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

Robb.hisself said:
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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I think the point of it is that it is better than nothing and a lot of people would rather do nothing than get the full exam.

I had a colonoscopy when I was 50ish and when I was due for another I kept refusing year after year until the doctor offered the Cologuard test, then I was willing to do that. Passed it the first time, but it has to be repeated every 3 years due to its lesser validity, and I failed the next one (turned out to be a false positive), so they managed to convince me to go in for the real colonoscopy -- which didn't turn out to be so bad, partly because I'd been trying for a long time to be low-carb and the diet in the days before the colonoscopy had to be carbs (glorious carbs! bread, crackers, white rice!).
 

Robb.hisself said:
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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Not only that...our insurances pay for them because it's cheaper than having you go in to get a colonoscopy.
 

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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But surely they checked your dad's weight and his blood pressure, heart-rate, and oxygen absorption (with that thing they clip on your index finger), right?

If any of that shows a problem, then your doctor will ask more pertinent questions and either examine you further or refer you to a specialist....because they only have 10 or 15 minutes to get to their next patient.

There's 2 causes for this: 1) your primary insurance is minimizing costs, and 2) there aren't enough doctors graduating from universities and going into practice.
 
debodun said:
I don't know for sure. I can only relate what my mom said.
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They probly did.

Weight, vitals, and O2 levels - that's basically your exam right there. And it isn't even your doctor who does that, it's an RN or MA or some other kind of assistant. And the doctor usually looks at that info on a computer screen before they look at their patient.

I don't like it either, but it isn't your doctor's fault. It's the business model, fully tested and proven to be financially beneficial.

I predict the next step will be patients getting their weight and vitals taken annually at the nearest location. No more office visits for a "physical", and your doctor still gets his/her 60-70 bucks per reading even if s/he's just sitting at home. And, of course, if you don't go get that done, you will be hounded with system-generated texts and prerecorded phone messages until you do.

So look forward to that.
 
Murrmurr said:
I predict the next step will be patients getting their weight and vitals taken annually at the nearest location. No more office visits for a "physical", and your doctor still gets his/her 60-70 bucks per reading even if s/he's just sitting at home. And, of course, if you don't go get that done, you will be hounded with system-generated texts and prerecorded phone messages until you do.
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As you have said in your post, the medical business operates on tried and true practices that have been tested and found most profitable. However, given that theme I would suggest your prediction is in error.

I believe that you are correct that doctors will do less and less hands on exams while simply reading off a computer screen. But, as you have said the medical business is cost conscious and profit motivated. Thus this system you've predicted will soon be the first victim of AI. A machine can be invented to do the same as the doctor. All that is necessary is to convince the patient that his collected data is 'read' by a 'doctor' and the diagnosis is from a 'doctor'.

This medical system will continue to retain med techs and nurses because they are the faces and appliers of medical treatments, today. Doctors are not. Thus doctors are really no longer necessary. The AI system would also address the drastic shortfall in the number of physician positions that have been vacant for so long and are not going to be filled any time soon.

In the recent past physicians lost control of their profession. Instead, today, the medical business is run by medical organizations based on business models; not medical models. The day of needing to see your personal physician is soon to pass. The profit motive dictates that.
 
Robb.hisself said:
... The day of needing to see your personal physician is soon to pass.
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Routine doctor visits is actually a fairly new thing. They like to call it preventive care, right? Makes it sound kind of necessary, like you're preventing yourself from getting something you were definitely going to get.

First time my gramps saw a doctor was when he was about 40. He and a buddy got really drunk and his buddy gave him a haircut that included most of his scalp. Gramps didn't see a doctor again until he was 72. He was diagnosed with throat cancer, so he had several subsequent visits for that, of course.

The only times my mom went to a doctor was while she was pregnant. My generation saw annual check-ups being recommended for kids, but I didn't start seeing a doctor regularly until after I had a terrible accident. I was in my mid-30s by then.

I think the end to routine doctor visits was always inevitable.
 
I only go to a doctor if they've scheduled a regular visit and they are usually the specialists (gastroenterologist, cardiologist, ophthalmologist, etc). I only see my PCP as needed. I really don't like her - she's a pill pusher, hand patter and hands off doctor, but she's local, so I avoid a long car trip.

Once when I had a complaint, she said, to the effect, that I have to expect to start having health issues as I get older. Another time I had two problems, but she would only hear about one and said if I wanted to discuss the other issue to make another appointment.

She also put me on anti-depressants after my mom passed. I felt I didn't need them. I took them for 9 months and didn't feel any better or worse and told her I wanted to get off of them becaiuse they were causing weight gain. She told me that they DO NOT cause weight gain and to just stop taking them. Bad advice - you just can't stop AD meds suddenly.
 
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debodun said:
I only go to a doctor if they've scheduled a regular visit and they are usually the specialists (gastroenterologist, cardiologist, ophthalmologist, etc). I only see my PCP as needed. I really don't like her - she's a pill pusher, hand patter and hands off doctor, but she's local, so I avoid a long car trip.

Once when I had a complaint, she said to the effect that I have to expect to start having health issues as I get older. Another time I had two problems, but she would only hear about one and said if I wanted to discuss the other issue to make another appointment.

She also put me on anti-depressants after my mom passed. I felt I didn't need them. I took them for 9 months and didn't feel any better or worse and told her I wanted to get off of them becaiuse they were causing weight gain. She told me that they DO NOT cause weight gain and to just stop taking them. Bad advice - you just can't stop AD meds suddenly.
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Might be worth the drive to see a "real" doctor. That's another reason to not isolate yourself in a rural area. As we get older, we need to be able to be close to necessary facilities.
 
Murrmurr said:
But surely they checked your dad's weight and his blood pressure, heart-rate, and oxygen absorption (with that thing they clip on your index finger), right?

If any of that shows a problem, then your doctor will ask more pertinent questions and either examine you further or refer you to a specialist....because they only have 10 or 15 minutes to get to their next patient.

There's 2 causes for this: 1) your primary insurance is minimizing costs, and 2) there aren't enough doctors graduating from universities and going into practice.
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Any significant weight loss should send an alarm. So many seniors are reluctant to tell a doctor we’re not ok. That leads to a poor prognosis in some cases.

I’ve been fortunate to have good physicians over the years. You definitely have to be proactive, HMO’s are our worst nightmare. My Medicare and supplement are expensive but I have no problem getting referrals to specialists.
 
Tommy said:
Good physicians deserve our attention and respect, but remember . . .
one in every ten doctors graduated in the bottom 10% of their class. :rolleyes:
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Guess where George Armstrong Custer placed in his West Point graduating class ? At the very bottom. JimB.
 
JB in SC said:
Any significant weight loss should send an alarm. So many seniors are reluctant to tell a doctor we’re not ok. That leads to a poor prognosis in some cases.
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Maybe too many doctors dismiss senior patient's complaints because they're seniors. When I was caring for my mom and she'd tell her doctor something wasn't working right, if the doc's response was something like "Well, you're just getting old," I got her a new doctor.

Clearly, she's getting old, but how 'bout we do something about the problem anyway. :rolleyes:
 
I was misdiagnosed by so many hands-on doctors that I am very happy with the present practice! I had chronic neck and back pains for many years and four different doctors gave me four different diagnoses when it came to the cause. The fifth doctor was the only honest, or smart one! He said: "Let's send you for an x-ray first because it's hard to tell by just probing!" And found that I had a narrowing disc at the C3/C4 level in my neck, most likely caused by an old injury, which was pressing on my nerves, causing the pain.

My present doctor is now from the hands-off school. I have had him for eight years and am quite happy with that. He has me take a blood test ten days before a scheduled visit and his nurse takes my weight and blood pressure. He's now got all the information he needs and I haven't had to take off a stitch of clothing. When I felt, back in April, that there was something seriously amiss I went straight to the ER of the local hospital where all the probing and poking was done. Ten days later I had surgery and they found that I had bladder cancer. I was given a choice: radiation or let nature take its course. At 87 I chose the latter.
 
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