Performance and Duration of Physical Examination in Outpatient Care: A Cross-sectional Study across Medical and Surgical Specialties in Morocco

CONTEXT: Physical examination (PE) remains a cornerstone of clinical assessment. However, its role in contemporary outpatient practice is evolving amid increasing reliance on diagnostic technologies. AIMS: This study aimed to evaluate the frequency and duration of PE and to identify physician, and consultation-related determinants associated with its use in outpatient care. SETTINGS AND DESIGN: A cross-sectional observational study was conducted in a regional public hospital in Morocco between February and November 2024. SUBJECTS AND METHODS: Data collected included physician characteristics, PE performance, consultation type, time allocated to PE, physician-patient communication, and test-result review. Consultation processes were directly timed using a standardized recording protocol. STATISTICAL ANALYSIS USED: Associations with PE performance were examined using Chi-square and nonparametric tests, while determinants of PE duration were analyzed using a generalized linear model with Gamma distribution and a log-link function. RESULTS: A total of 634 consultations involving 42 physicians across 13 medical and surgical specialties were observed. PE was performed in 57.6% of consultations and occurred significantly more frequently during first visits than follow-up visits (P < 0.001). PE performance was not associated with physician characteristics. Greater time spent reviewing diagnostic test results was associated with a lower likelihood of performing PE (P < 0.001). Follow-up visits and surgical specialties were associated with shorter examination duration, whereas communication time and test-result review time were independently associated with longer PE duration (P ≤ 0.010). CONCLUSION: PE remains a core element of outpatient care, functioning as a context-dependent diagnostic practice embedded within clinical reasoning processes.