How important is the physical exam?

Most of us do parts of it each time we care for a patient. Aspects of the physical exam are included in several of our nosocomial infection definitions. Yet how good are we at performing physical exams anymore? How reproducible and reliable are physical findings (within and between observers)? How sensitive and specific for diagnosing illness, including infection?

I'll admit I've sometimes thought (usually when frustrated over low hand hygiene adherence) that patients would be safer if healthcare workers didn't touch them at all.

If this topic interests you, today's NY Times has an article on Dr. Abraham Verghese, who is passionate about "taking back" the lost art of the physical exam.