A survey of psychiatrists' attitudes towards the physical examination

Background: Studies have shown that most psychiatric patients do not receive a thorough physical examination (PE). Methods: Psychiatrists working with Leicestershire Partnership NHS Trust were surveyed to determine factors influencing the performance of PEs, including their attitudes toward conducting them. Results: Responses from 118/192 (61%) psychiatrists showed that most (96%) believe that the PE is important. The majority (72%) indicated that their PE skills had diminished since working in psychiatry and this was reported more by senior psychiatrists compared to junior trainees (85% vs 40%). 77% considered that a patient’s mental state should have a bearing on the type of PE the psychiatrist performs. Conclusions: Likely reasons for poor performance of PEs include: shortage of time and equipment, challenges associated with agitated or uncooperative patients, and possibly a degree of skill atrophy, especially in senior psychiatrists. Further research is needed to investigate if strategies addressing these factors would improve the standard of PEs on psychiatric patients.