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Views & Reviews From the Frontline

Bad medicine: chest examination

BMJ 2012; 345 doi: (Published 04 July 2012) Cite this as: BMJ 2012;345:e4569

Rapid Response:

Re: Bad medicine: chest examination

Really important that challenging articles like this are put into the clinical and medical education domains. Any clinician who works with children knows that clinical signs often in no way equate to radiological findings and eventual diagnosis.

However I worry that the overall tone de-emphasises clinical acumen at the expense of further investigation and observation. I firmly believe that clinical exam has a clear place and, yes, being able to hear a pleural rub may actually be a futile education goal but being able to be confident you have heard no signs is vital.

Teaching the recognition of wellness and unwellness is underplayed and needs re-emphasising but any suggestion that clinical exam is not a cohort part of a whole assessment sets a worrying precedent. Not because is is supported by evidence (and as pointed out there is very little) but we need no further encouragement to adopt a less hands on approach to patient diagnosis.

Competing interests: No competing interests

05 July 2012
Damian T Roland
Paediatric Emergency Medicine
Leicester University
University Hospitals of Leicester NHS Trust, LE1 5WW