What should a physical exam encompass?

G

George1004

New Member
I changed doctors recently due to new insurance. I was given a physical but it was mainly a chat and blood work. Do physicals no longer involve examining the person?
 

Three days before my semi-annual visit, I get blood work done so the results are back in time for the visit. The doctor checks my blood pressure, goes over my medications, listens to my heart, and asks me if I have any new health concerns since the last visit. I showed him a spot on my arm I thought could be cancer. He said it was just a keratosis, and sprayed it with something, which made it go away in a few days, saving me a trip to the dermatologist.

Otherwise, I don't know of anything else that needs to be examined - but if I had any other concern and told him about it, he would address it.
 
I changed GP six months ago due to the distance and the previous GP was too intense 'cognitive test' spending almost 45 minutes and only 3 minutes for maintenance meds. refill.

The current GP is only 5-minutes distance and he focus mostly my well-being, not 'cognitive test.'
As to Physical exam, my GP did blood pressure, 'blood-work' and 'EKG,' both of them are in good shape.
He told me blood-work done every three months when I visited GP. Up to now, he did blood-work twice. My incoming appointment is in May.
He prescribed my HB med. and sent to CVS.
 
Nathan said:
I think that doctors are hesitant to touch patients, for fear of some allegation that becomes the basis of a civil suit or criminal charge.
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I have never had a PCP who didn't touch me.
Auscultation of the abdomen, do a breast exam, check ankles ( I am not diabetic but that is always done), check the ears and throat, manipulate the neck... and probably a few more things... are done during my yearly physical. Along with the things mentioned by MACKTEXAS.
 
Buckeye said:
Blood work and a quick listening to heart/lungs is about it, at least in my experience.
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I just had a home visit from the practice nurse. I am on a health care plan with my GP and every 6 months he routinely checks my bloods to make sure all is well and to make any necessary changes to my medications. Ingrid spent an hour with me talking about my home situation and checking out my lifestyle, diet and social support. When next I see the GP he will zoom in on anything that could be a red flag.

I pay nothing for the home visit, and also nothing for the visits to the surgery. All costs are covered by the federal Medicare program.
 
I think an annual physical with your primary care doctor should involve checking the eyes, ears, nose, throat, lymph nodes in your neck and armpits, heart, lungs, abdomen, reflexes and strength in hands, breast exam for women, prostate exam for men, asking questions about health changes, going over medical history and ordering a full blood panel.

If your doctor is doing anything less during each annual physical, time to find a new doctor. However, finding a good doctor these days is very difficult

I have lost a lot of faith in the medical profession and US health care system over the last 10 years for various reasons.
 
UpstateGal said:
I think an annual physical with your primary care doctor should involve checking the eyes, ears, nose, throat, lymph nodes in your neck and armpits, heart, lungs, abdomen, reflexes and strength in hands, breast exam for women, prostate exam for men, asking questions about health changes, going over medical history and ordering a full blood panel.

If your doctor is doing anything less during each annual physical, time to find a new doctor. However, finding a good doctor these days is very difficult

I have lost a lot of faith in the medical profession and US health care system over the last 10 years for various reasons.
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Uh, no thanks on that prostate exam....

Or on most of that other stuff. And no I do not want/need to find a new doctor.
 
Buckeye said:
Uh, no thanks on that prostate exam....

Or on most of that other stuff. And no I do not want/need to find a new doctor.
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That is your prerogative. My husband and I still pay a lot for our employer sponsored healthcare coverage premiums. If doctors are going to treat me like a customer in their business to earn revenue, well then as a customer seeking a service, I'm going to expect good service for my money.

Maybe my attitude would be different if I were getting free healthcare or had small affordable premiums in the years prior to retirement.
 
In the UK truck drivers have a compulsory medical examination periodically. The examination known as the HGV (Heavy Goods Vehicle) medical. Drivers of buses, PSV (Public Service Vehicles) are also required to have the same medical, periodically. The doctor checks:
  1. Medical History:
    You’ll be asked about your medical history, including any conditions you currently have or have had in the past.
  2. Eyesight Test:
    Your eyesight will be tested to ensure that you meet the required standards for driving an HGV or PSV.
  3. Hearing Test:
    Your hearing will also be tested to ensure that you can hear traffic and warning signals on the road.
  4. Blood Pressure Test:
    Your blood pressure will be checked to ensure that it’s within a safe range.
  5. General Fitness Test:
    Your general fitness levels will be assessed to ensure that you are physically able to perform the job of an HGV driver.
  6. Urine Test:
    A urine test may be required to check for underlying medical conditions.
  7. Alcohol And Drug Use:
    It is forbidden to drive an HGV while under the influence of either alcohol or a drug substance. A doctor will check for any indications of ongoing drug and alcohol usage during the examination.
That's more or less the same as the medical check that I had to keep my car insurers happy.
 
My current PCP is more like the school nurse than a doctor.

She relies on me to tell her my concerns and then she makes appointments for tests and follow-up appointments with specialists.

I just keep my mouth shut and am in and out in about fifteen minutes.

She’s perfect for me. 😉🤭😂
 
Last one I had included the 'Draw the hands on the Clock Face' test for Dementia.
Not sure if it is done for those of a certain age group.
A bit of a struggle at the beginning, final got it right.

My doctor knows of my involvement with the University study and we discussed continuing with it.

Other than that, a lot of blood work and 'Grib/Resistance tests.
 
Nathan said:
I think that doctors are hesitant to touch patients, for fear of some allegation that becomes the basis of a civil suit or criminal charge.
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My PCP is never alone with me, she has a scribe in the room that updates my chart and takes notes.

Personally, I don’t see much value to adding a person and increasing the cost.

My old PCP did all of his own updates and note taking in about the same amount of time.

Next we went to a remote scribe that listened in on each visit and made the necessary updates.

Then 2-3 years ago we went to an actual person in the room to handle the updates.
 
Insurance companies dictate what is covered or not covered, my doctors nurse told me. They cover what they decide and in blue cross it is the so called wellness exams annually which is blood work. No need to touch body unless necessary.
 
UpstateGal said:
That is your prerogative. My husband and I still pay a lot for our employer sponsored healthcare coverage premiums. If doctors are going to treat me like a customer in their business to earn revenue, well then as a customer seeking a service, I'm going to expect good service for my money.

Maybe my attitude would be different if I were getting free healthcare or had small affordable premiums in the years prior to retirement.
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I guess for me, it isn't about the money, or trying to "get my money's worth". I'm on Medicare now, but paid high premiums when I was working, but that didn't impact how I wished to be treated by my PCP. I do not want a bunch of unnecessary tests. Just do the basics, and if I have some other problem, I will let them know, and it will be addressed.

YMMV
 
My physical is very comprehensive. Blood draw for blood numbers, pulse ox, BP, listen to my heart and lungs. Uses an otoscope to look in my ears, throat and nose.

She has me lie down on the table and palpates my abdomen, lymph nodes in your neck and armpits, heart, checks lymph nodes in my neck lungs, uses the little metal hammer to check reflexes. Tests for strength in my arms, legs and hands.

She checks my records to make sure I’ve had a recent dermatology appointment, breast exam and bone density test. Discusses my meds with me to determine the need for any changes. Discusses any health and mental issues or concerns I have.

I never really realized how comprehensive the exam was till I read some of your comments!
 
Ronni said:
My physical is very comprehensive. Blood draw for blood numbers, pulse ox, BP, listen to my heart and lungs. Uses an otoscope to look in my ears, throat and nose.

She has me lie down on the table and palpates my abdomen, lymph nodes in your neck and armpits, heart, checks lymph nodes in my neck lungs, uses the little metal hammer to check reflexes. Tests for strength in my arms, legs and hands.

She checks my records to make sure I’ve had a recent dermatology appointment, breast exam and bone density test. Discusses my meds with me to determine the need for any changes. Discusses any health and mental issues or concerns I have.

I never really realized how comprehensive the exam was till I read some of your comments!
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I'm glad to hear you have a good doctor giving you a thorough annual physical(y)

My apologies to the others in this thread who were upset my post. The reality is healthcare is a business, your doctor is in a business to earn money. I will leave it at that so I won't be verbally accosted again for having an opinion...lol
 
I've noticed in the "after-visit summary" for my last couple of check-ups that I've been "screened" for various things.....mental health, depression, etc.

I'm not sure what they consider "screening" because I can't say I've undergone that procedure. Is breezing into the room and asking, "How are you doing?" screening, then I guess I have been screened.

I do like my current PCP.
 
Medicare does not cover an annual physical exam. It does cover an annual "Medicare Wellness Visit". In theory the doctor is not allowed to physically touch the patient (a nurse or technician may take temperature, pulse, blood pressure, &c). According to medicare.org:

"This visit focuses on creating or updating a personalized prevention plan and includes:
Health Risk Assessment: A questionnaire to evaluate your health status and risk factors.
Routine Measurements: Updating vital statistics like height, weight, and blood pressure.
Review of Medical and Family History: Updating any changes in your health history.
Screening Schedule: A checklist for appropriate preventive services and screenings.
Personalized Health Advice: Recommendations for health management and preventive measures.
Cognitive Assessment: Evaluation for signs of cognitive impairments.
Advance Care Planning: Optional discussion about future care preferences."

Our private insurance (Medicare Advantage Plan) covers our actual annual physicals.
 
Tommy said:
Medicare does not cover an annual physical exam. It does cover an annual "Medicare Wellness Visit". In theory the doctor is not allowed to physically touch the patient (a nurse or technician may take temperature, pulse, blood pressure, &c). According to medicare.org:

"This visit focuses on creating or updating a personalized prevention plan and includes:
Health Risk Assessment: A questionnaire to evaluate your health status and risk factors.
Routine Measurements: Updating vital statistics like height, weight, and blood pressure.
Review of Medical and Family History: Updating any changes in your health history.
Screening Schedule: A checklist for appropriate preventive services and screenings.
Personalized Health Advice: Recommendations for health management and preventive measures.
Cognitive Assessment: Evaluation for signs of cognitive impairments.
Advance Care Planning: Optional discussion about future care preferences."

Our private insurance (Medicare Advantage Plan) covers our actual annual physicals.
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And there's a reason for that. Medicare knows, based on tons and tons of data, that annual physical exams do not improve our health. The basic blood screen/BP measure/Blood Ox/etc test pretty much tell the whole store. Advantage plans include things like annual physical exams as marketing tools.
 

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