Osteopathic Examination Structure. 

As in any approach to medicine, the physician must develop certain clinical skills to gather sufficient data. There are many exercises that assist the clinician or student in further developing palpatory abilities.

For example, some of my teachers had us practice placing our hand on the center of a long table which had a coin tucked under one of its legs. Our job was to identify the location of the coin by palpating the center of the table. Another exercise involved placing a hair under successive sheets of paper and then to accurately identify its location under the many sheets. An elderly clinician who graduated from an osteopathic college in the early 1940s told me that he was asked to identify bones placed in a bag.

Normally this would not be difficult; however, all of the bones has been disfigured, with many of the major landmarks removed, and the remainder of the bones were cut into small pieces. From this point, the physician graduates to palpating the living system in all of its subtlety and dynamic manifestation.
Just as someone who lives in a foreign country is under a tremendous handicap if he or she fails to comprehend the local language, so too will the physician be extremely limited in his or her work with the living system if he or she fails to learn the language of the living body. The system is alive.

The living body has the ability to communicate to the physician in the most incredible manner, but only if the physician is open to receiving the information being offered. Many clinicians view the body as a thing to be experienced via the lens of laboratory tests, radiography, and other static interactions with a living, dynamic system. From the osteopathic perspective, the overreliance on static information is one of the greatest shortcomings of medicine, especially when it becomes the main arbiter of how one approaches the patient.