Has Medicine Outgrown Physical Diagnosis?
Authors: Robert H. Fletcher, Suzanne W. Fletcher
Journal: Annals of Internal Medicine (1992)

Editorials1 November 1992Has Medicine Outgrown Physical Diagnosis?Robert H. Fletcher, MD, Suzanne W. Fletcher, MDRobert H. Fletcher, MD, Suzanne W. Fletcher, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-9-786 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPhysical diagnosis has been the centerpiece of internal medicine throughout its history. Clinicians' diagnoses were made primarily with their ears, eyes, hands—and sometimes nose. Now diagnosis is more often based on results from machines such as CT and MRI scanners, and laboratory tests that are applications of discoveries in molecular biology, such as ELISA and RIBA. Technologic advances have extended diagnostic capabilities enormously. Only 9% of people with mitral valve prolapse documented by echocardiography have physical findings of the condition (1). The early, nonspecific symptoms of AIDS, such as weight loss and diarrhea, were easily confused with other conditions until...References1. SavageDevereuxGarrisonCastelliAndersonLevy DRRWSD. Mitral valve prolapse in the general population. 2. Clinical features:The Framingham Study. Am Heart J. 1983;106:577-81. CrossrefMedlineGoogle Scholar2. St. ClairOddoneWaughCoreyFeussner EERGJ. Assessing housestaff diagnostic skills using a cardiology patient simulator. Ann Intern Med. 1992;117:751-6. LinkGoogle Scholar3. NoelHerbersCaplowCooperPangaroHarvey GJMGLJ. How well do internal medicine faculty members evaluate the clinical skills of residents? Ann Intern Med. 1992;117:757-65. LinkGoogle Scholar4. PetersonHolbrookVon HalesSmithStaker MJDNL. Contributions of the history, physical examination, and laboratory investigation in making medical diagnoses. West Med J. 1992;156:163-5. MedlineGoogle Scholar5. Kortepeter M. MRI: My resonant image. [Letter]. Ann Intern Med. 1991;115:749-50. LinkGoogle Scholar6. WilliamsSimelRobertsSamsa JDLG. Clinical evaluation for sinusitis. Making the diagnosis by history and physical examination. Ann Intern Med. 1992;117:705-10. LinkGoogle Scholar7. Sackett D. The science of the art of the clinical examination. JAMA. 1992;267:2650-2. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. 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A time study of internal medicine house staff daysBeyond Heart Sounds: an interactive teaching and skills testing program for cardiac examination 1 November 1992Volume 117, Issue 9Page: 786-787KeywordsAIDSComputed axial tomographyDiarrheaEchocardiographyEnzyme linked immunosorbent assayHistory of medicineLaboratory testsMitral valve prolapseMolecular biologyWeight loss Issue Published: 1 November 1992 PDF DownloadLoading ...