The Importance of Communication and a Structured Contingency Plan

The physical exam is tough, but it's important. You're going to need to just get good at seeing it. Once you've ruled out some sort of wacky complication that's occurring right now, you can almost always mitigate being wrong or not perfectly right with your initial diagnosis if you have good communication and a structured contingency plan. If you really were wrong and the kid absolutely should have been treated, but the treatment doesn't start for 36 or 48 hours because you thought it wasn't as bad... The kid is still likely to be fine. It would have been a little bit better if a sleepless night that was not going to be avoided without antibiotics ended up happening anyway.