{"id":1430,"date":"2021-05-26T08:21:00","date_gmt":"2021-05-26T15:21:00","guid":{"rendered":"https:\/\/danschmidtforsenate.com\/blog\/?p=1430"},"modified":"2021-05-25T08:29:55","modified_gmt":"2021-05-25T15:29:55","slug":"physicals","status":"publish","type":"post","link":"https:\/\/danschmidtforsenate.com\/blog\/?p=1430","title":{"rendered":"Physicals"},"content":{"rendered":"\n
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Back in the stone age when I went to medical school, the \u201ccomplete physical\u201d was a full course in first year. We were taught where to poke, push, prod, palpate and percuss. We practiced looking at fingernails, eardrums, nipples and the back of your eyeball. Then the stethoscope came out and we auscultated (doctor for \u201clistened\u201d) to every sound your body might offer. I never heard any farts in the exam room, though I imagine they could tell me something.<\/p>\n\n\n\n

In our second and third and fourth years we were sent off to the wards to be the fifth or sixth person to examine a tired and sick patient. We were supposed to find things. So, if we had little mercy and were as worried about our grades as they wanted us to be, we prodded and probed the poor wretch with our inexperienced fingers. I always appreciated the patients\u2019 patience, for their generosity gave me experience, a wonderful gift.<\/p>\n\n\n\n

As I watched the more experienced physicians, I noticed their physical exams were often very abbreviated. I was listening to a sweating man\u2019s heart in residency when the attending came in and said, \u201cGet him up to the cath lab!\u201d without even getting his name or saying hello. The EKG told the story. The expediency probably added some years to the man\u2019s life. Time can save tissue when it\u2019s dying.<\/p>\n\n\n\n

But then I go into the office and see patients every day and wonder, just what do people expect when they schedule an \u201cannual physical\u201d? Do they know that no study has ever shown that such \u201cannuals\u201d are cost effective? We add some screening blood tests, consider some other tests, but the true value of seeing the doctor comes in developing a relationship. It is so I, or your doctor, can know your values, so when the tough times come, we can help you decide on a course of action that will support you and your values.<\/p>\n\n\n\n

Five times in my medical career, with the patient undressed I noticed a mole that I thought suspicious that turned out to be stage 1 melanoma. A few times I have felt lumps that didn\u2019t seem right. But of the thousands of physical exams I have done, most were on very healthy people. But that teaches you something too.<\/p>\n\n\n\n

I decided to quit the medical group I had been in for the last 17 years, so I was surprised to see a \u201ccomplete physical\u201d on my schedule the last week I was scheduled to work. Our office had shifted to an electronic record about five years before and this 50-year-old man had no entries in the electronic chart. \u201cWhy is he scheduled with me?\u201d I asked my nurse. She shrugged.<\/p>\n\n\n\n

So, I went into the exam room. \u201cHello, I\u2019m Dr. Schmidt. Who is your regular physician?\u201d<\/p>\n\n\n\n

He looked up at me and smiled. \u201cYou are!\u201d he said.<\/p>\n\n\n\n

I\u2019m puzzled because I don\u2019t recognize him. Indeed, he looks well, taking no medicines, blood pressure, weight all normal.<\/p>\n\n\n\n

\u201cI\u2019m sorry,\u201d I stammer. \u201cWhen did I last see you?\u201d<\/p>\n\n\n\n

He grinned. \u201cIt was about five years ago. I came in for a physical. You told me to exercise, lose 25 pounds and come back in 5 years. So, I did, and here I am!\u201d Not many patients take my advice. I appreciated that last complete physical.<\/p>\n\n\n\n

High school sports physicals were another wonder to me. I came to see them as school districts shifting liability. If a student athlete keeled over, they could say \u201cDoctor cleared him!\u201d<\/p>\n\n\n\n

But I came to view this opportunity to examine and visit with a young teenager and their parent as precious, though the form the school required to be filled out, boxes to be checked were pretty silly. More on sports physicals next week.<\/p>\n\n\n\n

So go ahead and schedule a physical with your doctor. If you\u2019re planning to stay put, that\u2019s what you should be asking them, because the value is in continuity, not poking or prodding.<\/p>\n","protected":false},"excerpt":{"rendered":"

Back in the stone age when I went to medical school, the \u201ccomplete physical\u201d was a full course in first year. We were taught where to poke, push, prod, palpate and percuss. We practiced looking at fingernails, eardrums, nipples and … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1430"}],"collection":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1430"}],"version-history":[{"count":1,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1430\/revisions"}],"predecessor-version":[{"id":1432,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=\/wp\/v2\/posts\/1430\/revisions\/1432"}],"wp:attachment":[{"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1430"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1430"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/danschmidtforsenate.com\/blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1430"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}