In her recent NY Times article http://www.nytimes.com/2010/08/03/health/03case.html?_r=1&ref=health Dr Danielle Ofri describes the significance of physically touching her patients during their examinations. I could not concur more.
There is no question that human beings need to connect with each other and that physical touch is crucial to making this happen. Neural impulses from our skin, in the context of personal contact, very likely evoke neurochemical responses in our brains. Neurotransmitters then released can impact upon our immune systems as well as to calm our "flight or fight" responses. The touch, therefore, can be calming, reassuring and ultimately healing.
This occurs on a person-to-person level as we can all attest to. It is the very nature of animal/pet interactions. And it is a crucial element in the patient-doctor encounter as well.
There is an intimacy to this relationship which cannot be measured or quantified. It may be reflected in the notion of "bedside manner". It is an aspect of this interaction in which often subtle signs of illness are transmitted through touch to the clinician. Likewise, the confident, reassuring touch which occurs during an examination may allay a patients fears and allow them to truly share their physical and emotional state of being with the physician.
It is no coincidence that when we feel an emotional connection with someone or something that we speak of "being touched". It reflects how closely our skin and our brain interact.
As physicians we either consciously or more subtly understand that a patient gives us very special permission when we physically examine them. Physical contact which would be otherwise extremely embarrassing and taboo under normal circumstances is allowed within the context of the patient-doctor relationship.
We should deeply respect this relationship and understand the subtle interactions that are occurring.
Often unappreciated is the mutual nature of healing that occurs with touching. I routinely shake hands with all of my patients (unless I kiss some whom I have known for years). At times I can actually recognize in myself a sense of being present in that moment. I recognize, in that personal touch, the deep trust that has been placed in my hands. It allows me to focus all my thoughts and efforts on that patient in that healing time and place.
It is a sacred moment in which both patient and physician "are touched".