Abstract

There is a newfound interest in bedside diagnosis; however, we are hesitant to call it a movement. Perhaps the best signal that the pendulum is swinging back comes from the Institute of Medicine’s report Improving Diagnosis in Health Care,¹ which states, “There are growing concerns that traditional “bedside evaluation” skills (history, interview, and physical examination) have received less attention due to the large growth in diagnostic testing in medicine … these methods were once the primary tools for diagnosis and clinical evaluation, but the recent explosion of imaging and laboratory testing has inverted the diagnostic paradigm. [Clinicians] often bypass the bedside evaluation for immediate testing.” The report continues, “A careful physical exam can help a clinician refine the next steps in the diagnostic process, can prevent unnecessary diagnostic testing, and can aid in building trust with the patient ….” We share these views. The bedside is where the patient is, and diagnosis needs to begin there.