Charting a physical assessment means physical assessment, not reviewed patient's chart. I work in ICU so I am familiar with how much time a doc may spend on an ICU patient. I fully understand that docs have huge demands on their time. I also understand that they have access to xrays/lab/vitals/fluid status etc prior to ever showing up. I understand they may have spent more time than I personally have seen with my own eyes and do quite a bit of work behind the scenes.
We have some great docs on my unit and it is obvious they are paying attention. We also have some crappy ones who do not pay attention, rely on the nurses and residents to point things out to them, and this is also obvious. It is obvious when their charting does not match (could not) match the patient's /condition/test results/etc. It is obvious when they are entering d/c orders on patients who are either stopped from transferring by an attentive RN/resident or turned right back around and re-admitted by the receiving floor because they are clearly in trouble.
Literally the assessments, notes, and plans they are charting totally contradicts the patient's test results, physical condition, ER presentation and computer captured vitals. If they would have at least laid eyes on the patient they would have noticed something wrong. Like the patient is breathing 40 bpm's, is on a NRB, is gray, and is absolutely not WNL respitorially and ready to be transferred out.
Doctors are not the only ones guilty of this, RN's, resident's, RT's, etc are as well. When you have a group of them all working on the same patient for multiple shifts patients can and do get in trouble. When you can literally go through the chart and track an expanding bleed via CT for days on the patient who crumped "suddenly" despite being A&Ox4, GCS 15, PERRLA bilaterally, MAE for those same amount of days?
When these incidents happen repeatedly, to the same people, over and over again?
And it may not even be an issue of malicious intent. In some cases it may be inexperience/not realizing what they are seeing, difficult dx's etc. Like the tricky foot fx that isn't totally visible on xray. If you never go in and look at the foot, see the swelling, bruising, etc. for yourself.
Physical assessment is important in my opinion. Even with x-ray, labs, CT, reliable notes etc. I know that my RN and MD coworkers as well as myself have caught things just by physical assessment alone. DVT's, dehissed wounds, fractures, etc. Even if all you glean from your physical assessment is that the patient just doesn't look right at least you know to keep a closer eye on them.