Better rectal examinations: technique, teaching, teamwork

Rectal examinations of adults have fallen into less and less use, with some claiming of a reduced role in suspected appendicitis, to evaluate gastrointestinal bleeding, and in screening for prostate cancer1, 2. Many authors lament the reduction in rectal examinations. Why does it matter? Efficacy and cost-efficiency are universally acknowledged. But there is another reason: relationship-building, as the patient realizes that no part of the body is off-limits or repugnant to a concerned examiner. Even in palliative care, where one might wonder if the intrusion and discomfiture are warranted, there is compelling rationale for selective use3.