Are thorough physicals still a thing?

It seems there is a consensus that annual physicals are/have become very superficial. If you don't mention any type of problem you might have, a physical takes less time than the drive through at a quicky gas station carwash. The labs from your blood tests are pretty much all the doctor looks at. Their hands on exams couldn't detect someone dying of stage 3 cancer.

I used to get prostate exams, but they don't do those anymore. I used to strip down to my under ware, but now I might be asked to remove my shirt and that's it.

I know there are lots of people on this site who are into medfet. But if you are hoping for a simi-quasi fun experience when you get your physical, it's not going to happen.

I hope I don't live to see the day they just have a dog sniff me. Well actually maybe I do.😄

At the hospital recently they had me on an IV to get the fluid out of my body and I felt great when I got back to work so my Dr put me on Lasix and I slowly got worse. She upped the dose and I feel great again. She wanted another blood test and when she saw me she told me to get an appointment with my cardiologist in the next couple months – no rush.

I went on line to set one up last week. Today the appointment setter upper for the medical group called to ask why I wanted an appointment when I just had one 2 months ago. I told her my PCP said to and she told me she was going to look into it and call me back. She called back while I was at work and talked to my wife with the options. The Dr. is on vacation but his nurse could see me at a time when I would be working so we got his assistant at a time when I can make it.

Still don't know why I'm seeing her or him but if an assistant can handle it it must not be too important. What is an assistant anyway?

The Dr. is on vacation but his nurse could see me at a time when I would be working so we got his assistant at a time when I can make it. Still don't know why I'm seeing her or him but if an assistant can handle it it must not be too important. What is an assistant anyway?

My sub has alternated seeing his cardiologist and his assistant at his appointments. They are like a PA except specializing in cardiology…I think. I have felt in good hands when our appointments happen.

I hope your assistant visit goes well @roscoe .

I agree with those that have suggested mental health has risen in importance as part of physical exams. My last one was a few weeks ago. I got the most limited testicular exam imaginable. The doctor (female) did check them, but with my underwear on, and with me standing. She just felt them without any visual inspection, very distanced, almost from afar, and only after she had me feel them first a little to find the one spot that was sensitive that she then followed up on.

The DRE was also the quickest I have ever had…I don't think she was in my rectum for even 3 seconds. But of course there was lots of talking. Maybe this is not indicative of other's experiences, but it didn't seem to really count as a physical, even thought it was classified and billed as such.

... The DRE was also the quickest I have ever had…I don't think she was in my rectum for even 3 seconds…

@dr65952 I don't mean to sound like I'm belittling your complaint, but… a quick DRE is still a DRE. Just be happy that you actually got one. Every DRE that I've received at my PCP has been less than 10 seconds. From what I've read on this forum, that seems to be common (for a real exam). It's all about perspective.

@BenDover I take your point, but the ones I've had in the past have been more thorough. This one, she seemed afraid to even be doing it, trying to do the absolute minimum. There's a difference between that approach and simply doing it quickly.

The exams done today are an abbreviated form of what previous exams were. They include the basics plus lab work which reveal a good amount of information. I had a fe friend go for her yearly exam, the MD felt something during the abd exam. Pt has no symptoms, but MD ordered a CT scan, and that exam revealed a mass in the pelvic region. Fast forward this to the fe is a RN, works in an academic medical center. She had the CT scan done the next day, called for a GYN-ONC appointment, only to be told he was booked 2 months out. She emailed him the next evening, saw him within a week and had surgery a week later. The mass has some strange type of cells so she gets a CT scan every year and an evaluation by him yearly as well. Connections help but with referrals, but u can find e mails for MDs easier than u think.

The exams done today are an abbreviated form of what previous exams were. They include the basics plus lab work which reveal a good amount of information. I had a fe friend go for her yearly exam, the MD felt something during the abd exam. Pt has no symptoms, but MD ordered a CT scan, and that exam revealed a mass in the pelvic region.

I'm glad your friend was able to catch the issue before it became serious.

But this is the problem. She had no symptoms. In most cases (at least in my recent experience and in reading below - and in the US, i should note) the PCP wouldn't do an abdominal exam if there were no symptoms. In most cases, it's weight, pulse, and blood pressure with the nurse, the HEENT, breath & heart sounds with the PCP, then blood & urine and off to billing & co-pay

Medical practice and norms change over time. Obviously Routine physicals are different (for most) than they were in the past. Is this a good thing or a bad thing? Think back to some earlier changes in medicine that occurred and how folks back then might have reacted:

• 4-5 hundred years ago Rocky comes home from the doc pissed off that they are out of leeches!
• A Victorian lady comes home angered after a Dr. won’t prescribe tape worm eggs for weight loss anymore.
• A guy from Australia during the 19th century was upset there weren’t any dead whale carcasses available to sit in for his arthritis treatments.
• During the 18th century Tobacco Enemas were used to treat headaches and other ailments – a sincere blow to enema enthusiasts when they were discontinued as treatments.

While these are somewhat extreme examples, it’s certainly possible there are very good reasons (besides cramming in more patients or for more insurance billing) for some of the changes in current medical practices.

Lab work and imaging allow Drs to see what's inside the patient much better than palpation and physical exam. Drs leave to the patient to tell if they feel something wrong.

Two days ago I got a pain in my back that was exactly like the one I had 27 years ago when I had a heart attack, so off I went to the ER just in case.

They wanted to do a stress test but said I had to be admitted to get it. That meant an overnight stay so they could charge me for a $$$ day in the hospital. I had the same test in 2016 but all I did was drive there in the morning to take the 4 hour test. That's not the reason I'm writing though. They have a new admission policy. When I got up to the room the nurses assistant had to do a full body skin exam before they let me get in the bed. It was a better exam than I got 2 months ago when I went to the dermatologist for a fbse. She started at the top of my head, down around the back of my ears, neck, face, underarms, arms, hands, fingers, back, front, groin--both sides, all around penis, balls, taint, butt sides inner and outer, legs front and back, balls of my feet and toes. Then she let me put my underpants on and a gown and get in the bed. Of course that cost a bit more than the $30 copay the derm got.

My insurance company applies $700 of the one day hospital stay charge to the deductible so I have to pay it. Medicare allows $~250 and pays that amount.

Drs and nurses seem to think it's too invasive for guys and would embarrass them. I say it's nothing compared to what they do to girls on a routine basis so why should they shy away from a thorough exam?

I just had my annual physical, which I described in another thread.

She had me strip to my boxers (she left the room while I did that). She then did the usual vanilla exam. She asked if I still see the urologist, and I said yes. She then said “ ok, I'm sure he will check your prostate so we can skip that today”

This response was expected, but I was still disappointed.

I'll get the sausage finger from the urologist next week.

The last somewhat “complete" physical that I had was approximately 6 years ago. My GP had me to strip and did the skin check and checked for lumps on the testicles. That has been the most thorough physical that I have had in about 26 years. I am currently going to a urologist (and even had a cystometrogram last week), and am on medication for enlarged prostate, and have only had the PSA blood test done. Although I am thankful that they don't want me to be in pain (they were first convinced that I was suffering from prostatitis), I can't help but be of the opinion that this “hands off approach" will lead to some things not being caught. As far as doctors depending on patients to tell them when issues come up, I was raised in a family where almost all of my mother's brothers had prostate problems. I grew up with the impression that straining to urinate was just part of getting older. I maintained that line of thinking, until I started not being able to urinate unless I was so full that I was in pain (and even then, it would sometimes be hours before I could actually urinate).

Colonoscopy over! Got there at 8! Home a little after 10. I know they did something Invasive but I didn’t know it! I woke up in the recovery and stayed about 15 minutes and they discharged me! I did ask the doctor if he did a rectal exam before the colonoscopy and he said yeah but you wont know it! I’m still sleepy! Good stuff today! If you worried about a colonoscopy don’t, it’s nothing to it !

Colonoscopy over! … If you worried about a colonoscopy don’t it’s nothing to it!

The colonoscopy itself isn't anything that worries me, stick a probe up my behind and see if I care.

However the preparation beforehand is something that does worry me. My late wife had one or two done and she said the drinking of the required liquid beforehand was horrid. Not only did it induce severe bowel movements, but there was so much to drink, in and of itself something of a great discomfort. And moreover the taste was nauseating she said, like chemical orangeade.

This I can understand. As prep for a scan when i had appendicitis a few years ago, I too was required to drink some two liters of plain water (thank goodness no laxative solution). I found it impossible to drink all the required liquid. I can't imagine what it must be like to have to drink so much liquid that also provokes such quick and thorough bowel movements. Sort of like adding insult to injury.

I've had three colonoscopies - and the prep was the worst part, but it really wasn't bad. One 16 oz SuPrep the afternoon before - followed by two glasses of water (I only did one) - then 6-8 hours before the procedure another 16 oz SuPrep followed by more water. Didn't spend all night on the toilet and I thought the prep was pretty easy.

I havent even taken off my shirt for my primary doctor since 2019, which was my last physical. I switched to a new health provider in 2020, and have been dealing with several long term health issues since, but the doctors so far have only relied on blood work and a few other tests to try to see whats going on with me. Im actually on flowmax for an enlarged prostate yet have never had a prostate exam in my entire life for example.

I only got a full physical once a year as a pilot. It used to be a full work up but the last one I got before being grounded was like you said not much at all.

My doctors certainly believe in (thorough) physicals!

The doctors I have seen are beyond thorough and my husband goes to the family doctor for his wellness test and he’s real thorough! He said the worst part was when he finished everything and he will say you know the routine and it’s drop your pants and spread your legs and bend over the table and the nurse takes it in! When I went a couple weeks ago the nurse stood at the door! They usually get you in the stirrups but she didn’t move a muscle! She wasn’t friendly at all!

A yearly exam is not even called a physical anymore, its an interview with someone who is fixed on a computer screen, interviews you, never touches you. Reviews blood tests that you already got before going to appt.

I don’t think I have ever had a yearly physical here in the uk anytime I’ve been to the gp with a medical problem they only examine that part of the body where the problem is

If so, I'm going to the wrong doctor(s). The practice I go to now spends more time asking me if I'm suicidal or interested in a sex change than the actual physical exam.

or interested in a sex change than the actual physical exam.

Why would they ask that? Do you give them any signals or indications?

If you've never brought it up yourself, there would be no reason for them to even bring it up with you.

I have a friend who just got a thorough physical this week, but he goes to a GP in Chelsea (the “gayborhood”) here in Manhattan, a doctor who specializes in LGBTQ health issues. The doctor had him strip to his underwear (no gown), did a full exam with him sitting or lying on the table, and ended with him having him pull down his underwear for a genital exam and DRE. Meanwhile, my own physical, just a few days earlier than that, was fully clothed, with an arm cuff for BP, stethoscope on top of my shirt while sitting up on the exam table, and a quick look in my ears with the otoscope. Didn't even lie down for the exam. Everything else was talk centered around the blood work. His only referral was not a dermatologist for a skin exam, but rather he referred me for an optional colonoscopy. (I think I'm pretty low risk, based on family history and a mostly vegan diet, but Ali Wong says the drugs are good, so maybe…)

My friend and I live in the same city, are about the same age (him 43, me 46), both openly gay and out to our doctors, both of whom are GLMA members and trained in LGBTQ health. I really do think the key to finding a doctor who still does thorough physicals is word-of-mouth.

In other words, I'm hoping his doctor is accepting new patients, so I can switch.

Why would they ask that? Do you give them any signals or indications?

If you've never brought it up yourself, there would be no reason for them to even bring it up with you.

It's actually very common over here now. There's a whole list of questions they run through. Last two doctors I've been to have been the same way. My wife said her G.P. (different practice than the one I go to) does the same thing. Probably some overreaction to “mental health awareness” and “suicide awareness” and all the other buzzwords driving the health care industry these days.

I am 46 going onto 47 in Feb and I havnt been to my Dr in over 3 years cause of covid-19 and other things and I just had to make a “new patient” appt because I havnt been there in over 3 years it's there rule that anybody who hasn't been seen by a Dr in 3 years or more is considered a new patient. To make things worse is the practice I go to rotates Dr in every 3 years once they complete there residency. So I have to see a new Dr and explain my history over and over again. They are part of the teaching hospital that I belong too. My first appt isn't until Jan, but it's just a 40 minute get acquainted visit and go over my history with my new female Dr. I was hoping to get a full physical at that appt but they don't do that hopefully at my second visit I can get her to give me a full physical. But I doubt that will happen. So yes full physicals is a thing of the past unfortunately.

It's actually very common over here now. There's a whole list of questions they run through. Last two doctors I've been to have been the same way. My wife said her G.P. (different practice than the one I go to) does the same thing. Probably some overreaction to “mental health awareness” and “suicide awareness” and all the other buzzwords driving the health care industry these days.

Not one single doctor has even asked me about anything sexually related. Not once. And by that I include all specialists and doctors in hospitals I have been to for a one time appointment. Sometimes I wish they would … ha ha

But asking about wishing to change gender?? Really weird if a patient hasn't even hinted about such a desire.