I don’t know if I would’ve caught the aortic dissection. I doubt that I would’ve, given that I have yet to do a perfect P.E. Nonetheless, this makes me glad to know that there is an endpoint to what we’re learning, and why we have to take many many histories and do as many physical exams in a week.
My med school doesn’t have the same attitude towards a physical exam as this guy, partly because many people can’t afford the diagnostic tests. These patients save their money for the treatments that their illnesses require. “Routine” exams are abhorred; professors will roast you if you cannot defend your request for labs.
The physical exam may not be as accurate as all these diagnostic tests. But when you’re able to diagnose mitral regurgitation with a stethoscope and your hands, OMG!