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Honing Clinical Skills
- Arthur S. Harrow, MD
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Your editorial [1] regarding the relative value of the physical examination stirred memories: During my internship, my students and I spent one night examining a newly admitted patient who had a systolic murmur. Textbook review led us to dynamic cardiac examination techniques, including squatting and the Valsalva maneuver. By rounds the next morning, we presented a diagnosis of idiopathic hypertrophic subaortic stenosis and were prepared to back this up with rather elegant physical findings. The attending physician, a recently trained cardiologist, then spent 5 seconds listening to the heart and recommended an echocardiogram, noting that this will give us a quick answer. Needless to say, the same physician was involved in reading echocardiograms at that hospital. I also recall neurologists whose standing admission orders always included magnetic resonance imaging and gastroenterologists who felt they wouldn't be seeing me if they didn't need endoscopy.
If more appropriate role models were provided in teaching institutions, more physicians would be oriented toward physical examination techniques in order to arrive at a proper diagnosis in a cost-effective fashion, rather than looking for an easy, high-tech answer.
Arthur S. Harrow
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright 2004 by the American College of Physicians
