NAPH members gathered this morning for the 2012 Annual Conference opening session to hear from a man who was shaped by a rural public hospital on the Tennessee border. “I cut my teeth there. I admire your mission and am honored to be here today,” said Abraham Verghese, MD, MACP.

Verghese is far from his days in Johnson City, but the lessons he learned there, caring for numerous AIDS patients who could use little more than a compassionate companion at their bedside as they died, stayed with him throughout his career. Today, he is a best-selling author and serves as a professor for the theory and practice of medicine and senior associate chair in the department of internal medicine at the Stanford University School of Medicine. And as he traveled north from Palo Alto to our meeting in San Francisco, he brought those long-ago learned, but not forgotten, lessons with him.

He offered a short history of the practice of medicine, describing its progression from the “barber system” in which doctors made no attempt at diagnosis, to the practice of using the physical examination – aided by practices and tools such as percussion, the reflex hammer and the stethoscope – to diagnose patients’ problems.

The point of his message was the physical examination. He described the medical students he works with, who come to medicine hoping their work will involve reading the body for signs of illness, only to find that they more often are reading the monitor, the data on the screen, while the patient lies forgotten on the bed. He described the ritual of giving the physical exam – how it can quiet even the loudest mind, the fiercest voice. It’s a partnership between the doctor and the patient, a bond that both, in their own way, must submit to in order to move forward in a collaborative effort to improve health. “We engage in this ritual to signal a transformation,” Verghese explained. “It’s a ritual at the heart of health care.”

“Don’t get me wrong, I’m not a Luddite,” Verghese warned. “I believe in technology, but I bring it to bear at the bedside.”

In closing, Verghese asked us to join him and his team at Stanford in reviving the culture of bedside medicine and proving to the patient that even though we are aided by tools and technology, we are addressing the patient and his physical body, not leaving him lying, forgotten, on the bed.