Physical with new doc will she check my genitals?

Hey everyone! I have a physical with a new doc coming up next week. She’s a PA. I’ve never had a female pediatrician or gp. I’ve also never had a gp examine my genitals. My question is: do you think this new doc will (1) examine at least part of my genitals (including a DRE or prostate exam) or (2) continue the trend and not even ask me to get undressed, just raise my shirt? I don’t know anything about her, and I’m really curious to see what’s going to happen. What do you think? (Obviously you can’t predict the future just asking for your guess 😃

As a rule, new patient physicals tend to be fairly comprehensive. However, it does depend on the practitioner. As you noted, it isn't like the old days where a full strip down is as common as it once was. How long has it been since your last physical? You may want to ask her for a complete exam. (DON'T ask specifically for a DRE or genital exam unless there is a complaint in those areas. She may think something fishy is afoot.)

Now, all that said, other factors are at play. How old are you? Do you have a family history of any particular condition? What do you do for work? All these things can play into what is done.

I would think a genital/hernia check could be a given, and, depending on your age, a DRE is possible.

Given the time limit allocated for exams these days, I’d expect more focus on your history, drugs, etc. if you have any specific or ongoing concerns, they may do a more thorough exam, or refer you to specialists or a follow up. Depends on the doc.

From my personal experience in my area, your first appointment with a doctor is labeled as a "new patient appointment", and usually last around 30-45 minutes. Almost all that I've been to and heard about in the last 5-10 years have been identical. They are mostly focused on health and family history, and current symptoms and issues. They perform a cursory exam at the end that includes listening to heart and lungs, and listening and feeling of the abdomen.

However, they do not consider this to be a physical exam appointment. If problems are brought up during the discussion, they make note of it, and move on. Even when my current PCP asked me about urination problems and family members with prostate cancer, she did not examine prostate. In my patient portal after the appointment, I noticed it still said that I was past due for an annual physical exam.

Due to various reasons, I've not had a "physical exam appointment" in the last 4-5 years, so I'm not exactly sure how, or if, it will be different from my "new patient appointments". I'm hoping it will be more thorough and comprehensive, but I'll have wait a few months before I find out. Hopefully, the OP will get a long, thorough exam, and it's everything he wants.

Hi Reluctant,

I would anticipate having to undress and wear a gown unless the practice allows for you to retain just your underpants for the exam. Either way, I would anticipate having to lower or remove your underpants. A genital exam is likely for a first time patient unless the doctor or NP just does a cursory check and has you return at another time. As for the DRE, this is usually age related starting around 40ish but also up to the doc's discretion and any concerns you might express. My preference is that following an exam, I want to know that all of me was examined!

Everybody makes some good points. Personally I don’t think she’ll (she’s a PA—I find PA’s tend to listen better) examine my genitals but may do a Dre or prostate exam because I’m of that age and due (I.e., haven’t had a colonoscopy in about 10-11 years). I have no symptoms to discuss with my penis testicles or anus so I don’t think she’ll check them. But maybe I’ll be surprised. Either way I’ll be prepared—trimmed and new underwear lol.

Most family practice providers or general practitioners nowadays rely on a PSA blood test rather than a DRE

@thereluctantpatient

If she does a DRE, I would expect that she would do a hernia/genital check. Sinch you will be you will have your pants down and she is "in the area," a genital exam before the DRE would be fairly standard (or used to be). While it has been noted that many doctors rely on just the PSA, most I have encountered will still do the DRE as a double check, especially if you are over 40-45 or have a family history. (PSA has been known to give false results)

Since you noted you are due for a colonoscopy, she may do the DRE to evaluate the rectal area prior to scheduling the procedure, not just to check the prostate. Since you are new, remind her it has been over 10 years since you had a colonoscopy.

Be sure to tell us exactly what happens! Best guess is she will not do a genital or a rectal exam, that's just the way it goes these days... 😢

I have recently switched from one female doctor to another one, and neither of them checked my private parts. And I prefer it that way.

If she’s younger then absolutely not. Most physicals these days are so lax that you don’t even take your shirt off.

One wonders if Reluctantpatient ever went for an exam?

One wonders if Reluctantpatient ever went for an exam?

@Nick321 I had to reschedule it; it’s in about a week and a half. I will definitely update everyone with the results!!

I guess you won't take off any clothe, like it was for me when I met my new "care team". Was the same for my wife.

You'll probably have a sit down opposite to her at her desk, doing a lot of blablabla while she does a lot of taptaptap on her computer 😜

So I had the appointment today. Turns out those of you who predicted no genital exam were correct. It was just a new patient visit -- medications, history, etc. She did listen to my lungs and heart and looked down my throat but that was about it. Fully clothed the whole time. But she is having me come back in a month for a full physical (annual wellness) and I have a hunch that I will be naked under the gown and at least get a dre. She seems very thorough and the type to do exams. I just got that vibe from her. Definitely looking forward to my next appointment!! I'll update this thread after that appointment with any news.

I had few 'yearly physicals' since I moved to US. All of them were basically taking body measurements while fully clothed - I may make bad joke that Americans are so fat that mobile phone, keys and wallet in pockets do not make much difference - then blood pressure, chat with nurse re medical history, then battery of blood tests, and finally a chat with GP that was mostly repeat of conversation with the nurse.

I am surprised by accounts of detailed, fully nude exams and so on. The 'yearly physicals' are fully paid by medical insurers and therefore what is done is dictated by their guidelines and standards. I doubt any doctor's office would be willing to provide any extra service for free.

As for DRE for prostate cancer screening - this has not been recommend for quite a while due to its inaccuracy. Main diagnostic method is PSA test.

Thanks for the update, @thereluctantpatient, do keep us posted with your next appointment details!

Unfortunately doctors do the bare minimum now during physical examinations so dont expect much

Just confirmed my Full Annual Wellness Exam for next Monday, I will keep everyone posted on the genital exam as well as all the other details. They had briefly rescheduled me to a male NP, but I asked for the original female PA who I initially saw, and they were able to schedule me with her for Monday, just a little earlier than my previous appointment. I thought I was more likely to have a "full" physical with a female PA than with a male NP, but who knows what will happen? Isn't that kind of part of the magic, the anticipation, the excitement of the unknown?

Recent family experience suggests you are more likely to get a full exam from a PA or Nurse Practitioner than from a physician. The doc's time is very valuable; the PA and NP less so, and the payor is likely to pay the same amount for the visit regardless of who actually does the exam. Let us know how it goes for you.

@thereluctantpatient . Your physical is starting to garner some attention. Hope the next one goes well. Please let us know. I had an annual physical from my female Doc. a few days ago and she did do a rectal to check the state of my prostate enlargement but I've been going to her over 15 years and have undergone tons of DREs , 3 colonoscopies, and 2 prostate biopsies, So as the other folks say, it depends. Sounds like you're hoping forward to getting a rectal from your new doc. Let's hope some big burly WWF looking male PA doesn't take her place on your next visit. Those finger visits aren't always fun. LOL

Today was the big day, and did it ever pay off. I wore track pants, a black polo, and a grey zip hoodie for easy access and disrobing. I got to the office about 8 minutes early but they took me right away. Nurse weighed me (fully clothed), checked my temp and pulse ox, and took my bp. It's always high in doctor's offices. Then the nurse asked me the last time i had a tetanus shot, and I couldnt remember, so she gave me one in the right arm. I slid my arm out of my hoodie (full zip for easy access), she alcoholed me up and then stuck the needle in. It stung for a moment and then felt tingly. I put my arm back in my hoodie and was zipping up when she told me to take of my hoddie and polo, put on a paper gown top, and sit on the table to wait for the PA. When she left, I took off my tops and put the gown on. It was one of those where the paper is glued or welded at the shoulders and it just kind of boxily covers you. Anyway, the PA came in and we talked for probably fifteen minutes. Then she began the exam. She checked my eyes, ears, nose, and mouth. Then palpated my neck. Then she pulled up the back of the paper gown and started to listen to my lungs. She had me take deep breaths for a solid minute. The gown had riped at this point so when she went to raise the front of the gown to listen to my heart, the whole thing kind of surrounded my neck. She listened to my heart and had me hold my breath while she did so. Then she had me lay back, and she palpated my abdomen. She had a very soft and gentle touch. It was wonderful. When I sat up, I started to pull the gown over my head, assuming it was over, but she said, "I need to do a scrotal exam on you." So I stood in front of her stool, and just like a teenager, pulled down my pants and underwear so she could check my balls. She used her bare hands and gently felt each one and then gave me a hernia exam on both sides. I coughed sotly, but it was evidently enough. Then she said I was a few years too young for a prostate exam (she starts at age 50) but I could have one if I wanted one. I didnt want to push it so I declined, but she did order a PSA blood test. She washed her hands and dried them with what appeared to be another paper gown (maybe there was no paper towel, not sure). Anyway, I pulled up my underwear and pants and put my tops back on while she wrote out the orders. The the nurse came back in to draw blood. All in all, it was a pretty good physical. Its the first time a doctor has examined my genitals probably in almost 20 years maybe. It was a refreshing change of pace to be treated like a patient and be given the examiner's full attention. Two thumbs up, no notes.

@thereluctantpatient . Glad it went well. Surprised you turned down the prostate exam. LOL

That’s good. That’s the way it should be.