Doctor visits in the 80’s compared to modern days

I, like a lot of people my age were examined fairly regularly as children by a GP or family physician. I recall that most of my visits were for respiratory issues, so consequently my chest was always auscultated thoroughly and often percussed front and back. Fast forward a decade or two, I would take my daughter when she was young and similarly she was more often than not examined much the same as I was, albeit maybe not quite as thoroughly.

I’m curious to know how modern day doctors examined the young, is it as thorough? For instance, do they auscultate and percuss a child's chest thoroughly these days etc. Equally as an adult, how thorough are your exams? My own exams are often limited to a quick listen to my chest and back and then its out. Just curious.

My experience in the 80s, with childhood asthma that I grew out of, is of frequent GP visits, thorough examinations with removal of most if not all clothing and diligent auscultation and percussion front and back, monitoring of peak flow, ENT and asthma clinic referrals etc.

I have no knowledge of modern approach to younger patients but my experience as an adult with a broken NHS post 2000 is very different to my memories from the 80s.

The last time I had a face to face appointment with a GP was 2005.

The last time I was prescribed any type of antibiotic was 2012 and that was by a nurse practitioner at a walk in clinic for a staph skin infection.

Last time I had any type of blood work done was via private self referral.

Access to any type of non-emergency primary care with my current GP is via submission of online forms using the eConsult online consultation and triage platform in the first instance. The standard level of response in my experience is an email from the GP 48 hours later saying something along the lines of ‘Symptoms are consistent with a virus. Get in touch again if you’re not better within a month.’

I have occasional blood pressure appointments with a practice nurse at the GP surgery (which I have to push for because of my concerns due to a family history of hypertension although I am not on any kind of medication). They do no more than one reading with an electronic blood pressure monitor that is no more sophisticated than you can buy over the counter and one manual blood pressure reading. Occasionally weight is measured fully clothed with shoes on. Appointments last no more than 5 minutes.

@Kristin92 The only way to stay in business today is to run a factory. The days of actually practicing medicine are over.

@Kristin92 They talk a lot about disease management. I am convinced much of our issues are tied to the food supply. You look at many other countries that don't allow half the shit we put in our food and they have longer life expectancies. less disease management and often less antidepressants.

To masterkinkster: You are so right.... what is wrong with our Country. Oh, that's right, since the pharma's can't make much money from the European market... they just jack up the prices on us. Look out for high fructose corn syrup. And generally the items that claim to be "healthier" are in fact worse than the real deal like real sugar. Some of these sugar substitutes are actually the very chemicals that are ban in most other countries

Now back to the topic. I have found that you have look hard to find a doctor today still has you remove clothes. At least something. I used a doctor for the first time and had a "physical exam" I didn't even take off my shoes or anything else. Then he asked me if I thought that my feet were swollen! So I never went back... I now have a doctor that will look at me as well as look at the blood work. Yes, that means take off your clothes.

In the eighties, there were not yet so many methods and devices for computerized examination of a patient. Doctors relied primarily on their knowledge, experience and erudition, as well as on the ability to auscultate, palpate and carry out differential diagnosis. Now it's all faded into the background. Why should a doctor know how to properly differentiate between noises and wheezes during auscultation?

It is easier to send the patient for an X-ray, CT scan or MRI and get the opinion of a radiologist. I think artificial intelligence will be everywhere soon. It will collect medical history, send patients for laboratory tests and computer examinations, process data and make a diagnosis. You will only need to undress in front of specialized medical professionals.

Back in the golden age, there were thorough head to toe exams at the clinics and at home during house calls. We had to be fully naked for the physical part. Nowadays we just have to answer questions. They fill out the record sheet. We should be happy if they check our blood pressure.

My experiences at that time, and a little later, were similar to as @The Scottish Patient described. More often than not, if I went to the GP when ill I would get a thorough exam, and be stripped down to my underpants, as I've described on here many times in the past.

As an adult, I don't get as detailed an exam when I go to the doctors now, although I at least get to take my top off when being listened to for a couple of minutes. Also mine still takes blood pressure manually. The last time I went to the GPs with stomach pains a few months ago I did get a fairly good going over, but I think that was as much because he had a junior doctor in with him he wanted to described stuff to.

In the 80s you could actually get an appointment to see a Doctor!

I have posted in similar threads: I was a kid in the 1970s and a teenager in the 1980s and I have never as an adult had a physical exam and detailed and complete as the ones I got then. Even my school's sports physicals in the 1980s were, by far, more comprehensive than any doctor visit now.

The protocol has definitely changed or evolved over time. I wonder if there’s any data or studies about changes in life expectancy, disease detection etc. due to these changes. Life expectancy has risen steadily over the years in every age group (with a dip during Covid) so can you really question the effectiveness of past and present medicine?

I wrote something similar in a different thread/post. I grew up in the 70's and 80's and going to the Doctor was a different experience than what I experience today. Back then I went to a pediatrician, to me it seemed mandatory that the nurse would take me into the exam room, my mother was with me and told me to get undressed just keeping my undies on. She would do the basic vitals. After the nurse left, we would wait for the doctor to arrive, and within 5mins he would be inside the room, chatting with my mother.

No matter what I was there for, he would always examine my genitals, thoroughly, and since my penis was overly sensitive, I would have an erection and ejaculate while my mother watched. Back then, whatever the Doctor did and said my mother took it seriously and listened and trusted him so that led to many different exams that I had especially the "growth & development" exam I had to go to every 90 days. Plus my home inspections.

Today, I am not sure what goes on at the pediatrician, but my main doctor, just does blood work, reads your lab results, quickly listens to your heart, does the blood pressure and weight getting undressed, gives you pills, and sends you on the way.

Funny story, I went to my doctor the other week and the nurse told me this funny story. The nurse was busy so it was a first-time patient so she had the patient wait in the exam room before she came in to take his vitals, about 5 minutes later the patient was undressed in his undies. As she told me this story, I too laughed and asked her how old was the patient he was in his late 60s. I told the young nurse that back in those days, it was common to get undressed into your undies before the exam started. She understood, we laughed and she told that patient to get dressed, and then she proceeded with the exam and the doctor's visit.

@The Scottish Patient

My experience in the 80s, with childhood asthma that I grew out of, is of frequent GP visits, thorough examinations with removal of most if not all clothing

You had to remove all your clothes for assessment of asthma? What was the reason for removing clothing below the waist?

Your experiences having a real life meeting with your GP sound absolutely dreadful. I can see doing some things via Zoom, but filling out a form and being diagnosed based on that? Frightening. Though I did have a professor who taught Sociology of Healthcare in the mid-late 80's who suggested in the future, accurate initial diagnoses could be made using a yes/no questionnaire, if questions were specific enough. I've never seen it IRL though. Certainly there are some screening tests for depression and anxiety, but they aren't diagnoses. They're used to see who might need to actually see a healthcare provider.

What do you think changed in/around 2000?

The guidelines that drive the services provided in a primary care setting for an annual screening physical are set forth in the US Preventive Health Services Task Force Guidelines. You can Google them to see for yourselves but they set out the standard of care and are updated regularly, annually even. I'm not sure when they first appeared. Even though I've referred to them for years maybe I should brush up

Visits have changed since the 1980s. As well as GP visits in those days, we had examinations at school, and these were thorough. They do not take place these days. Visits to my GP usually required me to undress so he could listen to my chest or check whatever the problem was. It sometimes meant stripping naked as I did for a skin examination for a rash I I had, and for a second opinion on phimosis.

80’s kid here…I do feel like the exams I had back then were less concerned with modesty or how I felt about a procedure and more about the doctor doing the most thorough exam possible, eg: I was always listened to with a stethoscope bare-chested as a kid whereas now there’s more thought given to the child’s modesty issues and the shirt is either not removed or the doctor will even auscultate through it - and I’m basing that largely on what I’ve read on this site and other medical-related websites (I don’t have kids, and asking my friends what it’s like when they take theirs to the doctor just isn’t something I’d do).

I don’t think the 80’s was the time where the change in exams took place though. The most thorough medical I ever had (detailed in another post I’ve made on here) was a pre-operation physical at a hospital in 1992, and that was the first and only time I was given a full check-up in my underpants only, so in England the 80’s obviously spilled over into the 90’s on this one. I sometimes wonder if 80s kids who now have kids of their own move with the modern times and think ‘I hated being examined without much clothing as a kid so I’m not going to make mine do that’ or whether they say stuff like ‘Come on, don’t worry, Dr [name goes here] will hear your heartbeat and breathing better if you take your shirt off just like I used to.’ The thing is though, I don’t blame doctors for moving with the times themselves and recognising that what was the done thing with one generation isn’t necessarily the done thing with the next one in terms of what’s ‘good practice’.

I don’t think the 80’s was the time where the change in exams took place though. The most thorough medical I ever had (detailed in another post I’ve made on here) was a pre-operation physical at a hospital in 1992, and that was the first and only time I was given a full check-up in my underpants only...

Same here. My exam in 1992, on my 16th birthday, started like all of my well-child exams at that pediatrician I could remember from the prior decade.

When the nurse took my mom and me into the exam room (stopping by the bathroom along the way for me to give a urine sample), she told my mom to take everything off of me except my underpants. (My mom let me undress myself, as she had in the prior couple of years, but before that, she took the nurse literally and undressed me herself even when I was in 8th grade.) Once I was in just my slightly-too-small Hanes boys briefs, and basically shivering while sitting on the exam table in the freezing cold exam room, the nurse returned and walked me down the hall to the scale to get my height and weight. She then took me back to the exam room and took my temperature, blood pressure, etc. and then asked us to wait for the doctor.

When the doctor arrived, he did the usual examination, talking mostly to my mom sitting in the chair next to the exam table. At the end, when he announced it was "time to check the plumbing," she got up and stood next to him, at which point he pulled my underwear down to mid-thigh and kept them down much longer than I think was really needed to complete a genital exam. Certainly, he asked all of the sexual development questions with my undies down. In prior years, he would ask my mom if I had started to have nocturnal emissions, and since I was a late bloomer, she would say no even up to my exam at 15, at which point he would comment that I was still behind for my age and pull my undies back up. It was the same ritual every year.

At 16, I finally had caught up, with an adult-sized penis and testicles and normal pubic hair, so that's probably what prompted him to talk to me instead of to my mom as he rolled my testicles between his thumb and forefinger, palpated the shaft of my penis, and pinched open my urethral meatus, as he always had in prior years.

"Has your penis started to ejaculate semen?"

"Yes."

"When did that start happening?"

"A few months ago when I was living on campus for science camp."

"Were you awake or asleep when it happened?"

"Awake."

He looked at my mom, and she nodded yes, so clearly I hadn't kept my masturbation quite the secret I thought it was.

At that point (not sure if this was his intent in keeping my undies down for an extended time, including the sexual questions, every year), for the first time during these genital exams, my penis started stiffening. Maybe because he was trying to protect my modesty, albeit a little too late, or maybe just because he figured my mom had finally seen and heard that I was sexually mature, the doctor pulled my undies back up. My mom sat back down in her chair.

I was mortified, because I knew what was next. He'd tell me to hop off the table, and he'd sit on his rolling stool, and pull my undies down mid thigh again for the hernia test, in full view of my mom with my side to her, but this time she'd see my penis pointing straight up at the ceiling. Fortunately, for the first time ever, he positioned the stool such that my back was to my mom, so only he saw my fully naked and erect penis. After he had me cough, he pulled my undies back up over my erection, with the waistband just barely covering my throbbing helmet-shaped glans.

When he turned me around to face my mom while he checked my spine for scoliosis, she saw my rock-hard five-incher pointing straight up, but at least it was covered with my tighty whities, albeit with a growing wet spot of seminal fluid. Where normally he'd tell me to hop back up on the table and sit there while he and my mom discussed immunizations (and in prior years, my delayed puberty), this time he told me to get dressed while he explained to her that I was fully caught up development-wise, and then talked about immunizations, safety, etc.

To this day, I don't know if that different treatment in 1992 was due to him changing practices to give boys a little more modesty, or if it was a direct result of them finally see my erect penis at Tanner Stage IV. I always assumed the latter until I started reading discussions like this one that seemed to demarcate the 1990s as when things changed.

I'm curious which of those two reasons the rest of you think led to the changes where the hernia check was with my back to my mom, and I was allowed to get dressed before the doctor left the room.

When I was a child, my pediatrician carefully listened to my heart and lungs because I had suffered from bronchial asthma and at the age of 9 I had a small episode of nephritis and my parents feared it might have compromised my heart valves. So I had a lot of cardiology visits as a child. It was the 70s and auscultation of the heart was the most important part of the visit. Then in the 80s and 90s the echocardiogram almost replaced cardiac auscultation.

I hope removing the requirement to be topless for auscultation was partly down to changing attitudes to child modesty. Loose clothing like a t-shirt etc would give sufficient access to listen to any internals. As a guy or even a boy being topless wouldn't concern me, but I can imagine for girls it must have been very uncomfortable.

@Paul_David Not sure what age your daughter is, but certainly by age 8 or 9 and the onset of puberty I'm sure she would rather be covered.

There is definitely a huge change. Back then, kids were in their underwear. Height, weight, BP, and temperature taking, and rectal temperature was rampant. Next, undershirts came off for boys, and bras off for girls. We were examined with a stethoscope. The doctor checked every part of us. Eventually, underpants came off, with parents in the room. Genitals were examined. If you were sick, I.e. had an elevated temperature, it was off to the table to lie face down for a penicillin shot. I’m sure that exams today are nothing like that on many levels. I know for my physicals, there is BP, oxygen level, and sometimes temperature with a forehead thermometer. We discuss blood work, questions are asked and answered, and a brief exam with a stethoscope with your shirt on. Clothing is not removed anymore.