MANUAL CHECK-UP: REESTABLISHMENT OF PHYSICAL EXAMINATION AS A RITUAL

Introduction and Objective: In times that health care is seen as a commodity, the word and the doctor touch too lost their value. We tried to establish a consistent practice based on quaternary prevention and resource savings, on the improvement of semiotic techniques, by running up an incomplete but comprehensive physical examination in order to evaluate the asymptomatic patient and fearful about their morbidity. Method: For each patient with the chief complaint translated "desire to perform a check-up", was offered a standard physical exam, consisting of 23 steps later recorded, printed, delivered and discussed with the patient as a kind of document. A questionnaire was applied then as the satisfaction or disagreement on the outcome of the consultation. Results and conclusions: 1) In a sample of 100 patients, including all ages, 87% among patients and caregivers agreed with the lack of need to perform blood tests and imaging tests, feeling understood, monitored and fully examined; 2) Thirteen percent showed no agree not to extend the diagnostic investigation even having no screening indication pathologies; 3) The two doctors participating residents who applied the tests perfected their skills in various maneuvers, fixing findings of normality and abnormality; 4) They learned also to transform main complaint before generating counter-transference in relationship-building opportunity by carrying out a ritual goal of quick implementation. It was found that it is possible to circumvent commercial course of medicine through the enhancement of sober and not costly conduct as a physical examination approach.