Moooon River! :-)
Seriously, After my old doctor retired I went to a new one, who was younger, maybe 5 years out of med school. When I went for my annual physical, he told me they generally don’t do the “two fingered salute” anymore, unless they have reason to suspect something. He said they rely on the results from blood work.
Phew! Didn’t have to go through that again!
Bloodwork is more reliable, but the “rigid digit” is cheaper (and philosophically aligned with ObamaCare).