Current State of Physical Exams

I think nowadays the GP , in my view, only assesses general health issues, not entering much into detail. The general practice is to refer you to another specialst doctor if you need an exam.

I think across the board at all ages and specialities, exams seem to be giving way to patient self reporting and self exams/self swabbing as doctors. I have probably had about 15-20 annual physicals in the last 25 years and only twice was in a gown, only once had a quick rectal exam and once (my last physical) did I have an genital and hernia exam and that was with a pa not an md I would assume an me wouldn’t have taken the time on that.

Evidently even pediatric exams these days don’t regularly include breast or genital exams any more unless there is something acute indicated or other special circumstances. There’s no more standing in front of the doctor as a 14yo with your underwear around your ankles as your dad and brother watching on. Is that good or bad? I don’t know. We survived. But a lot of the touching and nakedness, looking back, feels a bit excessive

I am surprised, or maybe actually not, with 'reports' of recent 'full physical' taking place here in US and involving whole body exams including genital and rectal exams. I think those are just pure fabrication based on fetishes.

Medical 'industry' in US is highly regulated by procedures from regulators, insurance companies, various boards and companies providing those services. No one is going to do anything extra and outside of procedure. There reasons are liability and costs.

Things like hernia checks may happen every given number of years, but definitely not every year. Rectal exams for prostate are thing of the past replaced by PSA (blood test), and MRI, if PSA not in norm.

It does depend on the doctor, but the full "old school" head to toe annual physical is definitely going the way of the dinosaur. Doctors have such a high turnover of patients, especially in a group practice or HMO, that they can't block out more than 30 minutes for a full exam, and 15 for a follow-up/wellness check. They rely on tests more than examination, and insurance compensates them MORE for tests than examination, so, unless you have a specific complaint when you go in, you will more than likely have just a cursorily exam.

I used to believe that internal medicine doctors gave my detailed physical exams, but it was a Canadian trained, family doctor who did my last, complete physical. My current doctor, who is young, stops at the waist, as did a previous, also young, doctor. It appears to be how they are trained. Referrals are mentioned for anything below the waist.

Once you retire, physicals are now referred to as "Wellness Exams". Or as I call it "My So-Called Wellness Exam". In the last seven years, there hasn't been any hands-on

checkups unless a specific problem is mentioned. I like to call it 20 Questions or less. Starting with the pre-doctor review with his assistant. BP/Pulse/Weight/medication review and the annoying "do you smoke, wear seatbelts...". Haven't disrobed since I retired. Only once after three years did I take off my shirt for an EGK (which they did every year up to the point of retiring). For 2026 there was no urine sample requested, but blood work including a PSA one.

I started seeing a urologist once a year, that ended any DRE/Hernia checks by my PCP (and this started before retiring). I don't think I've ever had such extensive checkups as some describe some off the pages here (Much to my dismay!). My latest uro doc did a decent overall check on my initial visit. They do a bladder scan too, but that only requires pulling up my shirt and slightly pulling down my pants to just above the genital's (so no exposure). Urine sample too. Next year I get "transferred" to his PA for my yearly exam, which I means unless a big issue comes up that'll be the way it is from here on out.

As some others also commented, here in Europe, or at least in the Netherlands (can't speak of other countries) you only see your GP when you have any specific issues / complaints, and then they only check that specific issue. Preventative, yearly exams, etc, are not a thing here.

@hellknight You're right for the situation in the Netherlands. I think in Belgium and France yearly preventive exams are more common. I don't know how it is in other European countries.

Well @SpiritAndBody and @hellknight, if you read some of the other threads on having exams with new providers or modern exams in the US, they are not very long or thorough. Even though I am in the US, I tend to follow a more European model of going when I have a specific issue or complaint.

In most US exams, the doctors only check things that are likely to have issues at a given age. They stop testicle checks at 35 because most men after that do not get them, although I did find a lump at 47 (which I found myself). So I asked why they dropped that part of the male physical exam the answer was: "a cancerous lump is so rare in your late 40s that we don't check for them." So 'preventive care' is an illusion.

Pretty much DDS - they don't do shit.

Not much of anything anymore. There are a ton of online surveys to answer which in my opinion are useless, asking sleep, safety, drug, alcohol use, tobacco use, and among others. I think technology and American healthcare has gotten to the point now where if a provider suspects something they just send you for imaging or labs and then to a specialist. They rely on more technology instead of examination techniques.

My current pcp listens to my heart and lungs. Unless I have some other issue or complaint I want her to assess that is the extent of any hands-on exam. Even if I have some other issue her response is to order diagnostic tests or refer me to a specialist.