Disappearing art of the physical exam

I've kind of associated the emergence of gowns for male physical exam patients in the 1990's with the emergence of insistence of political correctness that was occurring around the same time.

Around that time also too, you started to hear accounts of sexual harassment, inappropriate contact, even assault. And you're left to wonder if it's that perverted doctors being found out & reported, or are folks trying to collect a lawsuit paycheck to get rich.

So then when I see & hear about things now like stething over cloths, hardly undressing at all for a physical, gowns for male physical exam patients, I tend to think many doctors seem to minimize the time any part of any patient has to be exposed, even avoiding exposure if at all possible.

And because we've moved away from that old school, war soldier oriented society, where groups of guys line up together, get examined together, be exposed in front of each other together. You know, the Jimmy Johnson Ideal Group Physical.

I've kind of associated the emergence of gowns for male physical exam patients in the 1990's with the emergence of insistence of political correctness that was occurring around the same time...

...And because we've moved away from that old school, war soldier oriented society, where groups of guys line up together, get examined together, be exposed in front of each other together. You know, the Jimmy Johnson Ideal Group Physical.

While I personally have a bit of an aversion to uniforms and military stuff, I think you are right. I think there was a relationship to the kind of physicals I had growing up in the 70s and 80s to the kinds of physicals dads and grandfathers had for the draft. I think that also partially explains the much-talked-about "double standard" between boys and girls physicals, particularly for school and sports.

I think there was a relationship to the kind of physicals I had growing up in the 70s and 80s to the kinds of physicals dads and grandfathers had for the draft. I think that also partially explains the much-talked-about "double standard" between boys and girls physicals, particularly for school and sports.

Yup, couldn't agree more. I've said numerous times that I truly believe part of the reason why things where done the way they were back in the 60's and 70's when I was growing up, was due to a military influence. Examples: Boys were made to strip completely and receive their physicals without any gown or covering, either privately or in large groups with other boys -- and that was considered normal. While at the same time, girls were treated with much more privacy, dignity and modesty. Boys were required to swim nude at school or at the Y, either for P.E. or on a team. Girls were not, and were frequently present during the boy's nude swim sessions. And the boys were treated with a totally different level of modesty and privacy in their P.E. classes compared to the girls.

My theory has been that a lot of that double standard was due to the fact that the boys, in general, were expected to go into some type of military service -- the girls were not. All of that was designed to help prepare the boys for their eventual service when they wouldn't have any personal privacy and modesty was frowned upon.

I've kind of associated the emergence of gowns for male physical exam patients in the 1990's with the emergence of insistence of political correctness that was occurring around the same time.

Around that time also too, you started to hear accounts of sexual harassment, inappropriate contact, even assault. And you're left to wonder if it's that perverted doctors being found out & reported, or are folks trying to collect a lawsuit paycheck to get rich.

If you were to substitute the odd and imprecise concept of 'political correctness' with 'prudishness' then you would be on to something.

You forgot another reason why you might have started to hear more about sexual harassment and inappropriate conduct: because that kind of news sells and the media milks it for all its worth.

If you were to substitute the odd and imprecise concept of 'political correctness' with 'prudishness' then you would be on to something.

You forgot another reason why you might have started to hear more about sexual harassment and inappropriate conduct: because that kind of news sells and the media milks it for all its worth.

Agreed. Crap sells and the masses consume it. Ratings=Revenue and in a market driven economy revenue is king.

The subject at hand. I have heard the same as well. The annual physical is going the way of the dinosaur. I believe one reason I have been healthy and disease free throughout my life is getting that annual complete physical. I get all the tests, a comprehensive exam and a brief conversation about my continued good health habits. As long as my doctor is willing to perform the procedure and the cost is covered by my insurance then count me in.

So many influences making decisions. I concur on the military, since my doctor would have come through it, with its standards and practices, in the 1960's. Men were the ones making policy decisions. The documented naked males in Y pools coming from how rural males washed in public waters, overseen by male only boards. How weird, for us now, pictures of naked male swimmers next to females in swimsuits watched by the general public in the bleachers. Let's not forget what happened to naked wrestling weigh-ins when Dan Franco's videos surfaced. First 'dressed in singlets,' but now back to 'suitable underwear,' briefs, boxers, athletic shorts. Will the tide turn back all the way?

With regards to the art of physicals, I had them annually at work because that's how my employer ran the business. Had they not been offered, i probably would not have even bothered to find my own doctor to have physicals throughout my 20's, 30's, & most of my 40's. Which would make me an absentee ballot in the realm of the annual physical.

Since i was always healthy and never found cause to have anything checked out, there seemed to be no need. So I can understand the major cutback with how physicals are done, because probably for the majority of folks, they are equivalently as healthy.

But now that I'm older and I find that some things need to be watched a little bit, I sought out a primary care physician, and my annual physicals seem to be more or less as thorough as they once were. I would hope that older folks in general have more thorough physicals than their younger counterparts may require, and thus would not want to see the art of the physical exam be dying out in that regard.

My introduction to what now can be called a "full" physical exam came several years ago when looking for a new GP. Specifically requested a full exam since I was over due and towards the end the physician simply asked me "are your testicles ok". Was so surprised I mumbled something like I think they are. I should have just dropped my briefs or told him you're the doc please take a look and tell me, but I didn't. Funny how the patient/doc dynamic can make you react like that, even as a grown man.

We assumed that younger athletes were always in perfect health. Then, after enough of them dropped dead during sports, took a look at how we examined them. If a sports physical is the only physical that someone might receive during a year, it might also take on an extra burden. Which is to say that, yes, bodies begin to have problems as they age, but let's not forget about folks of all ages.

The doctor question to his patient about his testicles, I would use as an example of a doctor not wishing to make his patient uncomfortable, by, say, looking at the testicles, hence the all you can wear we'll work around exams, although at least the poster was in his briefs.

I recently had my yearly physical with my internist. My internist is always very thorough and I have never noticed in variation in the way that he conducts his exam of me.

I recently had my yearly physical with my internist. My internist is always very thorough and I have never noticed in variation in the way that he conducts his exam of me.

Some doc still give their patients the best service possible, while some donot. But i think its the patient has a right to choose the doc he /she want to consult with. At any point in time we feel unsafe and un satisfied with the the quality service rendered by any health professional then its time for a change

My previous Primary Care Doc always use to see me, then she started to pawn me off to her NP, then on to other doctors or nurses in the practice. It seemed like to me that the more I got tossed around in the practice the less I was examined. That was confirmed when I went in for my annual exam and the NP who was assigned to me that day had a NP in training tagging along with her. I thought 'Oh Hell YES!!! This is going to be interesting!'

And It wasn't. Sorry to say.

The NP allowed the NP in training to conduct the oral history, medications and a very brief blood pressure checks. I personally don't think she did the BP correctly, because it usually is high and they always ask if I am nervous or something. Instead she jots down her reading in my e-chart and moves on.

Because of my oral history and the confirmation of her checking my written history in her computer records, the NP in training asked if she could do a check for a hernia. (I think I have shared this story before on this site) Anyway the NP did give her permission to do one. She admitted to never having done one before and asks for some guidance. The NP huffs and dons a pair of gloves and goes in and swipes around my testicles, as if to say, do the squeeze tests for lumps first, blah, blah... and then does a quick finger up the inguinal canal and then stands up. The NP did say very little and the training NP could not really see much.

The NP in training gets down and hesitates. She puts my right testicle between her thumb and finger and gently strokes down the last third of my right testicle and then repeats that same bullshit stroke down the left testicle. The NP huffs again and tells her that I will instruct her how to do it. So I try to tell her. She then asks me how she can find my inguinal canal and she points into my pubic hair, above said area. I instruct her to come in from below and feel for the ring. She tries her best and gets close on the third attempt. She has me cough, then the left side. She then says she wants to do a DRE. I simply turn around and bend over, the NP tells her to re-glove. She enters my rectum, up to maybe her first knuckle. She flexes her tip of her finger and withdraws. They both leave the exam room.

I get dressed and sit down. The NP in training returns to the room and tells me everything is alright and I can leave now. I look surprised, I suppose. She then tells me she was instructed to refer male patients with genital issues to urology and let them handle it. I know the NP is (lazy) and unhappy (?) in her line of work. She doesn't like to do much if she doesn't have to. I think that poor girl got the worst trainer.

I have since left that practice. The straw that broke the camel's back, was the pre surgical physical I was to undergo at the same practice. The male doctor came into the room 7 minutes late. Asked me a bunch of questions, mostly related to anesthesia. Then left the room after 3 minutes. Then came back into the room to tell me I was good for surgery the following week. He spent 4 minutes with me. He never touched me. He never looked into my mouth, ears, nose, eyes.... The appointment was set up for 45 minutes and I was warned I might be there for an hour with this type of physical.

My new doctor, of the last two years is hands on and I do like her method of physical exams. Except she checks for hernia with me on my back, and she is above (or outside) the inguinal canal and I fear she is not doing it right. But I am no doctor, and am afraid to ask her to check me while standing. My two annual physicals I have had with her I spent about 3 minutes completely naked in her presence. She goes to take out a sheet for my modesty and I tell her it is not needed, then remove my gown for her to exam my abdomen, listen to my heart and bowels, do the hernia exam and the DRE while laying there naked.

In my early 20's I had a physical from an old-school internist. Best, most thorough examination I ever had. That by which all others are measured.

There's got to be room for discernment. I went in for a sprained/possibly fractured wrist.

The practitioner spent more time listening to my lungs than examining my wrist.

That was a pointless waste of time that served to do nothing but annoy.