Observation and physical assessment were integral to a consult, including noting social aspects, unusual neurological presentations (eye movements) and movement disorders, sensation and movements that caused patients to be at risk of falls, insulin injection sites, joints (rheumatology) and allergies.I am fearful that I may have missed things that could be important...for example, I was talking to a woman, and by the end of the consultation the penny dropped that she was morbidly obese [which impacted clinical advice]. This evidence concerns the gene INS and allergic disease.