I have certainly been fooled by some patients over the phone. Clinicians
who practice medicine are taught that the subjective and objective are very
important in assessing a problem.True, about 90% of the info one needs to
establish a diagnosis usually comes from the history, the physical exam is
extremely important. So I constantly remind the woman I am talking with
over the phone how important a visit is particularly for sore nipples. The
latest unexpected finding was a woman who had very sore nipples and plugs
and engorgement. I was amazed to find on exam that the baby had a poor
weight gain and that she had little/no let down, as evidenced by the lack
of swallows on exam. She had no clue previously that poor weight gain was
an issue!-Anne Eglash MD