Thursday, September 10, 2015

Physical exam training for Acupuncturists

keywords:  hospital practice, KSAs, physical exam skills, charting, SOAP, electronic health record (EHR), evaluation and management (E&M), practice standards

Physical exam training.  This was required part of schooling and part of the biomedicine board exam.  Both Western physical exam skills (such as Range of Motion) and Eastern physical exam skills (tongue, pulse, palpation, abdominal/Hara diagnosis, etc).  This is an important part of the objective measures section of the SOAP note.  The Objective measures section in the SOAP note will be more thorough during initial evaluations and re-evaluations/re-exams.  Re-evaluation is always done at scheduled discharge.

*only use the physical exams that are appropriate to the patient, as the patient case presents.

Evaluation and Management
Evaluation and Management (E/M) codes and standards are kept by the Center for Medicaid and Medicare.  For more information on current standards expected for evaluation and management as related to E/M codes and modifiers used (which are the codes you use when you do an initial visit and when you do a re-evaluation or re-evaluation/discharge), see this manual from CMS website.  It is a free federal resource, as part of the CMS's "Learning Network (MLN)".

Hospital practice L.Ac.s find that they need to keep their physical exam skills, both Eastern and Western, updated regularly.  

Medicare Learning Network (MLN)

Western Physical Exam resources
 Bates' Guide to Physical Examination and History Taking
Bates Visual Guide to Physical Examination
Hoppenfeld's Physical Examination of the Spine And Extremities

Eastern Physical Exam resources
Well, any of the references listed for the NCCAOM board exam
Barbara Kirshbaum's Atlas of Chinese Tongue Diagnosis
Maclean and Lytteton's series of Clinical Handbook of Internal Medicine:  the Treatment of Disease with Traditional Chinese Medicine
The standard red CAM book:  Chinese Acupuncture and Moxibustion edited by Cheng Xinnong

In the comments section, please list your favorite resources for Western physical exam skills or Eastern physical exam skills.  Please also provide a link to the resource.  Thank you!

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