People with a good feel for the physical examination process can recognize very quickly the style of exam they are receiving. The level of detail and time paid to the head, eyes, ears, nose, and throat for instance gives a good sense of what the rest of the exam is expected to look like.
The most powerful moments I’ve had is when this changes suddenly. In my early twenties, I presented for a routine physical - which generally meant changing into a gown and receiving a cursory 10-15 minute exam. This time, I knew something was different as I felt the blood pressure cuff deflate midway. With it still tight on my bicep, the doctor squinted slightly, closed the valve, and reinflated the cuff as if unsure he was hearing correctly. When he let the pressure release, instead of removing the cuff and moving on, he purposefully moved it to my opposite arm and repeated a measurement.
Finishing that, he paused and matter of factly told me that my readings were quite a bit higher than in the past. He asked if was anxious, and up until that moment I hadn’t been. From there, what would have been a thirty second listen to my heart while lying down became a fifteen minute study of examining my peripheral pulses, palpating my left chest, auscultating my heart seated supine and standing, and obtaining my first 12-lead EKG.
In the end not much came of it, but my heart was examined more closely than usual for a couple years following. It was my first sense of how significant those seemingly trivial moments in a physical can feel to an examinee.