As a primary care mental health provider, I really appreciate your emphasis on getting affirmative consent for hands-on examination. I work with military veterans and very often these semi-intrusive exams can be overwhelming and reason enough to avoid being seen altogether. Giving a person a chance to say no if they’re not comfortable makes a really big difference. It’s so important for your students and residents (and frankly your colleagues) to see good doctoring is about much more than remembering anatomy and following procedure and algorithms.
@DrJamesGill2 жыл бұрын
It’s also incredibly effective at building trust, which then flows over into the management plan
@SchleimKeim772 жыл бұрын
As a patient: Last time I was examined, the doctor didn't even tell me what he was actually examining. Telling me beforehand definitely would've made me feel more comfortable.
@bofa83 Жыл бұрын
It seems to be a British dr thing. My question is, what if they say no? What do you do then?
@thelearicist Жыл бұрын
@@bofa83 good call.
@cleocatra9324 Жыл бұрын
@@bofa83 you talk to them and ask how / what you can do to make them comfortable and what they are ok with. COMMUNICATE!
@ML-jk4dg2 жыл бұрын
I came for the ASMR to sleep Stayed awake for the info Now I can relax with open eyes The balance ⚖️
@DrJamesGill2 жыл бұрын
Any learning is good 😊
@rzsp4209 ай бұрын
I came for Asmr too and I completely agree with what you said
@starfishgurl19842 жыл бұрын
As someone with sensory processing disorder whose body overreacts to certain types of touch as a result I really appreciate the emphasis on making the patient aware of you touching them from behind! When I know I’m going to be touched from behind I’m less likely to move/overreact as a result because my brain has the time it needs to tell my body to relax in advance which significantly improves my body’s response to the touch.
@DrJamesGill2 жыл бұрын
It’s also just polite 😊
@thevengeful0143 Жыл бұрын
I appreciate that he specified how auscultation is the last step of an exam specifically in the UK vs it being different in other locations. As an RN practicing in the US, our EBP and most facility protocols call for auscultation between inspection and palpation with percussion last. His justification is also sensible, and his detailed yet professional approach is great as I continue to learn and develop my clinical assessment skills as I progress (hopefully) towards becoming a DNP specializing in geriatric primary care.
@DrJamesGill Жыл бұрын
I’m happy you found this useful. I think everything we do should be evidence based, even if that means challenging something which has been done before
@msaditu2 жыл бұрын
This is one of the best videos you've made. The detailed explanations and the annotations make it extremely informative and helpful. Thank you!
@DrJamesGill2 жыл бұрын
Thanks. It’s taken three days of editing, so I’m really glad you find it useful If you’d consider sharing it, others might also find it useful 😊
@derrickw5204 Жыл бұрын
Dr . Gill , as a paramedic in the U.S , I liked this ! However , the assessment guidelines set don't allow us to go into that much detail . The examination of the abdomen on the focused patient assessment is brief . The EMT or paramedic exposes and visualizes the abdomen looking for Deformities , Contusion , Abrasions , Penetrating injury , Burns / Bleeding , Tenderness , Lacerations , and Swelling . Then on palpation of the abdomen in 6 regions ( upper , mid , and lower quadrants ) we feel for associated pain , look for guarding of the abdomen by the patient , rigidity and distention .
@DrJamesGill Жыл бұрын
That is interesting, but I suppose you are looking for different things. I for example never need to worry about penetrating abdominal issues - that would VERY much be outside of my job description!! 👍
@natalieadkins67912 жыл бұрын
Wow! This made me look deeper into a B12 deficiency because I have those facial features and I will definitely be visiting my doctor now. I also realized my symptoms lately align with this.
@DrJamesGill2 жыл бұрын
Oh, I hope that you don’t have an issue with B12! It would be useful if you could tell us the outcome please 😊
@ancaiuliaangelescu97762 жыл бұрын
Brilliant presentation ! One thing I would suggest : as medicine is moving really fast forward I'm always telling my juniors we should consider bedside ultrasound as ''the fifth element '' in the abdominal examination after inspection, palpation, percussion and auscultation.
@DrJamesGill2 жыл бұрын
I agree ultrasound is going to be massively important, but until there is ubiquity like stethoscopes, I don’t think it will be part of the year 1 clinical skills syllabus. But hopefully one day
@BubblewrapMe2 жыл бұрын
My aunt had Wilson’s disease - really good to see you mentioned it, as very few people seem to know about it.
@DrJamesGill2 жыл бұрын
It’s normally a year 1 disease at med school, we discuss it in the first month, BUT it’s quite rare, so tends not to get a lot of exposure in the rest of the syllabus I hope your mun is ok?
@alejandrocastillo5771 Жыл бұрын
Very thorough and well explained with a touch of calmness, perfect teaching environment. As always thank you Dr. Gill for the video. Your videos allow me to replay them in my mind and connect the assessment to their rationale.
@DrJamesGill Жыл бұрын
Where in Texas are you studying? Any other areas we can help cover?
@alejandrocastillo5771 Жыл бұрын
@@DrJamesGill good morning I live in a bordertown to Mexico called Eagle Pass. I work at a ER where focus assessments are required depending on the issue? Common topics ENT (conjunctivitis, foreign objects, infections) chest pain & abdominal pain ( from MI, pancreatitis, cholicystitis, to epigastric pain like GERD) musculoskeletal (sprains, fractures, and dislocations), respiratory ( COVID, FLU A and RSV), gi ( diverticulitis, n/v/d), and strokes. 👍
@yadiazrael12902 жыл бұрын
Stumbled upon a video a few months ago (not even remotely related to my field of work). Yet, I keep coming back for the great content……. and David. Great video Dr. Gill.
@DrJamesGill2 жыл бұрын
Thank you for joining us anyway. What is your field?
@yadiazrael12902 жыл бұрын
Political Analyst in America.
@elizabethgaunt78632 жыл бұрын
Absolutely loved this video. Explaining everything was much more relaxing to me. These are the kinds of “asmr” videos I enjoy watching. Thank you. Very calming. 😊
@DrJamesGill2 жыл бұрын
I hope you found it useful 😊
@elizabethgaunt78632 жыл бұрын
@@DrJamesGill very useful 😁
@DevRSVR2 жыл бұрын
I’m not a medical student but I enjoy trying to understand all the medical stuff. The whole area of the abdominal palpation looks very nuanced. Is it something that is difficult to get confident at? The sound differences seem not hugely dramatic and seem like they could lead to a misdiagnosis given the fairly broad range of issues possible?
@DrJamesGill2 жыл бұрын
It’s very much something that comes with time. We teach students on “normal” so that when they come across something abnormal it stands out very obviosuly
@EgaoKage Жыл бұрын
I've been examined by many gastroenterologists (in the US). Not once has any of this been done, apart from two or three seemingly arbitrary proddings at my belly.
@MaxxyBee6 ай бұрын
same in canada, but its probably because theyre specialized doctors, theyll always send you to do scans and scopies instead cause theyre the ones doing these things (vs a gp doctor that has to do a diagnostic without these tools)
@bataismail8518 Жыл бұрын
This is exciting,l love to your channel,l am a first year nursing college. I will be very useful from your channel and your information,Thank you very much doctor💗💗
@DrJamesGill Жыл бұрын
Thank you 😊 Are there any areas it would help if we covered?
@gemmahamilton25652 жыл бұрын
Such a soothing voice, and love learning new things about the human body 😊 thank you for these videos, they're brilliant
@DrJamesGill2 жыл бұрын
Thanks. This one took quite a bit of work, but it’s the final part of the abdo series, so worth it. I think I’m going to redo the other masked videos now
@gemmahamilton25652 жыл бұрын
@@DrJamesGill it's definitely a video I'll revisit 😊 I look forward to seeing the rest
@Jonathan-gj2fe2 жыл бұрын
@@DrJamesGill .... would you add to the list of consideration an in-depth GALS screening tutorial? 😊 The masked version was great 👍 but I feel there's so much more to it.
@zakitadala29572 жыл бұрын
WONDERFUL it would be so good to have such explicative videos for each system 👌🏼
@DrJamesGill2 жыл бұрын
We’ve completed abdo now, we also have cardiac, knee and hip with this level of content. Also a playlist on cranial nerves examination But I think we perhaps need a step by step cranial nerve like this
@Dr..902 жыл бұрын
Did you know that I never liked MacLeod’s book and when I want to study it I go to KZbin for understanding because I do not like reading in KZbin there are many long videos and I was bored and hated studying more, but there was in me the motive of research I wanted to learn but I was unable, thank God that God guided me To you in one of the difficult coincidences, and I began to listen to your theoretical explanation with all the motive of love of learning and benefit, and I became like to study the theoretical book and I like to link your theoretical speech with practical application. There is such an effect in all of KZbin and I am sure of my words because I spent four years of my life searching and I did not find anything that matches your explanation. Thank you very much. I wish you stability and inner peace
@DrJamesGill2 жыл бұрын
It’s all about finding the type of learner you are. Many books are written from the perspective of “I want to tell you this” rather than “I want you to learn and know this”
@Dr..902 жыл бұрын
@@DrJamesGill Thank you so much
@tbip2001 Жыл бұрын
Brilliant. Also that sudden excitement in your voice when you saw the jvp react to liver pressure made me laugh
@DrJamesGill Жыл бұрын
Sometimes clinical medicine is cool!
@keithlivingstone25252 жыл бұрын
Nice to see you again Doctor (and David of course) 😁
@DrJamesGill2 жыл бұрын
The benefits of having found the internet again!
@wheelmanstan Жыл бұрын
Wow, this is extremely informative and helpful. Thanks!
@DrJamesGill Жыл бұрын
Glad it was useful😊
@JOEYFMISFIT2 жыл бұрын
Your vids are always so interesting!! How do you remember all that info!?!?! You have my absolute respect Doc!
@DrJamesGill2 жыл бұрын
Years of practice and revision. The first year of medical school, doing it the first time is HARD
@Hhgforesjkloihn2 жыл бұрын
Another perfect video to rest to, thank you once again Doctor :)
@pamw5652 жыл бұрын
Dr Gill, Love your videos. Can you tell me more about the Stethoscope you used today? I don’t think I’ve seen one like that before.
@DrJamesGill2 жыл бұрын
It’s a Littman 3000 so there is an electronic filter in it
@DGMouro2 жыл бұрын
Hi. Greetings from Argentina! I like your videos. This one is great. So many details.
@DrJamesGill2 жыл бұрын
👍👍 took a while to film, but glad it’s useful
@damebeauty3469 Жыл бұрын
@Dr James Gill Have you ever considered conducting an in person clinical course (of course paid course,your time needs to be valued lol)for doctors so we could learn from you in person.I know a lot of newly graduated doctors would love this.Please let us know
@DrJamesGill Жыл бұрын
It’s a recurring thought, but I don’t really think I’ve anything to offer beyond year 1 & 2 of med school. My knowledge base is very much basic clinical skills
@emilyb555710 ай бұрын
I think a back to basics before PACES course by you Dr Gill would actually be fantastic!
@jamierife77892 жыл бұрын
OK, the eyeballs shot in the thumbnail freaked me out! LOL!
@DrJamesGill2 жыл бұрын
Eyeball?
@jimkreider99972 жыл бұрын
I really like these videos. You learn from them.
@DrJamesGill2 жыл бұрын
So pleased you find it useful
@namdolignano93632 жыл бұрын
Bravissimo dott jamens molto professionale
@DrJamesGill2 жыл бұрын
👍
@eriklunden52182 жыл бұрын
Informative and pleasant to listen to :)
@DrJamesGill2 жыл бұрын
👍
@Pippa_McConnell2 жыл бұрын
2:45 MVP throw
@rtetal9562 жыл бұрын
How does an abdominal examination vary in terms of patient BMI? How does a patient with a lot of abdominal fat or obesity affect both palpitation and percussion?
@DrJamesGill2 жыл бұрын
It becomes more difficult that is for certain
@facundogomez45132 жыл бұрын
Greetings from Uruguay!!!
@DrJamesGill2 жыл бұрын
Welcome 😊
@ignotas5572 жыл бұрын
The GOAT 🙌
@lghostlyl5993 Жыл бұрын
Ok there is a question I have is your stomach does have like a pulse (as in it moves up and down) when relax what might that suggest?
@tommoj37682 жыл бұрын
After watching this video… I can confirm I am not an alcoholic 😰 I was worried
@DrJamesGill2 жыл бұрын
This video identified clinical markers of liver disease. What is that makes you feel you are an alcoholic? You don’t have to have liver damage to be an alcoholic
@tommoj37682 жыл бұрын
Ohh ok… so I’m an alcoholic… but with good liver I guess 🤷🏻♂️
@lukepearson8918 Жыл бұрын
Can you do "deep dives" for the other systems?
@CLIPATOАй бұрын
Thank u
@XX-gy7ue2 жыл бұрын
EXCELLENT
@DrJamesGill2 жыл бұрын
👍
@demetriusjones8712 Жыл бұрын
Great video
@TenkoBerry Жыл бұрын
This is Good 👍
@mgq8252 жыл бұрын
Greeaaat
@DrJamesGill2 жыл бұрын
👍
@mgq8252 жыл бұрын
@@DrJamesGill thanks for all your work!
@gabrielesimionato12102 жыл бұрын
2:40 shirt removal was not bad. 6/10
@DrJamesGill2 жыл бұрын
Hahahaha. Someone really should put up a chart!
@alexdenton6586 Жыл бұрын
I’ve just discovered I have clubbing What does it means ?? My doctor never made me do that taste before
@TessasDaddy7132 Жыл бұрын
I agree with the doctor.he’s definitely not pregnant lol 😂
@DrJamesGill Жыл бұрын
👍
@leonamotejlkova832810 ай бұрын
Tajo... mohl by mi někdo také namasírovat zádíčka? 🤭 a prsíčka😋
@ADjustinG2013 Жыл бұрын
Balloting the kidneys sounds like a great way to knock stones loose...
@MyDadsYouTube2 жыл бұрын
25:22 I never seen that before
@Ban-dp4gp Жыл бұрын
Please we want to see models
@DrJamesGill Жыл бұрын
Unfortunately I’ve only been able to use the abdominal model once, as the plastic model is too expensive to buy
@Ban-dp4gp Жыл бұрын
@@DrJamesGill ya I totally comprehensive totally true but in a same time in osce examination , thoose models use there
@outlawbrandiewales2 жыл бұрын
USA doct. Ck ur labs blood pressure weight ask any problems then ur done.
@DrJamesGill2 жыл бұрын
They will be getting a lot of additional information when they are looking at a patient too
@bofa83 Жыл бұрын
Which is exactly why people hate going to the doctor in the states.
@generalmunchiesАй бұрын
u look like kevin from shameless
@memetpajaziti3434 Жыл бұрын
Hi doc, I am diagnosed with peptic ulcer but h.pylori negative, can spicy food or stress cause it ?
@mebarak062 жыл бұрын
Awe.! Everyone left the chat. 😭😭😭
@DrJamesGill2 жыл бұрын
It seemed to crash out here.
@cleocatra9324 Жыл бұрын
Im so confused I’ve had 2 clinic drs tell me different things . At least I dont have rabies.
@DrJamesGill Жыл бұрын
I’m sorry to hear that. Unfortunately medicine is an art and a science. Often it’s about fitting things to patterns. Hopefully you’ve an answer you can work with 😊
@cleocatra9324 Жыл бұрын
@@DrJamesGill thank you sir. As of now they determined my kidney pain swelling is ‘idiopathic” which points to autoimmune disease. I also have erythromelalgia ( a blood vessel disorder). They want to try Humira injection for me. I enjoy your videos you have a calming nature.
@pacifiquebusiness11 ай бұрын
I study school medical Yale 22:05
@williamwinder3466 Жыл бұрын
4:38 Women have more testosterone then estrogen.
@DrJamesGill Жыл бұрын
Very true. One of the issues with the classic graph showing female oestrogen and testosterone is the two different scales used on the same graph
@YourNeedxim2456 Жыл бұрын
At this point anybody can become a doctor lmfao
@DrJamesGill Жыл бұрын
I’m actually of the opinion, if you can pass the OSCES, the written papers and the TDOCS then yes Anyone is allowed to sit a driving test. Meet the criteria, pay the fees, sit the test. Bingo
@DrJamesGill Жыл бұрын
That said, I can’t imagine how difficult “self taught” medicine would be
@Jake_1988 Жыл бұрын
How dare you assume his gender!! Damnit I’ve done it too!
@Dermeister009 Жыл бұрын
" patients being pregnant , not going to be the case here" i dunno man they are trying to tell use in the past few years that men can get pregnant... Don't assume as you will be called a biggot.
@tipoftheiceberg7034 Жыл бұрын
Pretty muscular guy right there. Even his obliques are lookin good