Utility of the History and Physical Exam in the Emergency Department

The study is trying to prove that the history and physical exam (H\&P) in the emergency department is the most important tool in exam of patients. The investigator is attempting to correlate the time of the H\&P of residents and attendings to the accuracy of diagnosis.

The purpose of the study is to examine the utility of the history and physical exam in the emergency room towards obtaining a diagnosis. The goal of this observational study is to correlate physician level of experience and time spent on history and physical exam, to the correct diagnosis. The aim of this study is: 1. To draw a connection between time and accuracy of the history and physical exam. 2. To draw a connection between time and level of experience as a physician based on post-graduate level. 3. To assess the number of laboratory and radiographic studies and the post-graduate level. 4. To assess the relevance of the labs and radiographs ordered. (Relevance is defined as something that changes plan of care.) Time is a critical component of the ED physician. Our study will analyse if modern medicine has created a more laboratory/image based need to ascertain a diagnosis or if history and physical examination alone can predict the ultimate diagnosis.