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