Alopathic Method

In Western Diagnosis, the logical order of proceedings is:

1. Medical History
2. Clinical examinations, including
   Inspection
   Palpation
   Percussion
   Ausculation
   Local Examination
   General Examination
3. Simple tests on urine, blood and stools are carried out as indicated
4. When the diagnosis is still not clear, more complicated tests such as x-rays, scanning, CT scans, etc are carried out
5. If the diagnosis is still not clear, more aggressive procedures, such as biopsy, laparotomy and surgical exploration are carried out
6. Finally, in event of death occuring without a diagnosis, the autopsy table is the last court of appeal.  A diagnosis can still be made, even though the patient is dead!

In TCM, the approach is a bit more holistic. 

First, the history is deferred while the patient gets a chance to get more familiar with the surroundings, as they are already anxious about their condition, and it is more difficult to share the complete story immediately.  Time is taken to establish some rapport and empathy with each other.

Mostly, this time allows the physician time to observe the patient as a whole, instead of directing attention narrowly to the part of the body that is giving symptoms.

Thus, inspection is the first procedure, to observe the body as a whole, total person.  

In my clinic, I spend a good 30-45 minutes with each patient, getting to know them, and in doing so, I learn much about them, their general disposition, what makes them tick, and hopefully, gaining that important measure of rapport and empathy.  I'm a big fan of humor to break the ice, and I found that once it's broken, patients will tell me things they have never told other practitioners.  I find it all extremely helpful in arriving at a selection of points that will benefit them the most.