Your editorial in The American Journal of Medicine of July 2017 1 was impressive and is very true. I would like to add that we "the physician community" carry the responsibility not only in developed countries, but we must be equally competent and ready to perform our duties in any part of the world. Think of Sub-Saharan Africa or poorly developed nations in Asia. When you don't have all the luxuries and gadgets of medicine, how will you diagnose and treat?-"history and physical examination." Recently, I saw a patient with tuberous sclerosis complex. The first step for the diagnosis was to look at the patient's face and her skin lesions. Another example of examination was when I examined the nails of a patient with recurrent bilateral pleural effusion. With all the advanced tools, he was treated for congestive heart failure with bilateral effusions until Funding: None. Conflicts of Interest: None.

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