>>>She writes at length about doctors not being taught to do physical exams, and the consequences thereof.
>
>US training is slightly different, but collegiate training has enormous emphasis on physical exam. But it involves time and inconvenience for patients to undress compared to delegated ticking of boxes on a form, so here we go again.
>
>In fact the main emphasis of training probably should go on taking a history, or listening as described in your books, which historically provided 80% of the diagnosis AND is what paitients most appreciate = the wise counsel in time of trouble. Ironically the internet can be quite good at listening if you can't get a human to sit down and engage which creates lots of opportunities for snake oil salesmen. Meanwhile in healthcare, what mostly is listened to these days is the sharp in-drawing of breath as the serum rhubarb is extracted, and the chirping and pinging of Sylvester McMonkey McBean's investigating machine. ;-)

I agree on the history. I had a great experience recently. I started having some pain in one leg, at first minor, but that eventually got bad enough to interfere with sleep, so I went to the doc. My primary ordered an x-ray to make sure there was nothing acute and told me to take Aleve (x2 twice daily). When a couple of weeks of Aleve didn't entirely get rid of it, she sent me to an ortho.

When I saw the ortho (right after having read the Sanders book), he sat and listened and let me tell my whole story without a single interruption. He then did a brief exam and gave me the diagnosis (ilio-tibial band syndrome). When I thanked him for listening so well, he said I'd told him the diagnosis; the exam was just to confirm it.

Another few weeks of Aleve and some PT and all is well again.

Tamar