Kenneth Flegel should be commended for drawing attention to an ominous trend in medical training, the gradual elimination of the physical examination in favour of laboratory investigation and imagery.1 Far worse are so-called outcome analyses based solely on questionnaires and telephone interviews of patients who have undergone a surgical procedure.2 How can one pontificate about the success of an operation if the patient is not examined after the operation, preferably by independent observers? To rely on telephone interviews in potentially contentious situations involving third parties (such as worker's compensation cases and automobile accidents) is to court very unpleasant consequences both for the patient and the surgeon.3