Away with the system review: a plea for parsimony.

body systems as a routine, not to be missed, part of the initial history taking. This exercise has been variously called the system review,13 functional inquiry,4' systemic inquiry,6 7 and symptom review.8 The authors generally advocate asking every patient specific ques? tions related to possible disease in each system. As many as 60 may be asked,9 less those already asked with the presenting complaints, but with addi? tional if any of the ones prove positive. Of the clinical methods texts reviewed, only Swash and Mason10 in listing their routine questions suggest that only those relevant to the system sug? gested by the presenting complaints should be put. All eight of the 13 medical schools in the south east of England who responded to a personal letter asking for details of notes given to clinical medical students embarking on their introductory course currently recommend one or more of the above textbooks or