Are thorough physicals still a thing?

I'm 39, turning 40 this year. Every year I schedule a physical and it feels like it's very superficial. Doctor feels my glands, listens to my heart and lungs, listens to my abdomen and feels it and then ask how I'm doing and order labs for cholesterol, etc.

Are annual physical exams really like this now? Or am I not scheduling it correctly when I schedule it? I just ask for a physical, should I be asking for something else?

If that's what a thorough physical is these days, that's cool. But if it's not, how do I go about to get one scheduled? What do I say? I'm not one to try to use my kink to get unnecessary medical procedures just to satisfy my kinky desires but if I am missing out on a thorough physical, I'd love to know what to say to get one. LOL

I had a doctor refer to a more thorough physical as a CPE, Complete Physical Exam. I declined as I have learned through experience that there is nothing to be gained by getting annual CPE’s.

@ChubbyLeahCD – Unfortunately my experience has been the same. the hottest thing in the world for me is to watch a strange man feel up my wife. but now they never do anything. while an annual well woman exam used to be really thorough, now they mostly dont even do annuals. they do not recommend clinical breast exam, which was always one of my favorite shows. and they do not recommend annual pap smears. now only a pap and hpv test every five years. and they do not recommend manual pelvic exam at all. just to get the pap and hpv sample. but no more fingering her and probing her butt hole.

the new recommendations really suck!

I hate to say it, but if you really want an old fashioned exam, you'll have to find a doctor who likes to do things the old fashioned way. It means finding an older doc who hasn't really had to change with the times.

If that's what a thorough physical is these days, that's cool. But if it's not, how do I go about to get one scheduled? What do I say? I'm not one to try to use my kink to get unnecessary medical procedures just to satisfy my kinky desires but if I am missing out on a thorough physical, I'd love to know what to say to get one. LOL

@ChubbyLeahCD Tell your doctor exactly what you said here. If you feel a more detailed exam would be more thorough, discuss your concerns. If you feel he/she is just brushing you off, perhaps you should find a doctor you’re more comfortable with. I am comfortable with the level of exams I get today. All of the “more detailed” exams I ever had never detected anything. If I had a specific concern or something odd showed up in my labs, I am confident my doc would address/inspect It or refer me to a specialist.

I am over 65 and on medicare. Medicare calls it a wellness exam. There is really nothing to it. The nurse took my blood pressure, pulse, and temperature. I took a EKG printout to them from my heart doctor. The doctor came in and ask me a bunch of questions and then listened to my heart and lungs. Then I did a urine test and blood test. That was it.

A few years ago he would palpate my internal organs, check me for a hernia, and check my prostate. Not anymore. I don't know if it is medicare doesn't pay or if at my age he thinks the rest of the stuff is unnecessary.

Not so much anyone from the PCP, seems like it's easier for them to refer you to specialists for any related issue unless that's part of getting older.

I did attend of my GF's annual exams/wellness visits with her PCP and she did offer to do a breast exam in addition to the simple auscultation and feeling the abdomen with lymph nodes through clothes.

I am over 65 and on medicare. Medicare calls it a wellness exam. There is really nothing to it. The nurse took my blood pressure, pulse, and temperature. I took a EKG printout to them from my heart doctor. The doctor came in and ask me a bunch of questions and then listened to my heart and lungs. Then I did a urine test and blood test. That was it.

A few years ago he would palpate my internal organs, check me for a hernia, and check my prostate. Not anymore. I don't know if it is medicare doesn't pay or if at my age he thinks the rest of the stuff is unnecessary.

@Buttshotlover Is this the same doctor who checked your internal organs and prostate, and then just stopped doing it one year ?

When the annual physicals at work started becoming performed by a nurse practitioner as a cost cutting measure, the 1st year the nurse practitioner gave me THE most thorough exam I ever had (penis included). And the next year, we just sat at her desk and I was advised about this and that and that was it.

I can answer only for France since I am french.

I am afraid that thre will be no more a thorough physical examination at a doctor's office like it was several years ago, more than a decade indeed, for a check up or an annual casual exam, it was very different of my younger years,.

There are many reasons : lack of time of doctors, lack of interest if you are not sick , fear to embarrass a patient by instructing him to remove clothes ( ieven being ausculted with stethoscope bare chest is not the most frequent, very often the doctor did it above your shirt or tee-shirt)

The doctors seem to be always in a hurry and they usually took your blood pressure and pulse, sometimes palpated quicky your belly, heared at your heart and lungs and asked some questions and it is finished …

Nothing to compare to when I was Young with old schoool doctors who wanted you to undress as soon as entered in their office and checked you from head to toes front and back.

And at my time there was a lot of mandatory physical exams all along childhood, teenahood and even as a young adult, ( at school, at university or superior school, to enter at summer camps or boarding schools, apprenticeship, for the military service , for the first job, to enter in the administration and so on … not now because most of them had been suppressed or when they still existed, they are optionnal like at school or they are much more quickly performed in a very different way ( never group exams like in the past )

I was a kid in the 1970s and a teenager in the 1980s and I have never, ever as an adult had a physical as thorough and as detailed as the most thorough and detailed ones I had back then.

JTmac, yes it is the same doctor. I forgot to mention that until this year they always did a chest x-ray. It was also omitted this year.

This whole thread sounds like a description of my complaints. 2013 was the last year I got a real physical where I stripped naked upon entering the exam room and about a half hour later when the doctor was through, put them back on and left. He retired/quit on Dec. 31 2013 and I had to find a new doctor. She never did more than listen, through my clothes, to the sounds my insides make and never wants to see any bare skin. When I asked about a rash next to my testicles she didn't really want to look at it but when I dropped my tighty whities to show it to her, she kind of had to. A few years ago when I lamented the lack of a “take em all off” physical she agreed with me and did do it the next time but never again.

I made a first time appointment with a dermatologist a month ago expecting to be checked everywhere at my age of 82. Sorry boy!!!! She was great but never got below my waist except to look at the past tense sore I had on my penis which I mentioned on the entrance paperwork. It was caused by the nurse at the hospital who had to get a “clean” urine sample who scraped the inside of my foreskin and coronal ridge with the “urinal” bottle.

So real exams like some of us were used to have gone to live in the grandfather's clock.

I've had one thorough physical in my life and that was about 8 years ago, but that doctor changed practices and was bit farther than I wanted to drive. Since then all my physicals have been very superficial as others have said. My current PCP (who I like overall) and have been seeing for a few years has never done any kind of check below the waist. My PCP before that was similar. He maybe once lifted the waist of my shorts to take a quick look at my genitals but that was it. My annual dermatology appointments as least get me to my underwear but they only ask if I have any concerns in that area and don't check unless I prompted them.

When my wife was in her early twenties we saw a local doctor that just opened a practice. He said he would do a very thorough exam because she wanted to make him her regular doctor, and back then they wanted to know what issues you had going on.

He did not use a gown because she did not want him to--that is a story i have talked about before--and he spent more time on her than any other doctor i have ever seen. His exam took more than one hour. It might have been close to two hours and he looked at everything and talked about everything. Made her stand in front of him, again fully bare, and he talked about the veins in the back of her legs. He did not see anything wrong, he was just explaining about varicose veins and how they start. He explained lots to us. It was a very thorough exam.

He explained the things that she should be doing. It was super hot watching him have these conversations with her. him fully dressed and her completely bare. It was just amazing. Sometimes she was standing and sometimes she was sitting.

He showed her, on a plastic model, how a diaphragm goes in and where it sits. That was hot. Him and her leaning over his desk holding the model.

He showed her how to do breast self exam and spent a long time talking about and feeling her breasts.

The good old days for sure.

I found most doctors my wife and I have went to over the past 10 years basically asked questions then did basic heart, ears, blood pressure a couple blood tests and sent my wife to a gyno for a Pap smear and mammogram. That was it. Until she called and made a appointment at a Naturopath MD now this female NMD spent an hour just on the physical portion for her, doing everything from questions to breast exam, genital and Pap smear. A one stop shop that my wife says was her most complete physical in years.

So I made an appointment and had the same results, a complete blood work up plus additional blood work I never heard of, next week was my actual physical. Which was one hour long, full skin exam, genital, testicular, rectal exam and then a digital exam of my prostate. She even opened the head of my penis and loomed with a bright light inside.

Just had a complete routine physical about a month ago. My doctor checked me from head to toe including the genital and prostate exam

I used to have full body exams, requiring me to strip down to my undies. I switched doctors around 15 years ago, and haven’t received anything more than a list of medical questions, vital signs, and bloodwork. I actually prefer it this way. It’s far less stressful. Besides, I hate rectal exams.

I required a full medical including blood work and an eye exam. I wanted to start to fly again this was all required. My Dr. does not even mention my diaper anymore other than asking permission to open the tapes to examine me.

@XposeHer That must really been a view when your wife was nude for a longer period of time while you and doctor were dressed and watched her.

I actually haven't heard that somebody had that thorough regular physicals, except I once had a gf who went to an examination for her work certificate, and I told that story in detail in this post (15) : https://en.zity.biz/index.php?mx=forum;ox=display;msg=1243590;nox=2510537

He performed really thorough full body exam, but most interestingly really long breast exam, brief vaginal inspection and detailed rectal exam. He also made her walk in front of him in her undergarments to look at her posture. The exam was very intense, especially because she didn't expect it at all.

And I noticed that a lot of your stories happened a long time ago when doctors were much more brave and even rude. But this story happened very recently, maybe 5 years ago.

Yearly exams are a sham. My doctor spends maybe 5 mins with me and most of that is just sitting at her computer. Listens to my heart and lungs then does a half-assed abdominal exam and I’m out the door! It’s quite unfortunate.

As folks have touched on, it's a reimbursement problem. If one wishes to delve deep into the bowels of Medicare regulations concerning annual wellness visits, you'd find that the exam elements required are shockingly minimal: bp, height, weight, bmi, maybe waist circumference and anything else is at the discretion of the clinician. That's part 1 of the issue.

Part 2 is primary care at least in the US is underpaid, so in order to get enough patients seen in 1 day to break even much less be profitable, they have to stuff the schedule as full as possible, meaning shorter appointment slots and less time with the clinician. So you put that all together, and that's how we got the current situation. If you want to have the clinician spend more time, your best bet is a direct primary care practice or a concierge practice. Even small practices determined to do it right from the outset sooner or later run up against the cold, hard, unyielding financial reality.

Source: I am a medical biller, I've worked in areas from tiny startup main street practices all the way up through regional hospital systems, outpatient and inpatient.

So they actually NEED to keep the massive turnover rate? I assumed they were just trying to get people in and out because it cost too much to actually treat people. i.e. they were operating at a loss. I was thinking “if you'd actually cure me, i'd stop making dozens of appointments a year and clogging your system up.” but I guess if they actually need more people in to make money, they want me to keep making all of these meaningless appointments where nothing is accomplished.

@Somebody , if they wish to stay profitable, then yes. The margins in medicine are to some degree ones you have no control over. Insurances will pay what they will pay (or deny claims), supply and insurance costs are quite expensive, plus all the standard business overhead (rent, utilities, staff, non medical supplies, taxes, etc). The break even for primary care is usually 40 patients a day.

The margins in medicine are to some degree ones you have no control over. Insurances will pay what they will pay (or deny claims), supply and insurance costs are quite expensive, plus all the standard business overhead (rent, utilities, staff, non medical supplies, taxes, etc). The break even for primary care is usually 40 patients a day.

@hearmyheart It seems to me that they have spread - or moved - the costs around. Sort of like playing hide the wienie! My PCP is an Internist and does a 30 minute consult that covers the basics along with my list of concerns and orders a pretty thorough lab workup. She has me see a urologist once a year for the the usual, a gastro once every other year, a pain management doc for shoulder and back issues, a dermatologist annually, an orthopedic doc for some joint issues, a hematologist if something funny shows up in my blood labs, an ENT for any sinus issues, and so on ….. in fact, last year I had more doctor visits and imagery done than ever, and I basically don't have any major medical issues outside of being not so young anymore. Everything I note with my PCP gets addressed.

Over the course of a year I feel that I get a very thorough exam coordinated by my PCP, she is sort of the quarterback reading the defense and calling the plays. By parceling it out it costs medicare and my supplemental more than the old single point physicals - but I am seeing specialists that have better knowledge and experience in specific areas than a General Practitioner. I feel well taken care of.

And that's excellent that you feel well cared for.

What I'm asserting is that frequently there's a lot of crazy financial dynamics going on behind the scenes, but the independent unaffiliated practices can do things a bit differently should they choose, but its a very fine line to balance timewise making enough to keep the lights on and good patient care.

@hearmyheart

And that's excellent that you feel well cared for.

What I'm asserting is that frequently there's a lot of crazy financial dynamics going on behind the scenes, but the independent unaffiliated practices can do things a bit differently should they choose, but its a very fine line to balance timewise making enough to keep the lights on and good patient care.

that’s what I was implying. The PCP makes her quotas, but farms out the rest of the healthcare. That’s the crazy financial dynamics.

I'm now aged 79, and live in the UK.

In my school years and in my time in my 20s, medical examinations were very common. At school to check development, and later for pre employment and life insurance requirements. Generally you would end up naked and have the ‘cough and drop’ test.

These days much more reliance on blood tests and scans. Ending up undressed at the surgery is now and again, rather than routine.

Maybe there were some advantages in being as old as I am!

It's all about the $$$$. Most HMO' s or other medical plans now refer to it as a wellness checkup which means nothing more than blood work and a few “anything bother you” questions.

Yes, they are, and for children and teens more often and more thorough than ever. But they are are often done under deep sedation or even general anesthesia, so that the patient is not aware of it. The kid will often be given some explanation that tells about just a limited purpose. But what is really done is not limited. It often incorporates more than one of these: Endoscopic inspection, ultrasound examination or specimen taking of the urinary system, upper digestive system, respiratory system, lower digestive system, abdominal cavity, chest cavity, joints or nervous system. The explanation given will will often tell about just one small part of what i really done, or it will tell about some small surgery like tonsillectomy, dental work, or hernia surgery.

So is the reality that the general public i not aware of. The patient, most often a kid, will usually wake up with symptoms from several body parts, but will be given some dummy explanation that most tend to believe in.

Of course this cost money, but these are payed secretly by the government, WHO, UNICEF, school system, child protective system, research organization and other instances with some interest of knowing everything about the kid. These secret activities is one of the reason that many services cost steadily more without any visible increase of the usefulness of the service or steadily increased taxes in many societies.

Yearly exams are a sham. My doctor spends maybe 5 mins with me and most of that is just sitting at her computer. Listens to my heart and lungs then does a half-assed abdominal exam and I’m out the door! It’s quite unfortunate.

My sub's yearly “physical”, which I need to schedule, is very much similar @med_switch except he does get a few more minutes discussing his gout and uric acid levels. We spend about the same time with the nurse as she draws his blood.

But they are good about calling and letting me know his blood work results. Even sending out a paper copy to add to my notebook. I'm old school and have yet to understand the online medical stuff.