The Assembly Line Approach for Siblings

Nashville, Tenn

Practical Pointer
Discover Shortcuts Devised by Colleagues

Beginning with the oldest, calmest patient, I auscultate the heart, lung, and abdomen. I do the same for each patient working my way to the youngest—and typically most anxious—child. Following the same order, I examine the eyes, ears, and other systems. I usually examine the musculoskeletal system last, because this does not require patients to be in a seated position. By the end of the When I have more than 1 patient per visit (ie, siblings), I attempt an assembly line approach. This allows for a more efficient visit; I first collect the history and share anticipatory guidance then perform the physical examination. examination, this looks like a game to the younger kids. The assembly line approach is especially useful for well visits. This approach can be used for sick children; however, the clinician has to focus more on the affected system and remember any atypical findings.   ■