book post: medicine as it is practiced

Last month, I read Lisa Sanders's Every Patient Tells a Story. Sanders is talking about diagnosis, how it can be difficult, and how the process has changed over the last 20-30 years. The "annual physical" is a thing of the past, and many doctors doubt that a physical exam is ever worth doing, given modern medical testing (from blood tests to MRIs). Other doctors regret the loss of the physical exam, but suspect it's too late to save it: you can't teach skills you never learned. Sanders falls somewhere in the middle: not that everyone should have an annual physical, but that there are things the doctor will learn from talking to the patient, watching them walk, and so on, and that these are things worth doing if the diagnosis isn't obvious.

( cut for length; this review also discusses Bernard Groopman's *How Doctors Think* )