I have a history of some GI issues, which have been well controlled for years. I see a GI doctor annually. Today I saw her. Of course in this day and age you expect almost no time to be spent with you. And my issues have been stable for some time now. However, I couldn't believe the cursory physical I got. It was practically to the point of "Why bother?"
First the MA took my vital signs. She told me my HR was "68." I was feeling anxious and could feel my heart pounding away. When she left the room I took my own HR and got 122.
For the physical exam, the doctor listened to my lungs in 2 places and listened to my heart for about 2 seconds. I was a little surprised to say the least when she told me that was it. I didn't even get on the exam table. There was no abdominal assessment at all.
That being said, I don't mean to single this particular person out, as this has become the norm. I understand that some of this is from time limitations, but I still feel you can do a more thorough exam.
Everyday when doing my initial assessment on my patients I do a more thorough exam than that. I typically listen to the heart for at least 30 seconds and usually in two different locations. I listen to lung sounds in all fields. I listen to bowel sounds. I look in their mouths. I check for pulses in all four extremities. I look for edema. I check for capillary refill. I look at any wounds. I look at their central line site and flush any unused lumens and check for blood return (so when I need that lumen later it's not a surprise that it's clotted). I ask them to demonstrate incentive spirometer use. That's it. It takes
I'm sure saying that I have no issues bought me a less thorough assessment. I'm also sure more complex diagnostic studies have led more to the death of the physical assessment.
But really, if I'm paying for your time and expertise, don't I deserve a bit more than that?
I wonder if it would have been different had she known I was an RN.
