The type of assessment skills presented by the book and video clips is rapidly becoming a dying breed. Palpation is still used frequently (for hepato-splenomegaly, to feel for ‘the olive’ in pyloric stenosis, RLQ exam for r/o appy, etc) but percussion has definitely fallen of the clinical pathway. The use of CT scans and bedside ultrasound have replaced percussion for establishing +/- free fluid in the abdomen, liver size, masses, etc. These high-tech tools are fast and easy. Images are transferable to clinicians miles away within minutes, allowing for better clinical decision making for the benefit of the patient. However, with the loss of the hands-on skill come the increased cost of the test – which burdens our health care system even more.
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