A medical examination must be such and there is no space for sexual excitement. This is the premise. If it's about playing the doctor, the speech is different.
I lay the patient on her back, wearing her bra and panties, telling her that I will try to realize her peripheral sensory response, starting to massage the breast slightly with the tip of her finger, on the bra, for a few minutes. Then I ask her to move the bra cups under her breasts, in order to expose both breasts, thus giving her the feeling of not being competently free, the feeling of light bondage.
The same procedure will be performed on the vulva, with the panties worn, first with the legs apart, then with the legs collected at the breast. Only after these preliminaries, will I tell her to move her panties to her knees and to stretch her legs, which are joined together. I will then go to the examination of the breast (which will not be a medical examination, but of stimulation) and, finally, to the vulvar examination (ditto, not medical but slow stimulation), proceeding to the retraction of the clitoral hood (which with the legs extended and held together is very exciting) and finally, with the legs collected at the breast, the examination of the vulva and of the anus, providing to verify the extension of the small lips, the tension of the fork and the navicular dimple, and counting the anal folds .
The subsequent clitoral stimulation, very slow, holding the clitoris between thumb and forefinger, as if you were making a small ball of wet breadcrumbs, and the stimulation of the vaginal vestibule with two fingers, and a finger in the anus, should lead to orgasm preliminary, which will be followed by a more thorough and detailed visit ...