I’m talking about full physicals here, not a sports physical.
I had one a while ago where the doctor spent a decent amount of time with me - checked a bunch of crap, gave me an audio test, blood tests, they offered to give me the treadmill test too, and basically was very thorough. cannot remember how long it took, though.
then I went to another one, and I was at a health office where I guess people didn’t go for physicals (university health clinic) and the physical was more like “do you have any problems? no? ok, go get your blood tested, bye”
Now i’m scheduled for another one, and the nurse says that it should take 30 minutes, which seems on the low end of the spectrum (i.e. closer to physical #2 than #1)…
Is this going to be a waste of my time if they’re telling me I’m only going to be in there for 30 minutes?
In school we’re first taught how to give a physical exam and how to take a history. Each of those sessions took us about an hour and 15 mins. Then in our 2nd year of this course, we’re taught to try to give a full physical and history together in an hour and 15 mins. Then they cut it down to 45 mins. I think the final end goal is for the doctor to be able to get a patient’s chief complaint, and give a proper physical in 20 mins eventually or maybe less.
The goal for an appointment is to be trained to see a patient in 20 mins or less.
Right now, I can give a physical in about 30-45 mins, but I’m just a student and that would be a full physical exam excluding genitalia, but there’s something like over 250 different aspects of the exam to go through. Most doctors I know do NOT ever try to do a full physical exam like that (with criteria such as: inspected then palpated DIPs, PIPs, and metatarsals from above and from the sides. That right there is like 2-3 points).
So to answer the question: it varies on the doctor and what you mean by a “full physical exam”. A full 250+ point just pure physical exam doesn’t even begin to include labs, exams, or those other tests you mention. Most doctors are trained in trying to give a pertinent review of systems and to assess the areas with with the patient has a chief complaint (so if the patient has stomach problems, then you pull out the portions of the abdominal exam and apply those to the patient, there’s no need to check his DIPs or PIPs).
Again, as for how long a visit takes? It depends on the doctor, some try to shoot for 20 mins to be done with fully seeing the patients, others like to take their time and go for 30-40 mins. It’s whatever rhythm the doctor feels most comfortable with and how he does his procedures. Some doctors like to focus more on the history, others more on the physical, and others the assessment/planning.
But currently as a student, my final exam in the class on how to give physicals will be given a time limit of 20 mins to figure out what is wrong with the patient. I will have to divide my time between interview and pertinent physical exams as I see fit though. So i can ask more or less questions and have the left over time to do my exams, and then I’ll need to present what I believe is the issue with the patient and write up the appropriate SOAP note and such afterward.
**Toejam’s **post indicates that there are at least two types of physicals. One is to “figure out what is wrong with the patient.” Obviously, that is more focused, the history may be directed by the patient or the doctor, and the intent is for the doc to arrive at a diagnosis. Another is a general physical exam, like a yearly physical. That may be a survey of the various systems of a person, and some discussion on whatever topic the patient or doctor deems relevant, it’s more health oriented. If you’re going to the doc presenting a series of complaints that may be symptomatic of some illness or disorder, that’s different from if you’re going just to evaluate your general health. And those can obviously take widely differing amounts of time, ultimately determined, I would assume, by the doctor’s time constraints. A general check-up shouldn’t take only 20 minutes, however, even if you don’t know the doc.
yeah, this is what i’m going for. There’s nothing wrong with me. I’d like to keep it that way so I’m moderately proactive about my health in that I go for routine-ish “general physicals”
My concern is as you point out related to the time constraints of the doc: if 30 minutes is insufficiently long to give a general physical (or at least cutting it close) then I will find another doctor who isn’t so stingy with his time.
I mean I called once to book and once to reschedule, and they were wide open on both days I asked for, which struck me as a bit odd; the longer, first physical that i talked about had to be booked almost 1.5 months in advance. (meaning, to me that the booked-in-advance doctor only did a few of these a week and specifically allotted time in his schedule for them)
is it possible these nurse/receptionists/whoever are not understanding what i’m asking for in a “physical” ? (i mean i even asked her about fasting the night before for bloodwork, she said nothing about it, and said that they order the tests separately and you come back, which seems like either a) she’s not giving me the physical i’m looking for and/or they don’t do them frequently enough or b) they’re really bad at abusing the patient’s time)
Initial physicals may take longer, since the physician is getting to know you. Subsequent physicals tend to consist more of ‘interval updates’ and don’t take nearly as long, unless significant problems have arisen.
I’ve had extremely complex patients who took an hour or more of my time for the very first physical, but once having gotten to know them, subsequent updates may be done in 20 minutes or less, depending on the issues.
And annual physicals are no longer recommended routinely. They have not been shown to be either beneficial or cost-effective as far as finding diseases or reducing bad outcomes goes.
Current emphasis is on problem/chronic disease-oriented medical visits, with added emphasis on those preventive topics which have been shown to be helpful to screen for, such as colon cancer, cardiac risk assessment, smoking cessation, or other areas specific to one’s age/ethnicity/gender/risk profile, etc.