The physical exam has changed, let’s admit it.  In what ways?  Let’s compare the old school and new school physical exams and see how things have changed in just a matter of a few generations.

Old school: the general exam
New school: whole-body CET

Old school: heart exam including assessment of JVD and peripheral edema
New school: TTE, stress test, and bilateral lower extremity US

Old school: lung auscultation
New school: CXR followed by CT chest

Old school: inspection, palpation, and auscultation of the abdomen
New school: CT abdomen & pelvis, right upper quadrant US, and GI consult

Old school: rectal exam
New school: colonoscopy

Old school: skin exam
New school: Dermatology consult

Old school: thyroid exam
New school: thyroid US

Old school: the eye exam with ophthalmoscope
New school: Ophthalmology consult

Old school: rapid alternating movements, two-point discrimination
New school: MRI brain