Current State of Physical Exams

I agree! I thought it was just a bad experience at first. But this year, my physical consisted of conversation with the dr then straight from there to sitting on the table fully clothed and checking the glands, listening to heart and lungs, and then ended with a quick and exam. I even asked the dr for a breast exam and she said that they don't do those anymore, furthermore, if i felt a lump at home, to just go get imaging done. I was disappointed. I later went to a gyn for breast and pelvic, she was extremely through. More than I've ever had.

I'm lucky that I've had the same doctor for 11 years. He still does pretty much the same exam on me now as an adult that I got when I was a kid.

Is there a way I can ask for a thorough exam from my doctor?

In the UK your lucky now even to get to actually see a Dr let alone get an examination. I had an ongoing problem that went on for over year and I only got to actually see a dr once. Every other appointment (about 10) was done over the phone even when I was referred to a urologist, that too was phone only. Although this started due to the Covid pandemic it’s going to carry on as my GP surgery has now switched to a new online consulting system and they have said you will only be invited to see a Dr if they feel there is a real benefit to a face to face examination. Since I have no wish to discuss my private personal business over the phone or have to write it all out on an online form where I don’t know who actually can get to see it. I doubt I will ever get to see a real Dr again unless it’s by being taken to hospital in an ambulance.

In my experience, it's by who the Dr is and the practice. Most are just diagnosing the reason why you've made the appointment, and have too many other patients to see for a lengthy check-up. I've had Dr's request that I make another appointment on my way out for a complete physical, but I decline as I'm in good health, would prefer to see a specialist for non ear, nose, throat problems, and want to avoid paying the additional costs. I wouldn't be surprised if those requests are simply to keep revenue coming in, as opposed to a genuine concern for my health.

Annual physical exams have been ingrained in us as necessary health checks. For kinksters - they even provide a smidgeon of embarrassment/humiliation or just plain fun, However, some studies question the need and or value of annual checkups.

https://time.com/5095920/annual-physical-exam/

But while annual well visits are a familiar part of the health care system, a growing pile of evidence finds that for healthy people without any symptoms, these yearly physician exams are a waste of time and money—and in some cases may do more harm than good.

One large-scale review, published in 2012, found that annual physical exams do nothing to improve a person’s disease and mortality risks. Another recent study found a little evidence that annual physicals could reassure some people of their good health, and therefore reduce worry. But it did not find that these exams save lives or prevent disease. As a result of these lackluster findings, some experts have called for an end to annual physicals.

“If you’re healthy, there’s every reason to believe these visits make no difference,” says Dr. Ezekiel Emanuel, a professor of health care management and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania’s Perelman School of Medicine. “Doing a bunch of unnecessary tests and taking up valuable time for people who are well—that’s not useful.”

That is all good and well but I hate doctor exams overall. I probably wouldn't go either if I was sick and in fact didn't when I was having heart issues for months. They caught it at an annual heart thing. So yeah if people weren't knuckleheads like me you probably wouldn't need annual check ups.

I am in my 20s and recently had my yearly exam with a new adult doctor. Growing up going to the pediatrician it was a typical exam asking questions, checking my development and then for the genital exam would lift up my boxers after feeling my abdomen and feel around. Since changing to an adult doctor a few years ago it was more thorough in asking questions about my health and then would do a normal exam…he feels my groin muscles while I am lying down and then has me stand up for a more thorough genital exam and I had never stood up before. I have to pull my boxers down to my knees and he does a hernia check, feels my testicles and penis…the standing up part is new to me and really embarrassing.

“If you’re healthy, there’s every reason to believe these visits make no difference,” says Dr. Ezekiel Emanuel, a professor of health care management and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania’s Perelman School of Medicine. “Doing a bunch of unnecessary tests and taking up valuable time for people who are well—that’s not useful.”

Thanks @gwhap for sharing the info and the link. I saved the article so I have a source for my inevitable debates now that I can safely open my mouth to argue this.

Vindicated! My last checkup was well over 20 years ago. Since then I have gone to the doctor as needed- once for an infected finger after a janky manicure, once for a sinus infection and an annoying number of times for a knee injury. It's been 10ish years now. I have no plans to go to a real doctor anytime soon. A play doctor on the other hand…

@MittenKitten mentions

I have no plans to go to a real doctor anytime soon. A play doctor on the other hand…

ooooh Ms Kitten I'm smitten😜

ooooh Ms Kitten I'm smitten😜

@That_Australian I imagine I would be equally smitten hearing your accent 😊

Oh !…. Blushes😢

Do you think i might need a check up .... Here lay over my lap ...where's that thermometer got too 😁

My most recent physical was for my cdl. was expecting something somewhat thorough (as cdl's can involve transporting good via big rigs or transporting individuals via mass transit, etc) and turned out to be anything but. seems that primary care and entry level providers are most concerned with getting a patient in and out quickly so that another can be seen and billed. praying everyone stays safe out on the roads as there doesn't appear to be a guarantee that all drivers are safe to transport (not trying to offend careful and responsible drivers here - just an observation).

What irritates me is that even though you are in and out quickly, getting the fully clothed, barely touched you, barely looked at you “physical”, they still bill the same as a complete, thorough exam. All that does is help keep everyone’s insurance premiums high. If they aren’t going to really give someone a true physical, and they whisk them in and out instead, maybe that should cost a lot less than what they bill for a real physical.

What irritates me is that even though you are in and out quickly, getting the fully clothed, barely touched you, barely looked at you “physical”, they still bill the same as a complete, thorough exam.

I'm not sure about private insurance, but our doctor has separate billing codes for “Wellness” checks and "Physical exams. If the doctor feels there is cause for a more complete exam and they can justify it to Medicare - it may be covered. Some Supplemental plans do cover the cost of a complete physical. I don't believe they charge the same for a wellness check as they do for a complete physical.

Ah yeah I was just so used to getting complete physicals for every doctor I had but my current one doesn't check too many things so I figured that was a bit odd since I've always had complete physicals no matter what doctor I had at the time. The one doctor I had less than 10 years ago would just unzip my pants and check my genitals while I was reclining on the exam table as he was examining me. He was an older doctor though so maybe thats why. It's too bad the days of a full physical is fading away

@Buttshotlover let us know how the exams go with the urologist and the dermatologist

I received an email today from my doc's office saying that if you had been putting off getting a physical due to the pandemic that their offices are open and taking appointments. Is anyone else's doctor's office doing the same kind of messaging to get people to come back?

My last physical was probably in 2019. I've done a few telehealth sessions during the pandemic with my PCP, but I've otherwise avoided medical buildings for anything nonessential. And I think I want to lose the quarantine 15 before I go back. It's always embarrassing when a doctor gives you a few stern words about your weight (especially if you're hardly wearing anything).

Most of the doctors I go to spends the majority of their time in my appointment typing things on a computer.

5/14/2022. No change since original post - Drs. are more pressed for time than ever before and with the advancement in tests and testing procedures over the decades, there isn't much need for a Dr. to perform all the physical tests that use to be performed during a physical. A family doctor/General Practitioner has become a gateway to the world of specialties rather than a real practitioner.

That does not mean your family doctor is not a good doctor, only that health care can be the single most expensive item in a [person's/family's budget, and the proliferation of big medicine works hard to keep it that way. Pay for an initial visit, spend 2-5 minutes with the doctor who diagnoses your problems based on your verbal explanation of the symptoms, either get a prescription for a drug or a referral to a specialist. Example: When I changed doctor and medical group several years ago the first words out of the new doctor's mouth after I explained my urinary difficulties were, “We don't perform DRE's anymore, only urologists do that.” The idea is to reduce the cost of care and make sure the patient pays through the nose by referring them to higher priced specialists, who can then refer them to another specialist.

It is a business model, not a health care delivery model, that is based on numbers - most people will describe their symptoms adequately for a GP to make a good guess at what is wrong and what to do about it. Most outcomes are satisfactory. For those that slip through the cracks, big medicine spends millions, maybe billions of dollars on political action groups that twist politicians' arms to pass legislation to protect their interests.

I could go on and on, but I'll stop-I don't want to spoil the rest of my day.

Out of my last 4 physicals from 4 different doctors ( doctors retired, left the practice or in las test case, I moved to Arizona, only one doctor has done what I remember to be a Full Physical Exam. I now go to my wife’s Naturopathic MD and she has done a complete head to toe physical and complete skin check. This included a genital, hernia, testicle and rectal/ prostate

My current pcp is absolutely terrible. She spends about 3 minutes in the exam room with me basically listening to my heart and lungs and that’s it. No pressure exam bloodwork or anything else. As was stated previously, she spend most of her time typing at her computer.

At the practice I’ve been going to for the last 11 years, the doctor the physician assistant and the nurse family practitioner are very thorough. Every annual physical I’ve had involved a general to examination as well as a DRE.

@Newbie35 do you wish the Doctor would do more? Spend more time examining you?

@Nath42 it's not ok that I went undiagnosed for asthma until I was 28.

I had a physical exam early this year (2022), middle aged, but otherwise healthy man. Very plan, all clothes on, even shirt and shoes (I was weighed in shoes!). Too bad as my Dr was cute!

I can sum it up in two words- fucking lame. Everything is rushed and impersonal. That gentle human touch that us and our parents are used to is gone.

Everything seems to either be done by MRI or lab tests nowadays. OR you get passed off to a specialist.

I will let you know next month.

The overall structure of my physical exam has not changed. Once I enter the exam room, the nurse takes all the vitals and asks a few questions about meds and gathers info on any health issues - there are rarely any issues. She leaves and I wait for my Dr.

When the doctor comes in, he goes over my lab work (blood was drawn a week prior to the appointment) and asks questions about current health, exercise routines, job, etc.. Once he's done, he has me strip down to my underwear and I hop on the table for the exam. Based on some of the responses, my exam seems pretty thorough as he checks, eyes, ears nose, throat and glands. Then he checks lungs. After laying on the table he checks heart rate and palpitates my abdomen thoroughly.

Lastly, the underwear are stripped off for hernia and testicle checks and lastly comes the DRE. I feel like he spends adequate time with me and overall i think I have been sufficiently examined.

It does seem like exams are headed in the general direction described by the OP. My two most recent PCPs for example have not seen my genitals. For my pediatrician back in the day as well as my first dr. as an adult, they had me strip to my underwear, and they would come in and examine me, including the genitals. I then changed docs when I moved to a new area (only saw him one time due to subsequent change in insurance) and I didn’t undress at all during the appt. This was a younger doc unlike the previous one who was older. I recently had my second annual physical with my current one, not that old or that young. I am to strip to my underwear but then put on a pair of shorts that they give me. I am then given a physical exam, reflexes checked, abdomen palpated, but I still don’t have to remove my shorts/underwear unless I have concerns about my genitals. I am however, asked about sexual activity and the sex of my partners, and am offered screening for HIV/STIs.