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Volume 334:918-920 April 4, 1996 Number 14
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Clinical Problem-Solving: If at First You Don't Succeed

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by McKenna, M. T.
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by Ross, J. M.
To the Editor: In the case of the 22-year-old Laotian immigrant described in the Clinical Problem-Solving article entitled "If at First You Don't Succeed" (Dec. 7 issue),1 does the one-year interval between the first medical consultation and the complete relief of symptoms by curative antituberculosis chemotherapy indicate that she received high-quality health care? The record says that her physical examination was "normal." Can one assume that signs of thyrotoxicosis were sought in the eyes and not found? That post-tussive rales were absent? That a goiter was absent? What has happened to the practice of comprehensive history taking and physical examination? . . . [Full Text of this Article]

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