They should be thought of as complimentary information. Since it is not anticipated that one should accurately detect all of the abnormalities on exam, we should learn to accept not detecting lesions . We should also learn to be honest in our elicitation of findings. Prejudice can influence the results easily. If one pays close attention to history, one can anticipate findings in the chest.
Clinical exam is more like detective work .
Information gathered during general exam will help you anticipate problems. Then focused or prejudiced exam can be done to elicit an abnormality. I divide pulmonary exam into screening and focused or prejudiced exam. Screening exam should be done in all cases. Focused physical exam is conducted in selected cases after history and screening exam have identified certain problems.