How thorough does my clinical exam need to be for big cases? Thorough enough that nothing surprises you later, and that means a written checklist. The clinical half of the diagnostic visit is genuinely up to you, your niche, your training, your judgment. If you have done a course like John Kois's, your list will be far longer than any generic one. But the point stands: clinical findings drive both the complexity and the fee. How hard the case truly is, whether the long term result is predictable or not, what the long term risks are, all of that lives in [...]