The Physical Examination—Use It or Lose It

It is true that physical examination findings have their limitations, but I agree with Dr. Alpert that we should not be too hasty to rid ourselves of looking.1 I suspect there are levels of sensitivity, with more advanced disease findings being easier to detect accurately. I find that feedback from imaging studies helps me, hopefully, to improve my examination skills. Without the clinical history and examination, ordering the appropriate imaging techniques is at best a guess, and the incidentalomas found lead to a diagnostic cascade that often does not benefit the patient.