At one point, clinical skills of physicians were the subject of research in medicine. Today, evidence-based medicine researchers tell women how often to have a pelvic exam. Both patients and clinicians suffer at the hands of the researcher's meta-analysis and systematic review. The clinician must tell the patient what the latest peer-reviewed paper said the astute clinician should do as the patient's abdomen remains unexamined.

Dennis

Dennis Mazur

I think a blend of technology and examination of patient could be the best option, as the computer has the capacity to tabulate tests results etc. that can be helpful to the clinician and reduce the amount type spent in the actual clinical analysis: Here's are related links in RG:

Article Use of Computer Technology to Modify Objective Structured Cl...

https://www.researchgate.net/search.Search.html?type=publication&query=advance%20of%20technology%20setting%20the%20stage%20for%20dwindling%20clinical%20examination%20and%20clinical%20analysis%20skills

Best regards,

Debr

Agree with dr@

Debra Sharon Ferdinand-James

Of a truth technology advancement has set the stage for quick and more accurate diagnosis of cases. However just like Debra Sharon, both clinical skills and technology work better results. There are some aspects of body examination that would need thorough observation by an experienced eye and thorough palpation by an experienced hand. They are quite inseperable. The spate of poor or wrong diagnosis presently is for the neglect of the old, which is he clinical skills. The old should not be discarded for the birth of the new. Both old and new approaches in medicine can save the day for the patient.

• Clinton, the human body is like a string quartet. When the quartet is strummed properly, it releases the divine music that lies hidden or latent within it.
• Technology does the reverse. It un-strums the human body. A good doctor knows how to treat, the better doctor knows when to treat, and the best doctor when not to treat. For a doctor with reverence for the human body, the perfect machine of creation, the strings of the quartet align by themselves to reveal what is hidden to the eye. Technological advances has robbed that reverence from the practitioners of medicine.
• The pinnacle of reverential handling of the body is the ease with you diagnose atrial fibrillation from the missing 'a' wave of the JVP, comfortably assess the x and y descents of the JVP and HJR, establish paradoxical pulse, the dicrotic aortic pulsation as well as Quincke's pulsation or first degree clubbing, d/d the mid-diastolic rumble, hear with delight the reversed splitting of the second heart sound in RBBB and the click-murmur of MVP, appreciate early and late para-sternal lift of ASD or RVH or the loss of percussion dullness over the liver to suspect intestinal perforation, palpate a mildly enlarged spleen in the right lateral decubitus, declare a doughy abdomen and rebound tenderness with confidence, know about the Baid sign for pseudo-pancreatic cyst, know how to elicit the Babinski sign from several locations over the affected leg, be able to palpate a soft liver that USS/USG misses...When you master all this and much more, the human body speaks to you itself in gratitude of being in the hands of a master.
• The touch-feel school has what the modern generations are gradually losing: logic or commonsense and ESP. If standing by the bedside does not instill you with a fear of your own dissolution, does not drown you in a sense of responsibility such as law and legality cannot, does not overwhelm you with awe for the super-machine called the human body, does castrate you through your vast field of ignorance and uncertainties, and does not deafen with you with the terms idiosyncratic or empirical or stress, you do not qualify to be called a doctor--regardless of the fellowships or the memberships that you suffix.
• Remember, no ESP if you do not touch.

Great Sir!

• I described for the first time the concept of occult sarcoidosis as the body spoke to me (see file), for a patient initially managed at Manchester, UK for 18 months. I believe that this work affects three-fifths of humankind.
• The strumming of the body and its secrets are still locked in my mind as I have another giant focus on the field of research-migraine, that affects one fifth of humankind.
• Clinton, you would benefit tremendously just to read the preface and epilogue of my book, Adaptive Mechanisms in Migraine, Nova Science, New York, 2009--an exercise in pure esoteric strumming of the human body coaxing it to reveal its secrets, a book that is must-read for all doctors for all times. In Jan 2003, I was recognized as a Living Legend. But I have much more to do yet.
• Happy reading.

O quite grateful, Sir!

Hello Vinod Kumar Gupta

I realise it is a long time since you first started this question/thread but I think the topic is always relevant and I totally agree that medicine today - and I have observed this practice and have observed students following this behaviour - is totally ignoring clinical skills, history-taking/examination and instead ordering lots of expensive tests

@Lee

Now, Google does everything, effortlessly. No effort is required by students. A price is paid for every scientific advancement. Like obesity for cars, elevators, escalators, and refrigerators.