Getting ready to go to a new primary care in a couple of weeks, and got to thinking about the thoroughness of exams over the years. I'm not talking about specialist exams - just my annual physical exam.
Eighteen years ago, I moved to Northern Virginia:
The routine was something like this and varied some with each visit:
1st doc: Male, caucasian, late-30s / early 40s. I saw him for 3 years. Nurse takes height and weight in the hallway, leads me to exam room, takes vitals/history, places a cloth bed sheet on the exam table and tells me "please remove all of your clothes and cover yourself with this drape. The doctor will be in shortly. A few minutes later, the doc comes in and conducts a pretty thorough exam including feeling lymph nodes, abdominal palpation, and genital/hernia exam (no DRE). Exam finished each time with me standing fully naked. Only real variance was the last time the nurse led me to the exam room, told me to undress completely and cover myself with the drape, then she came back and took my vitals. Blood draws were all done after I had dressed. After 3 years, doc left to open another branch of the practice in a neighboring city.
2nd doc: Same practice. Male, Asian, late-20s/early 30s. Saw him once. Nurse took height and weight in the hallway and led me to exam room. Told me to undress to my underwear and handed me a gown, noting "the opening goes to the back." She came back shortly thereafter and took my vitals/history. Doc came in (and nurse stayed). Exam involved looking in ears, eyes, and throat. Listened to heart and lungs, gown dropped to my waist (in sitting position). Had me stand and bend over and touch my toes (no gown), I guess to check my spine? Asked me if I had any abdominal or testicular discomfort. When I said "no" I was told to dress.
3rd doc: Same practice. Male, caucasian, mid-to-late 60s. Nurse weighed me in the hallway, took me to exam room and took vitals/history. Told me doc would be in shortly. Doc comes in, does exam and has me remove my shirt to listen to heart and lungs. Has me lay down and listens to bowel sounds. Told me to put my shirt on. Done. Saw him for 5 years, then he retired.
4th doc: Same practice. Female, Indian, mid-40s. Nurse took height and weight in the hallway, took me to exam room and took vitals/history. Says doc will be in shortly. Doc does exam and has me remove my shirt to listen to heart & lungs. Has me remove my shoes and socks. Finally, has me drop my trousers and underwear to DRE. No genital exam. Saw her for 4 years. Only on the last exam did she do a testicular exam because I was complaining of tenderness.
5th doc: Same practice. Female, Physician Assistant, early 30s. Saw her once. Nurse took height and weight in the hallway, took me to exam room and took vitals/history. Says doc will be in shortly. PA arrives, reviews history, plays 20 questions. Examines ears, throat & eyes. Listens to heart & lungs. Reviews history, asks about testicular tenderness. When I said that the tenderness comes and goes she asks me if I want her to "take a look at it" - I say "your the doc, if you think so." She leaves and comes back with a nurse who "chaperones" by turning her back and working on her hand-held computer tablet. PA does a testicular exam and orders a testicular ultrasound (I wrote about that elsewhere here on Zity).
6th doc: Same practice. Female, Physician Assistant, early 40s. Saw her twice. Nurse took height and weight in the hallway, took me to exam room and took vitals/history. Hands me a gown and says please get undressed down to your underwear - says doc will be in shortly. PA comes in, and does a pretty thorough exam to include DRE.
7th doc: Different practice (I moved). Female, Physician Assistant, late 30s. Saw her twice. Nurse took height and weight in the hallway, took me to exam room and took vitals. PA comes in and takes history - asks many questions. Looks in ears and throat. Listens to heart and lungs. Asks if I have any concerns. For each concern she does no exam but writes a referral to a specialist. This is/was my current doc. Changing to a new practice a little further away.
The point of this post is that as I've changed caregivers multiple times over the years, most have been with the same practice but the thoroughness of the exams has varied greatly.
Has anyone else experience such a wide range of experiences at the same practice?
Any medical professionals here have any comment on the inconsistency?
Thanks,
Fred.