I have several different points on this topic, not that any one of them will add to the point of the post, just my two cents worth.
As a medical professional it makes perfect sense to examine a child during a physical from head to toe. The doc is doing his/her job correctly by doing so. Now with this being said, I believe the following also applies.....
If a child comes into the office every year for a well child physical, I don't necessarily think a genital exam needs to be done at every visit. It is okay if it is done, but from my professional medical standpoint it doesn't have to be. I do think that during the years of or at "critical growth" points it should be done if that makes any sense. For example, new patient, new doc, head to toe needs to be done to establish that patients base line. When children are in their first weeks to probably about three, should be done every year, then again at 5 or 6, then again around puberty. To me, these are the most essential times these exams need to be done.
I have noticed a difference between what is and isn't acceptable between the states. For example in Ohio most of us just expect to have to take something off when we go to the doctors, and we don't think anything about it, in New York, not so much. This can also differ greatly between cities. A lot of it depends on, well, to be quite honest with you, on how sue happy that state is, or if there has been a medical professional accused of misconduct lately. You might be surprised how quickly a parent will turn on a doc if the doc doesn't make them 100 percent happy. And unfortunately, when we sign our medical license, we sign away about 90 percent of our rights as an American. Trust me on this. If someone calls our governing board, we are guilty until proved innocent. People love gossip and drama. And news about a naughty medical professional will spread quicker than herpes. What these people don't get is accusing a medical professional of misconduct will usually ruin that persons life, even when that pissed off parent admits that they lied. Not to mention, it will cost the medical professional hundreds of thousands of dollars to fix the damage, whether it be paying the lawyers, or being mandated to go to therapy, lost wages and or patients, and the list goes on and on, and this is EVEN WHEN THEY ARE PROVED INNOCENT!!!! The damage has already been done, and often medical professionals are afraid to do their jobs the way they are meant to be done in fear of this exact thing. It's tragic really, not to mention a total shame, oh and may I add disgusting, and a total injustice. However in the end, the person that gets hurt or has the potential to get hurt the most is the child, and that's just plain sad.
Now, as a parent myself, (taking my nursing cap off and putting my parenting hat on) I (sorry Doc, not trying to discourage your patients or meaning to cut into your source of income), but I as a parent do not really believe in well child visits. You usually don't need to be a medical professional to know if there is something really wrong with your child. As a matter of fact, I have never owned a thermometer until about 4 years ago, (it's a rectal one, and no, it's never been used on my kids lol) If your child is running a temp high enough to warrent seeing the doctor, trust me when I tell you, you won't need a thermometer to tell you so.
My children, and I have two, have had a total of 4 physicals combined in their entire lives, with the exception of when they were babies of course. My oldest had her first one when she was 16 and became sexually active. My youngest had a few, 2 to be exact when she was between the ages of 1 and 3 because the doctor didn't think she was developing correctly. So we had to go and do the whole x-ray of the hand to make sure the growth plates were correct or whatever so he would know if she would be of normal height. All was fine, came to find out she wasn't delayed or small because of a medical issue, rather she learned quickly that she was the baby and all she had to do is point and mumble and her older sister would go and get whatever it is she wanted. If I could sit on my butt and have people go and get me what I wanted, I wouldn't bother learning to crawl, walk or talk either, lol. Then I had her back again at 6 because she was gaining weight like crazy and drinking like a fish. My first thought actually was diabetes. So off to our regular doc we went, she was examined and off to the pediatric endocrinologist we went. So for 250 dollars he walked in the door, shook my hand, asked me if she grew any this year, I said yes, about 3 inches already. Then he said, he reviewed the finding from my doc, she doesn't have diabetes and kids with thyroid problems don't grow, she's fine. And out the door he walked.
Well, she continued to drink like a fish and gained a lot of weight. At 14 I took her to a new doc, I was establishing her as a new patient there and also wanted to address the wt issue along with what seemed to me to be a gross lack of hair growth. Now Doc believes that 90 percent of diagnosing can be done through a patients history, and I totally agree. Well, I have shared in many posts before this one that I have PCOS as well as a form of hypothyroidism. Both of these diagnoses could be a her issue as well. Makes sense medically speaking. In this case however, my child was not examined, which I do not agree with. Blood work was done there and it was found that her thyroid level was 7.9, which means that she did in fact have hypothyroidism. Do I think she had it when she was 6, yes, absolutely I do, and if that pediatric endo would have taken a few minutes to run some labs or examine her properly, we would have been able to make her feel better physically and mentally about herself during those transitioning pre-teen years that basically set your self image for the rest of your life.
So as a parent, medical professional or not and you notice a problem with your child, that something really isn't right, then get them in to see the doc. For example, if your son only has one testicle, the other one might not have descended, that is an issue. If your doc still administers the required shots, when they are there to get those, that also is around the appropriate time for them to be seen for a physical. But again, I personally do not believe in well child visits on a yearly basis.
And way off topic for this thread, and yes, I am well aware that I am rambling, so sorry, but doctors are very busy. And when this country gets done with their health care reform, many Americans are going to find that the doctor they have been going to for years is having to close his doors because he's gone broke. Which means that the private family docs that are able to stay in business are going to be that much busier. It will take weeks, maybe even longer to get an appointment. If I am sick I don't want to wait weeks to be seen by my doctor, the one I am already comfortable with, so it leaves me no choice but to go to an urgent care, and in our area they have very limited hours, or go to the ER. However, while I have top of the line insurance, one of the clauses in my coverage is that ER visits do not have a co-pay if you are there for a true emergency. Notice I said "true" emergency. If it's what my insurance company considers my issue as a medical necessity I have to pay the co-pay, and if I use the ER as my "doctors office", then they will pay nothing. Which I totally agree with for the most part. But, if you are sick and can't get into your own doctor what is a person to do? So I try to do my part and I don't bother my doctor unless I have to.
Just my two cents and a little extra for today.
Mashie.