I really appreciated Dr Walton’s germane reflection on the role the physical examination seems to play in patient assessment these days [BCMJ 2021;63:102 [11]]. I’m one of those Neanderthal retired family docs who practised before CT scans, MRIs, and other magical technologies.

An acute appendix was first on a differential diagnosis as the result of history and specific physical examination. It was okay to then proceed to the OR, recognizing that it might rarely end as an exploratory event. It’s now quite kosher to listen to breath and heart sounds through clothing—it’s happened to me, by a fine young physician. The world moves on, but practising the fine points of physical diagnosis need not be a dying art.
—Neil Finnie, MD
Victoria

This letter was submitted in response to “The lost art of physical examination.” [11]