Current State of Physical Exams

I am curious on the current state of physical exams in the year 2020. I feel like most exams these days are more about history, family history and everything than physical examinations. They still look in your ears and mouth and listen to you breathing, but I have not had to get named for an exam in a very long time. No physician has looked at my abdomen or genitals since the pediatrician and I'm just curious if that's how exams have become of late or if it more because I am in the healthiest years of my life (20's).

I'm curious to hear your experiences of late at a physical exam.

I have not had to undress for a physical exam since my college days. I am lucky if the doctor reaches under my shirt to auscultate me. It is a sharp dichotomy between this and the exams I received from the pediatrician. I often wonder why I was thoroughly examined by my pediatrician, and now only receive a cursory exam from my physician. I would like to know if pediatricians still thoroughly examine their patients. Perhaps the change in examinations occurred at the same time as I transitioned from the pediatrician to my adult physician. Do any members have recent experience with being examined by the pediatrician? I would like to hear about the examinations you received.

Just ask for a full head to toe exam. I had to only way I got a testicle hernia exam. I always ask for hernia if they dont give me one since I had hernia repair done while back.

I guess I'm lucky because my current primary care physician (female Internist) still performs a thorough annual physical exam. That includes checking pretty much everything from head to toe. Genital, hernia and prostate exams included. If she suddenly changed her routine where it wasn't as thorough, I'd probably begin my search for a new physician. But based on everything I've heard, the minimal "physical" that focuses on history and reviewing your meds seems to be the trend now.

I do not know if it is an American thing, but I only heart about regular pediatrician visits from Americans on this forum. In Europe, there were a few exams with a school doctor, but not as thoroughly. I do not know anybody that had to go to a pediatrician. Of course, there are some exceptions for specific cases.

As a consequence, I also do not have regular (full body) exams as an adult. The few cases that i am really sick, the doctor is auscilating. Only removing my shirt, is the most naked I have to go.

Also, I have read that in the US women are expected to get a full well women exam every year. In my country (Belgium), it is expected to get a PAP smear every 3 years. Then, only the sexual health is checked with no other things, like weight..

I grew up in the 1970s and was a teenager in the 1980s. I rarely had a physical at that time when i was not fully naked for at least part of it and I NEVER had a doctor visit at all where all my clothes stayed on. Even a quick visit because I wasn't feeling well, my shirt at least would come off. The least amount of undressing I can recall at an actual physical exam back then was when I was 16 and had to have a quickie physical at the state health center for a summer job at a park. For that one, i was wearing a flannel shirt and jeans with no t-shirt and I was told to unbutton my shirt the whole way and open my pants up.

But now, I rarely have to take anything off at all. I'm often weighed wearing shoes, even.

My last physical the doctor never even laid a hand on me. He just talked and asked questions.

He laid gloved hands on me and included a thorough genitalia exam even more thorough than the pediatricIan.

I haven't been asked to get undressed for a normal annual physical in years. Normally it's height, weight, a boatload of questions, listen to my heart and lungs and finally blood work follow up at the end. No genital exam or rectal. Only time that happens is at the urologist and then I'm fully dressed--exam takes like 10 seconds. Doctors simply don't take the time anymore and they're also afraid of malpractice suits.

I'm afraid the current state of physical exams is a sad one that isn't getting any better. I think in the western world, doctors not putting a hand or a stethoscope on a patient unless there's a problem, is becoming the norm. I do remember being in my underwear at my pediatrician's office most of the time, that I went every year and the exams were quite thorough, including a belly exam (my favorite) and a brief exam of my genitals…..fortunately no rectal or rectal temperature.

I'm trying to remember when I left the pediatrician's office and how the exams were in young adulthood. I remember one pre employment physical I had in my 20's which was particularly thorough, done by a male PA at the local hospital's occ health office. Stripped down to boxers, gown and drape. Very lengthy exam, lots of heart auscultation and palpation of pulses. Comprehensive neuro and musculoskeletal exam and a very thorough abdomen exam….auscultation, general percussion, light and deep palpation and percussion and palpation of my organs and a hernia check…i thought I was the only one who did all that anymore…and that was the last time it was done to me. Since then any pre employment or DMV exams I've had have been fully clothed and quite unsatisfactory. I was at urgent care last year for one and was quite excited to see my NP was a younger, fit ginger named Kelsey. Any excitement I may have had quickly waned when I was not asked to get into a gown. The entire exam was seated, she didn't even lay me back for cardiac or abdominal….really just listened to my heart in 2 places and squeezed my abdomen once. Terrible!

As far as my primary care doctor visits go, I've been pretty lucky over the past 10 years or so. I've had to change doctors a number of times due to corporate continuously changing our coverage, which means I always feel inclined to go for a new patient exam. All of my docs have had me in a gown at least, even if I get to leave my pants on. They've done a moderately thorough routine exam, which has been nice. I'm excited to see what my new doc has in store for me, she's a very cute, athletic woman in her 30's and after missing my in person visit due to covid last year, I finally get to see her next week.

Back to my original point, the many ladies I've examined over the years have mostly told me that their doctor spends all of 5-10 minutes examining them in the context of a routine physical, sometimes in a gown if it's for a gyno appointment but otherwise fully clothed. Most say everything is very brief, probably half don't ever remember having any sort of abdominal exam. I hosted a physical and abdominal exam clinic in Toronto last year before covid and discovered that things might even be worse up there. Only 2 out of my 6 patients remembered a doctor ever touching their belly during a routine exam and most said they don't get those anymore anyways…something about Ontario health not reimbursing for office visits if there's no problem, so doctors don't encourage them. Sad indeed.

I see my primary care doc twice a year. The first is the ridiculous Medicare “wellness check” fully clothed. Review of lab tests (blood and urine), blood pressure, heart, lungs, and conversation. Once a year, however, I have, and pay for out of pocket, a true physical, with the lab tests, ekg, and a full physical exam, including prostate and hernia check.

As far as I'm concerned, I might not be seeing the doctor at all anymore unless I'm sick within a few short years. Haven't had any physical as that of my pediatrician ever in adulthood. Soon it will only be fetish folks like us playing doctor still doing it.

As far as I'm concerned, I might not be seeing the doctor at all anymore unless I'm sick within a few short years. Haven't had any physical as that of my pediatrician ever in adulthood. Soon it will only be fetish folks like us playing doctor still doing it.

Same. Not one single physical exam I've had as an adult comes anywhere close to the detail and comprehensiveness of the ones I had as a kid and as a teenager in the 1970s and 1980s.

My last few annual exams. Doctor asks questions and types on computer. Nurse comes in and draws blood. Thats it.

Kind of funny considering all the you tube videos we watch here of the head to toe exams… Nice to fantasize about but never happens.

Someone mentioned that the cursor nature of physical exams could be a fear of malpractice - could be, but I think it's just profit driven. It's the need to push patients through quickly so that they can see more, in order to ensure that quarterly or year end bonuses are made. It's probably the decision of the LPN or PA that you're seeing, but the culture being set by the business office - “let's get as much money from the insurance companies as we can!”

I think it all depends on your doctor. More “old school” doctors will still do a “real” physical. At my last check-up, I had to undress to my underwear, and the doctor gave me an actual physical, including pressing on my abdomen and a genital exam that included touch. For the latter, he asked me to drop my underwear, gloved up, and felt my testicles, then checked me for a hernia. I'm too young for a prostate exam, so no idea if that would have been included.

I'm 18, and have never really experienced an intimate exam. Modesty is taken far more seriously nowadays.

My last annual was 3 weeks ago. No longer called an annual physical it is now an annual wellness exam. Only clothing removed was shoes and socks. BP taken and listened to heart and lungs. had to draw a clock and repeat 3 words.sent to vampire for blood draw. Been like this for last 3 or 4 years. Patient count - push em through.Practice now owned by large conglomerate that owns the health insurance company and med. provider.

So actually, I had my annual today and while I wouldn’t say it was exhaustive, he did check everything out including my genitals and I got a few swabs. I think you have to find the “needle in the haystack” so to speak but they are out there! And, he’s a young doc, maybe 30s.

In the UK you need to go for a private health assessment by e.g BUPA, BMI or NUFFIELD where you will get the full head to toe. Cost £500+

I have had quite a few physicals over the years have yet to undress to an embarrassing level too much focus on modesty here in the U.S. in my opinion.

I still have to pull my knickers down every time when I go for my medical.

I had a full physical examination last year in 2020 by my GP. I was given a gown and instructed by the nurse to remove all of my clothing. She then exited the room, and returned with the doctor a few minutes later.

My exam included a digital rectal exam, and palpation of my penis and testicles.

It was the first time I’ve had these procedures since childhood. I believe if someone goes in specifically for a (full physical), a full physical is what they will get.

My last physical was in 2019, because of COVID, but I will share some thoughts.

I have been going to this clinic since 2016 maybe. It is very small and independent with just an NP in her 50s and an MD in his mid-60s. I'm pretty sure they give the most-thorough physicals around, at least the MD does. This is partly because I have a history of prostate cancer in the family and have made it clear I need to be screened for that.

Each time, I have been instructed to undress and wear a gown. For the physicals from the MD, I have been told to take off my underwear before the doctor comes in. The most-recent exam for the NP they told me I could leave my underwear on. She reached into my shorts briefly, while I was standing, and examined my testicles, but no hernia check and no penis exam. She checked my prostate with me on my side, after telling me to slip down my underwear. This is awkward because it's hard to take down your underwear when you're also wearing a gown. I don't feel like she pushed inside me too far.

The MD is more thorough. He pushes up the gown while I'm lying down and checks my testicles and visually inspects my penis. Then he has me roll on my side to do the DRE. He inserts his finger very deeply and thoroughly checks my prostate.

Before going to that clinic, I tried a clinic that was part of a big medical group. I was excited to go because the doctor was young and very cute and still a junior resident. I thought chances were decent that maybe a teaching doctor would be in the room with us. (I had a fun experience when I was 19 and examined by a medical resident not a lot older than I who was nervous as he told me to undress bit by bit, until I was in my white briefs, which ended up at my ankles as he fumbled around on my penis. At that age, of course, DREs are rarely done and that was true in the 1980s when it occurred.)

The more-recent exam from the medical resident was disappointing, and quite honestly was concerning, because there was no DRE or any undressing at all. The young resident made it a point to tell me they don't do DREs anymore, and the PSA is more than enough, so that is what he did.

Based on my experiences, the days of the thorough physical exams are numbered.

Well, I had my annual today, a year and a half late because of CoVid. I'm a Kaiser patient and due to several moves and my company switching up health plans over the past 5 years, this was my third new doctor. Not gonna lie, I picked her because she was attractive in her profile pic and that did not disappoint.

The medical assistant took my vitals and much to my dismay I was not asked to get into a gown. Doctor came in, she was as previously stated very attractive and fit looking. We talked about my health over the past 18 months, mental and physical. She reviewed all of my recent lab results which she was quite pleased with. She reviewed the one medication and the supplements I'm taking and asked if there was anything I was concerned with.

She said “ok I'm just going to do a few things I always do as routine”. She looked in my eyes and ears. She palpated my lymph nodes and thyroid. She listened in 4 cardiac auscultation points for a surprisingly long time, probably because some NP had put a slight murmur on my record years ago, she said everything was fine. She listened to my lungs in 4 places and pounded over my kidneys.

Then my favorite part “ok I'm going to lay you back so I can check your stomach”. She laid the head of the table back and pulled the extension out. She listened quickly to bowel sounds in 2 spots and to my aorta. She kind of laid her hands on my abdomen over my shirt and pushed in, then asked about my drinking as she kneeded my belly a bit in all 4 quadrants, quite deeply actually.

She seemed satisfied with my answer and had me take a deep breath as she felt up under my ribs. She didn't touch my liver as far as I could tell. She patted my belly and said “ok everything's good you can sit up”. No rectal, no prostate, no hernia check….all ok by me. I know, I'm boring. She told me to reach out if anything concerned me and to keep up the good work. That was it.

Heh, my last one was a work physical prior to getting in. Nothing really intrusive. Just vitals and stuff. A quick press on my abdomen (lasted like 10 seconds), that was about it.

Wouldn't have minded if it was a little bit more thorough…

Certainly things have become a lot more modest and anything unnecessary not really performed.

Had my regular yearly physical back in January. Nurse did the basics and then handed me a gown and said that I should take everything off except for my underwear. When she left, I stripped down to my blue briefs and put the cloth gown on. When the doctor came in he did a pretty good exam. When he had me lay down, he pulled the gown up to my chest area exposing my semi erect penis in my briefs. He continued his exam of my abdominal area. He listed the waste band of my briefs and pushed around my pubic area. He then said “I have to check your testicles”. As I stood in front of him, he instructed me To lower my briefs and spread my feet. He then palpated each testicle and checked my scrotum skin. He pinched the tip of my penis and said he was checking for discharge or rashes etc. When that was done, he said to turn around and bend Forward. As I did , he separate my cheeks and pressed his finger against my rectum but didn’t insert. He then said I was good and could pull umm up.

I'm scheduled for my annual physical exam on Thursday @ 9:20am. This one will be different since I'll be seeing a Physician Ass't vs the female MD that I have seen the last 2 years. I didn't undress at all for her--lots of questions, heart, lungs, blood work and that's it. The entire exam lasted 10 minutes tops. This time I'm seeing a male PA so we will see….still not holding my breath for a full exam, though especially since he will see on my medical history that I see a urologist 2x a year for a prostate check.

@ls12 write back with details after Thursday. I’m sure a lot of us would appreciate it.

@DrColin When the doctor asked you to lower your briefs and spread your feet, were you still wearing the gown? Did you have to hold it out of the way?