and DeGowin text on bedside exam) has spent much of his career practicing rural medicine, with less access to sophisticated technology. He expressed a concern shared by many: the lack of value given to experience. “Even the most sophisticated technology will never replace a highly skilled master clinician. It is the most important tool that we have. Medicine is an experienced based craft, with skills that take a long time to acquire.”

Assuring residents obtain the needed skills throughout their training was a key topic of discussion. The general consensus among the participants was that the current internal medicine system of teaching is in need of reform. “There is no quick fix; we need to completely redesign entire program. A process, which I believe is right around the corner,” said Ralph

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Horwitz, MD, Department Chair.  “We need to create a framework for people who aspire to be master clinicians. There is a clear path for research, but none for master clinicians,” added LeBlond.

As the participants left, they realized that conversations would continue long after the symposium ended. It was only the beginning of the mission, which brought them together in the first place: a  shared commitment to the craft of medicine.

Currently, this dedication is exemplified with the “Stanford 25,” a new initiative designed to showcase and teach 25 fundamental physical exam skills and their diagnostic benefits to interns. Taught by experts in the art of the physical exam, the “Stanford 25” provides interns and residents with a unique educational experience.

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