Clinical history-taking and physical examination in medical practice in Africa: still relevant?

Advancement in technology is continually redefining the practice of medicine globally, with sophisticated diagnostic machines, investigative procedures, and medical tests now widely available for medical diagnosis. Indeed, new discoveries, devices, and the internet have positively influenced the way physicians diagnose, treat, and palliate diseases. However, unlike in many high-income settings, where advancements in medical technology have, in most cases, been complementary to understanding disease pathogenesis and acquisition of core clinical skills, emerging evidence from many low- and middle-income countries, especially Africa, point to the contrary (1,2). There are widespread concerns about doctors’ declining bedside skills and clinical aptitude (3). While it is a requisite that medical students and doctors-in-training must demonstrate competence in history-taking and physical examination, there are reports that doctors fail to maintain and improve on these skills over their professional practice owing to over-reliance on results of medical tests (3). In Africa and many resource-constrained settings, where majority can hardly afford simple medical tests, the essence of detailed history-taking and physical examination cannot be overemphasized. It is therefore important to consider if improvements in health technology and medical diagnosis, and their introduction in many African settings, should alter the role of the fundamental history-taking and physical examination in general clinical assessment.