What's this medical practice about not giving patients a physical exam?

debodun

debodun

SF VIP
Location
way upstate in New York, USA
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.

When my dad started losing weight, my mom would take him to the doctor and the doctor would say, "How are you feeling?" and my dad would say, "Okay." and that was the visit. By the time it was found out what the problem was, he had terminal renal carcinoma.
 

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Must be where you live Deb. Here our annuals include lab work, heart & lung check by stethoscope, ear visual check with the ear check instrument, abdomen pressing, & visual check of mouth & as much as can be seen of the throat. Eye chart which is really redundant because our comprehensive yearly paid for by insurance eye exam is far more accurate. And 1/2 hour discussion of our health.

Maybe the best part is there is zero out of pocket cost because we have Medicare Advantage plan.
 

It may depend on why you're there and how long since your last physical, or maybe they are trying to work within insurance parameters.
Always remember your doctor works for you, if you want a more thorough exam speak up, if they refuse find a new doctor.
 
debodun said:
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.

When my dad started losing weight, my mom would take him to the doctor and the doctor would say, "How are you feeling?" and my dad would say, "Okay." and that was the visit. By the time it was found out what the problem was, he had terminal renal carcinoma.
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welcome to the world of the NHS...
 
debodun said:
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.
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It looks to me like congress didn't allow Medicare to cover physical exams, only allows the wellness exam and exams for specific complaints. Apparently the very first 'welcome to medicare' exam does include a physical exam maybe, or anyway something more than just the wellness visit.

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I prefer the interview. Less time I spend there the better. If I can walk in, I am fine. Not a fan of doctors. They can't prevent the inevitable. When I become too ill, they will know quite definitively.

I know, I am living a delusion blah, blah, blah. Save it for someone who believes doctors aren't just giving us their best guess according to an obscure timetable.
 
debodun said:
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.

When my dad started losing weight, my mom would take him to the doctor and the doctor would say, "How are you feeling?" and my dad would say, "Okay." and that was the visit. By the time it was found out what the problem was, he had terminal renal carcinoma.
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I will imagine down the road the cases of did not find out until too late will be rising and rising....
it is the same with virtual visits bad lighting can make others not look pale as a ghost or miss jaundice etc....
Patients lie all the time about how long a symptom has been going on or do not tell another item they may feel is unrelated but could point a good doctor into the right diagnosis. some are not a big fan of hands on........... but i feel many times it is better then them dismissing something because a patient did not explain it well.
 
Sounds like my doc, deb. I chose him for that reason, years ago, now I want hands on and will discuss with him, or possibly change. I think it has something to do with their payments. They get paid for 15 minutes, I think.
 
debodun said:
The last two doctors I've had appointments with used to do a hands-on physical examination. Now it's just an interview style visit. I think they could be missing some important issues doing that.

When my dad started losing weight, my mom would take him to the doctor and the doctor would say, "How are you feeling?" and my dad would say, "Okay." and that was the visit. By the time it was found out what the problem was, he had terminal renal carcinoma.
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With respect to the anecdote about your father couldn't your mom or dad simply asked for a complete, hands on physical? If you don't get what you want isn't it up to you to ask for it? I know most people look at doctors as if they are to be unquestioned gods, but they are not. You should question them the same as you do anyone else who is 'selling' you something. I do.
 
Robb.hisself said:
With respect to the anecdote about your father couldn't your mom or dad simply asked for a complete, hands on physical? If you don't get what you want isn't it up to you to ask for it? I know most people look at doctors as if they are to be unquestioned gods, but they are not. You should question them the same as you do anyone else who is 'selling' you something. I do.
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My mom finally had him admitted to a hospital where he finally got a diagnosis.

The oral interview exam may have something to do with COVID when MDs were doing virtual exams. They just never got back in the practice of a hands-on exam. I really don't like to be touched, even by a doctor, but feel it's one of those necessary inconveniences.
 
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My feelings about hands on exams have changed over time. Younger, it was fine. The medical organization I belonged to most of my life was known for its emphasis on keeping patients healthy. However, now as an older person (I am 75) I'd rather not know if I have a life ending disease. So going to look for it via a complete exam I wouldn't want. I'd rather not know of a life ending disease because I know from observed experience that at my age I could not be cured. But, that perspective is uniquely my own. I wouldn't suggest it for others.
 
HoneyNut said:
It looks to me like congress didn't allow Medicare to cover physical exams, only allows the wellness exam and exams for specific complaints. Apparently the very first 'welcome to medicare' exam does include a physical exam maybe, or anyway something more than just the wellness visit.

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I haven't had a "hands-on" exam from a doctor in years. I use to get a physical (ears, eyes, throat, heart, lungs, abdominal palpation, knee reflexes, etc., etc.) but none of the doctors we had when we lived in other states, touched us. Just took BP and asked a couple questions. I haven't had a mammogram since I turned 71 (6 years go). They say it's not necessary after 71.

Those Wellness exams are a joke and waste of my time and, unfortunately, I have one scheduled for next week with my doctor. I had a doctor (quack) in AZ that sent me for a Wellness exam and it was in a walk-in clinic. It was the height of flu season and the waiting room was packed with people coughing and sneezing and you had to walk through this to get to the reception desk. There was a separate waiting room that she sent me to to wait for the nurse practitioner. The room was dirty and I only stayed about 5 minutes and left. We found a different doctor...who turned out to be just as bad.
 
Robb.hisself said:
My feelings about hands on exams have changed over time. Younger, it was fine. The medical organization I belonged to most of my life was known for its emphasis on keeping patients healthy. However, now as an older person (I am 75) I'd rather not know if I have a life ending disease. So going to look for it via a complete exam I wouldn't want. I'd rather not know of a life ending disease because I know from observed experience that at my age I could not be cured. But, that perspective is uniquely my own. I wouldn't suggest it for others.
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It's not just your perspective. I feel the same way. For example, I detest those Colorgard kits they send you! I got one not long ago and I told my (late) husband to throw it in the garbage. I told him at my age (77) I don't want to know and there's no way I'd go through all the "treatments".
 
Before getting on Medicare I got a complete physical on the military base. I got referrals for a couple of different things.
When you get on Medicare you have to search and choose a civilian Dr. I chose a P.A. that was recommended and is right down the road. My thinking is that I need someone available to see for urgent care, referrals and prescription refills. Anything major is going to be referred out to a specialist anyway.
 
debodun said:
The oral interview exam may have something to do with COVID when MDs were doing virtual exams. They just never got back in the practice of a hands-on exam. I really don't like to be touched, even by a doctor, but feel it's one of those necessary inconveniences.
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Frankly, I have often wondered who exactly will benefit from a complete physical exam. It is sort of like taking your car to a mechanic for a check up. You have got to be prepared for the mechanic to find something for which to charge you. After all he's a business man who is in business to make money. And, so too is the doctor. I often wonder what makes patients really happy - to be told you're o.k. or to be given some pills to make them 'feel better'. I think patients just want attention and know someone cares. And, then the doctor makes money and the patient 'feels better'. Just like going to an auto mechanic.
 
Robb.hisself said:
Frankly, I have often wondered who exactly will benefit from a complete physical exam. It is sort of like taking your car to a mechanic for a check up. You have got to be prepared for the mechanic to find something for which to charge you. After all he's a business man who is in business to make money. And, so too is the doctor. I often wonder what makes patients really happy - to be told you're o.k. or to be given some pills to make them 'feel better'. I think patients just want attention and know someone cares. And, then the doctor makes money and the patient 'feels better'. Just like going to an auto mechanic.
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I think you are right.
Some people go to doctors and/or specialists because they are lonely.
 
Colleen said:
It's not just your perspective. I feel the same way. For example, I detest those Colorgard kits they send you! I got one not long ago and I told my (late) husband to throw it in the garbage. I told him at my age (77) I don't want to know and there's no way I'd go through all the "treatments".
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Agree 100%. What really bothers me about the Colorgard kit is that I am certain that when I send it in they will contact me to come in for the full exam because the kit really guarantees nothing. It says right on the package that it produces many false negatives and false positives. So what's the point? It is only a lure to grab you and get you in for the full exam.
 
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