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November 2016

Preserving Physical Diagnosis—A Time-honored Art

Author Affiliations
  • 1Department of Dermatology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
  • 2Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
JAMA Dermatol. 2016;152(11):1217. doi:10.1001/jamadermatol.2015.2237

Physicians of old were masters of eliciting relevant diagnostic information through their physical examination skills. Rich descriptions of disease presentations formed the basis of study, and the most proficient practitioners would render accurate diagnoses by gleaning subtle signs by using all 5 senses. In the past century, burgeoning advances in imaging, genetic, and serologic technology have allowed us to enhance our diagnostic accuracy and even to uncover nascent and as-yet undeclared disease. The art form of physical diagnosis is at risk in our modern age: teaching physical examination skills may suffer as medical school curricula expand to include a myriad of technological advances, and the value of possessing such skills may be questioned as we become more reliant on adjunctive tests for diagnosis. The scope of curriculum in dermatology residency training has similarly increased and many subspecialty areas compete for residents’ attention.

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