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Editorials |

Has Medicine Outgrown Physical Diagnosis?

Robert H. Fletcher, MD; and Suzanne W. Fletcher, MD
Ann Intern Med. 1992;117(9):786-787. doi:10.7326/0003-4819-117-9-786
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Physical diagnosis has been the centerpiece of internal medicine throughout its history. Clinicians' diagnoses were made primarily with their ears, eyes, hands—and sometimes nose. Now diagnosis is more often based on results from machines such as CT and MRI scanners, and laboratory tests that are applications of discoveries in molecular biology, such as ELISA and RIBA. Technologic advances have extended diagnostic capabilities enormously. Only 9% of people with mitral valve prolapse documented by echocardiography have physical findings of the condition (1). The early, nonspecific symptoms of AIDS, such as weight loss and diarrhea, were easily confused with other conditions until


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