Can Physical Examination Skills Survive the Era of Modern Diagnostic Tests?

This article was migrated. The article was marked as recommended. There is a perception by the internal medicine community that physical examination skills have declined amongst both learners and teachers of medicine. A sense of lack of time and the development of more sensitive and specific diagnostic tests are amongst some of the reasons for this phenomenon. Internists need to be familiar with the clinical usefulness of physical examination maneuvers learned during medical school and residency training so that they know, at the bedside, what to focus on during the patient encounter. Here I would like to highlight some of these easy to perform physical examination signs that some data argues for and support their clinical utility in daily practice in the era of modern diagnostic technology. These are: the third heart sound; maximal tracheal height and Hoover's sign; the "HINTS" examination for patients with vertigo; and simple bedside questions to screen for delirium.