Image: Sir Willam Osler at a patient's bedside
"The history and physical examination remain the backbone of medical evaluation and assessment. However, the many advances in both laboratory and imaging technology and the pace of modern medicine have resulted in the physical examination being abbreviated and undervalued, and viewed (subconsciously, perhaps) as redundant.
Although few studies examine physical diagnosis skills over successive generations of physicians, skill and familiarity with certain bedside maneuvers and confidence in eliciting physical signs appear to have declined, with increased dependence on the aid of a radiologist or first-tier laboratory data. The new student on the wards soon finds that skills at the computer in getting data back and arranging for tests to be done are valued as much or more than learning to percuss well or hear a pericardial friction rub. At times, it almost seems as if the patient in the bed is an icon for the real patient who exists in the computer, and 'rounds' (a word that in this context connotes motion) are conducted with the participants immobile and seated in a room and with the patient represented either on an index card or a PDA (personal digital assistant) screen."
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If your doctor is paying more attention to his gadgets and to test results than to you and what you tell him, maybe it's time to worry...
