Bio

Clinical Focus


  • Internal Medicine
  • Medical Education
  • Bedside Exam
  • The Patient-Physician relationship
  • Medical Errors
  • Story and Ritual of Medicine

Academic Appointments


Administrative Appointments


  • Faculty, Stanford Center for Biomedical Ethics (2009 - Present)
  • Adjunct Faculty, Freeman Spogli Institute: Stanford Health Policy (2010 - Present)
  • Clerkship Director, Stanford University, Department of Medicine (2007 - Present)
  • Vice Chair for the Theory & Practice of Medicine, Stanford University, Department of Medicine (2007 - Present)

Honors & Awards


  • National Humanities Medal, President Obama and the National Endowment for the Arts (2016)
  • Fellow of the Royal College of Physicians, Edinburgh, Royal College of Physicians, Edinburgh (2014)
  • Honorary Doctorate, Royal College of Surgeons of Ireland (2014)
  • The Heinz Award in Humanities, The Heinz Foundation (2014)
  • Doctor of Humane Letters (Hon), Upstate Medical University, SUNY Syracuse (2012)
  • Member, Institute of Medicine, National Academy of Sciences (2011)
  • Doctor of Humane Letters (Hon), University of Northern Illinois (2007)
  • John P. McGovern Medal, Osler Society, Montreal (2007)
  • Member, Association of American Physicians, Association of American Physicians (2006)
  • Master, American College of Physicians (2005)
  • Doctor of Science (Hon), Swarthmore College (2001)

Professional Education


  • Residency:East Tennessee State University Medicine (1983) TN
  • Medical Education:Madras University Medicine (1980) India
  • Master of Fine Arts, The University of Iowa, Fiction (1991)
  • Board Certification: Pulmonary Disease, American Board of Internal Medicine (1988)
  • Board Certification: Infectious Disease, American Board of Internal Medicine (1986)
  • Fellow in Infectious Diseases, Boston Univ School of Medicine, Infectious Diseases (1985)
  • Board Certification: Internal Medicine, American Board of Internal Medicine (1983)

Research & Scholarship

Current Research and Scholarly Interests


My interest is in clinical skills and the bedside exam, both in its technical aspects, but also in the importance of the ritual and what is conveyed by the physician's presence and technique at the bedside. This work interests me from an educational point of view, and also from the point of view of ethnographic studies related to rituals and how they transform the patient-physician relationship. Recently we have become interested in medical error as a result of oversights in the bedside exam.

Teaching

Publications

All Publications


  • Evolutionary Pressures on the Electronic Health Record: Caring for Complexity. JAMA Zulman, D. M., Shah, N. H., Verghese, A. 2016; 316 (9): 923-924

    View details for DOI 10.1001/jama.2016.9538

    View details for PubMedID 27532804

  • I Carry Your Heart. JAMA cardiology Verghese, A. 2016; 1 (2): 213-215

    View details for DOI 10.1001/jamacardio.2015.0353

    View details for PubMedID 27437895

  • Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes AMERICAN JOURNAL OF MEDICINE Verghese, A., Charlton, B., Kassirer, J. P., Ramsey, M., Ioannidis, J. P. 2015; 128 (12): 1322-?
  • Clinical education and the electronic health record: the flipped patient. JAMA Chi, J., Verghese, A. 2014; 312 (22): 2331-2332

    View details for DOI 10.1001/jama.2014.12820

    View details for PubMedID 25490318

  • A piece of my mind. The road back to the bedside. JAMA-the journal of the American Medical Association Elder, A., Chi, J., Ozdalga, E., Kugler, J., Verghese, A. 2013; 310 (8): 799-800

    View details for DOI 10.1001/jama.2013.227195

    View details for PubMedID 23982364

  • The Attending Physician on the Wards Finding a New Homeostasis JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Wachter, R. M., Verghese, A. 2012; 308 (10): 977-978

    View details for Web of Science ID 000308579300017

    View details for PubMedID 22968883

  • The Bedside Evaluation: Ritual and Reason ANNALS OF INTERNAL MEDICINE Verghese, A., Brady, E., Kapur, C. C., Horwitz, R. I. 2011; 155 (8): 550-U125

    Abstract

    The bedside evaluation, consisting of the history and physical examination, was once the primary means of diagnosis and clinical monitoring. The recent explosion of imaging and laboratory testing has inverted the diagnostic paradigm. Physicians often bypass the bedside evaluation for immediate testing and therefore encounter an image of the patient before seeing the patient in the flesh. In addition to risking delayed or missed diagnosis of readily recognizable disease, physicians who forgo or circumvent the bedside evaluation risk the loss of an important ritual that can enhance the physician-patient relationship. Patients expect that some form of bedside evaluation will take place when they visit a physician. When physicians complete this evaluation in an expert manner, it can have a salutary effect. If done poorly or not at all, in contrast, it can undermine the physician-patient relationship. Studies suggest that the context, locale, and quality of the bedside evaluation are associated with neurobiological changes in the patient. Recognizing the importance of the bedside evaluation as a healing ritual and a powerful diagnostic tool when paired with judicious use of technology could be a stimulus for the recovery of an ebbing skill set among physicians.

    View details for DOI 10.1059/0003-4819-155-8-201110180-00013

    View details for Web of Science ID 000296066300022

    View details for PubMedID 22007047

  • Internal Medicine Residency Redesign: Proposal of the Internal Medicine Working Group AMERICAN JOURNAL OF MEDICINE Horwitz, R. I., Kassirer, J. P., Holmboe, E. S., Humphrey, H. J., Verghese, A., Croft, C., Kwok, M., Loscalzo, J. 2011; 124 (9): 806-812

    Abstract

    Concerned with the quality of internal medicine training, many leaders in the field assembled to assess the state of the residency, evaluate the decline in interest in the specialty, and create a framework for invigorating the discipline. Although many external factors are responsible, we also found ourselves culpable: allowing senior role models to opt out of important training activities, ignoring a progressive atrophy of bedside skills, and focusing on lock-step curricula, lectures, and compiled diagnostic and therapeutic strategies. The group affirmed its commitment to a vision of internal medicine rooted in science and learned with mentors at the bedside. Key factors for new emphasis include patient-centered small group teaching, greater incorporation of clinical epidemiology and health services research, and better schedule control for trainees. Because previous proposals were weakened by lack of evidence, we propose to organize the Cooperative Educational Studies Group, a pool of training programs that will collect a common data set describing their programs, design interventions to be tested rigorously in multi-methodological approaches, and at the same time produce knowledge about high-quality practice.

    View details for DOI 10.1016/j.amjmed.2011.03.007

    View details for Web of Science ID 000294043100019

    View details for PubMedID 21854887

  • The Physical Exam and Other Forms of Fiction J Gen Intern Med Kugler J, Verghese A 2010
  • Cutting for Stone A novel published by Vintage Books Edition, NY Verghese A 2010
  • Cutting for Stone A novel published by Alfred P. Knopf, NY Verghese A 2009
  • A touch of sense "Health Affairs Verghese A 2009; 24 (8): 1177-82
  • Learning bedside medicine. The virtual mentor : VM Kugler, J., Verghese, A. 2009; 11 (11): 900-903
  • In Praise of the Physical Examination British Medical Journal Verghese A, Horwitz RI 2009; 339: 5448
  • The Five-Minute Moment. American journal of medicine Chi, J., Artandi, M., Kugler, J., Ozdalga, E., Hosamani, P., Koehler, E., Osterberg, L., Zaman, J., Thadaney, S., Elder, A., Verghese, A. 2016; 129 (8): 792-795

    Abstract

    In today's hospital and clinic environment, the obstacles to bedside teaching both for faculty and trainees are considerable. As Electronic Health Records (EHR) systems become increasingly prevalent, trainees are spending more time performing patient care tasks from computer workstations, limiting opportunities to learn at the bedside. Physical examination skills are rarely emphasized and low confidence levels, especially in junior faculty, pose additional barriers to teaching the bedside exam.

    View details for DOI 10.1016/j.amjmed.2016.02.020

    View details for PubMedID 26972793

  • My Own Country: A Doctor's Story of a Town and Its People in the Age of AIDS Simon & Schuster, New York, NY 1994. Verghese A
  • The Tennis Partner: A Doctor's Story of Friendship and Loss 1998 Aug. (Harper Collins in the USA, Vintage in the UK, Penguin in India). 1999 Oct Paperback version (by Harper Perennial in the USA and Vintage in UK) Verghese A
  • How valuable is physical examination of the cardiovascular system? BMJ (Clinical research ed.) Elder, A., Japp, A., Verghese, A. 2016; 354: i3309-?

    Abstract

    Physical examination of the cardiovascular system is central to contemporary teaching and practice in clinical medicine. Evidence about its value focuses on its diagnostic accuracy and varies widely in methodological quality and statistical power. This makes collation, analysis, and understanding of results difficult and limits their application to daily clinical practice. Specific factors affecting interpretation and clinical application include poor standardisation of observers' technique and training, the study of single signs rather than multiple signs or signs in combination with symptoms, and the tendency to compare physical examination directly with technological aids to diagnosis rather than explore diagnostic strategies that combine both. Other potential aspects of the value of physical examination, such as cost effectiveness or patients' perceptions, are poorly studied. This review summarises the evidence for the clinical value of physical examination of the cardiovascular system. The best was judged to relate to the detection and evaluation of valvular heart disease, the diagnosis and treatment of heart failure, the jugular venous pulse in the assessment of central venous pressure, and the detection of atrial fibrillation, peripheral arterial disease, impaired perfusion, and aortic and carotid disease. Although technological aids to diagnosis are likely to become even more widely available at the point of care, the evidence suggests that further research into the value of physical examination of the cardiovascular system is needed, particularly in low resource settings and as a potential means of limiting inappropriate overuse of technological aids to diagnosis.

    View details for DOI 10.1136/bmj.i3309

    View details for PubMedID 27598000

  • Caring for Ivan Ilyich J Gen Intern Med Charlton B, Verghese A 2010; 25 (1): 93-5
  • Culture Shock: The Patient as Icon, Icon as Patient New England Journal of Medicine Verghese A 2008; 359 (26): 2748-51
  • The Calling New England Journal of Medicine Verghese A 2005; 352 (18): 1844-7

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