you are conflating several issues.
People are dragging the med staff for missing an obvious concussion. In doing so they are mocking the “back injury” explanation yet also up in arms that no “back exam” was done. There really isn’t such that is significant in the patient I described above.
also, you can lecture about the list art of physical exam (it’s certainly not lost in my practice, but thanks for the helpful hints), but no spine or ortho spine doc is going to make a spot diagnosis of any specificity in an acute on chronic injury. Many won’t see a consult until MRI is in erecord for them to view.