RT Journal
A1 Silk A, McTigue KM
T1 REexamining the physical examination for obese patients
JF JAMA
JO JAMA
YR 2011
FD January 12
VO 305
IS 2
SP 193
OP 194
DO 10.1001/jama.2010.1950
UL http://dx.doi.org/10.1001/jama.2010.1950
AB 
The notion of the standard 70-kg patient is outdated; in the United States, the mean weight of men is now 88.3 kg and the mean weight of women is 74.7 kg.1 The most recent national data show that 35% of adults are obese,2 defined by a body mass index (BMI) of ≥30. These patients, like healthy-weight patients, rely on their primary care physicians for diagnosis of illness, but the physical examination is often particularly challenging. The primary techniques of the physical examination—inspection, palpation, auscultation, and percussion—are ways for physicians to try to confirm normal physiology and detect pathology. However, each of these techniques is undermined when the viscera and vasculature are enveloped in a thick layer of adipose tissue. To ensure good care of obese patients, special emphasis must be made in teaching physicians to overcome these challenges.