I'm wondering if my annual physical exam with my doctor was as complete as it should have been.

They went through the usual stuff: weight, blood pressure, hearing test, vision test, urine sample, weight check, questionaire, etc. I had to get undressed and put the gown on. He listened to my heart, lungs, checked my throat, etc.

Those parts I'm fine with. But when it came time for the genital exam, he never does anything but check for a hernia. "Turn your head and cough". That's the extent of the genital exam. He didn't examine for lumps, etc.

I know that most doctors don't do the digital rectal exam until a man is 50 or older, unless you have a history of colon/rectal cancer in your family. But, if you read or view videos on what goes on during a normal physical, the doctor is supposed to examine your penis for lumps, he examines the scrotum, the urethra, shaft, etc. Usually, you lie down and he examines your genitals pretty thoroughly....or so I thought. That portion of the exam lasted about 5 seconds.

I can see him not doing the rectal exam, since I'm 41, and I don't I have a family history of colon/rectal cancer.

I do self exam in the shower from time to time, but what if I miss something? I would think that the testicular exam would be something that most doctors do automatically---similar to what a woman goes through at the gynecologist when she has a breast exam.

I even had to request blood work to check for cholesterol, etc. You'd think that he'd have ordered that himself.

Do all doctors do this? Maybe I should switch doctors? Maybe a man needs to see a urologist to get a good exam anymore?

Well, actually, I think physicians usually start the dreaded digital rectal exam when you turn 40. You should do it.

With insurance companies failing to cover procedures now days, doctors or only doing what's necessary, and pushing you out the door. I started getting the prostate exam at age 40, with the psa test. The blood test, I would have to remember to ask the doctor, other wise, he would forget to schedule it. As for the routine exam, I've never had a doctor that done any more than the the usual (turn your head and cough) procedure. I'm uncircumsized, but have always wounder, since so many men are clueless about their foreskin and keeping it clean, that the doctor doesn't do a theral exam of the penis. Other than the cough that they ask you to do, they don't touch/handle your penis at all. I have a great doctor, but he's never even ask me if I had any problems with my penis/foreskin. When I started having the anal exam for prostate cancer, it was my suggestion to have it, and every year now I've made it part of my annual/yearly exam. So alot of things, they leave up to you to ask. What ever happened to customer service...

I might switch doctors for my next physical. He even suggested that I don't come back until I'm 45 (4 years from now). I don't think I want to wait that long, you know?

I may ask for the digital rectal exam at my next physical. I guess that's the only way you get decent service anymore.

Not too long ago, I moved to a new state. I had physicals but they were very superficial as compared to my previous experiences. One guy took my medical history, looked in my eyes and ears and never even asked me to get undressed for the other necessities.

Then, I noticed that my old Dr. in the old city was covered by my insurance. I went to visit friends, made an appointment and had a proper physical -- Genital check and Digital Rectal Exam, EKG, etc...

My conclusion after the experiences I had was that it depends to a certain degree on the common practice of the physicians in the area and I am also convinced that it has to do with insurance coverage. The new Drs. I was dealing with seemed to want to take the money and run. My old Dr., if I dare to characherize the healthcare industry, was more interested in checking things out so as to cover his butt.

Keep looking until you find some one who really wants to take care of you.

-Filippo

Hi
Where I live, the local hospital does a free prostate screening once a year. It is sponsored by the local chapter of the American Cancer Society and some local doctors. I take advantage of that and have done so for about 5 years now. I am 48. If not for this, I probably would not have even known that this is something that I needed to have done. And, my father had prostate cancer, but did not die of that...he had advanced altzheimer's by the time the cancer was found and died from that. But still, I did not know about the screening for that. I probably thought that you would have pain with that, which is not true. And another thing..I have AFLAC supplemental insurance with my company and they pay me $75 for the prostate exam even though it is free, so it is like I get paid for the exam. My PSA levels are very low and everything is good, which gives me a good peace of mind. Well, I hope this helps you.

I have to agree with Filippo... moved to a new area, saw a new doctor for a physical... or lack thereof. Nurse did blood pressure, pulse and weight. Doc came in and talked a while, then left. I asked about the exam and he said that my numbers were fine and it wasnt necessary. Not what I was expecting at all.

I wasnt happy at all, so the following year (last summer) I went back to my hometown (only 2 hours away) and scheduled an appt with my old doc. Just said I wanted a physical geared for someone my age. What a difference -- Doc said for my age (27) it was a good time to get baseline tests done, so he set up two visits.

First visit was with the nurse, did height and weight, temperature, blood pressure, pulse, breathing rate (never found this out until I got the results), ekg, echocardiogram (yes both), blood tests, urine test, vision and hearing tests, and an exercise stress test. She also went over the immunizations and brought me up to date. (I don't even want to think about how many needles I had stuck in me that day.)

Next visit was set for a week later to allow the test results to come back. Nurse did weight, temperature, blood pressure, pulse, and breathing rate again. Doc went through family history for updates, went over tests and then did a full physical. And I mean full. I'm telling you, he spent more time examining my heart than I spent in the first doctor's office from start to finish. Yes, he did the "turn you head and cough" test, and yes he made sure there was no testicular cancer.

Afterwards I talked to Doc and told him about my exam (or lack thereof) with the first doctor. He said that many practicioners are moving that way. He did say that the tests I went through are a bit extreme, but he believes in getting a baseline series of results while patients are young and healthy.

Yeah, I felt like a human test dummy after my exam, but I also felt that a) Doc took the time to give me a full checkup, b) Doc answered all my questions, and c) Doc got all of the necessary information for future care.

I haven't seen a doctor do a testicular exam on me in probably 20 years. I always thought that they would do it as part of a complete exam without "asking" them to do it, for pete's sake. I examine my own testicles from time to time, but a doctor should still do it once a year. You can still miss things.

I have a hydrocele, which came back shortly after I had it surgically removed when I was 16 years old. It's never really bothered me, but it still should be looked at once in awhile.

When you read what is part of a complete genital/rectal exam, I don't think doctors bother with 90% of it anymore. Turn your head and cough, and that's it: you're done.

I'm 45 and have had the same doctor since I was in my mid 20's. Back then when I had my yearly physical, while I was laying down he would pull down the front of my briefs and press around the pubic area. Then it was stand up and drop your drawers and he would roll my testicles in his palm and then reach up underneath on each side and have me turn my head and cough. He has always done a rectal exam, even when I was in my 20's and for that he just has me turn around and bend over and its done in a flash. My last few physicals he still pulls down on the waisteband of my briefs and presses the pubic/appendix area. However he does not check my testicles anymore and the hernia check is simply him pressing on each side of my pubic area and telling me to turn my head and cough. Thats it for the genital exam. The rectal exam is done so fast I wonder how he can tell anything. I feel that as I'm getting older more attention should be on things "south of the border".
I've heard of some doc's examining men with their legs in the stirupps, like a woman.

According to the medical establishment, the current evidence doesn't support the usefulness of an annual screening physical exam for asymptomatic adults.

Here's a recent medical journal paper on that subject:

Arch Intern Med. 2006 Feb 13;166(3):368. "Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers." Prochazka AV, Lundahl K, Pearson W, Oboler SK, Anderson RJ.
Ambulatory Care Section, Denver Veterans Affairs Medical Center, Denver 80220, USA.

Your checkup should have included a testicular exam and a digital rectal exam. While I wouldn't go so far as to characterize your doc as negligent, he should have been more thorough. I'd find another group if I were you.

A doctor I know recommended seeing a nurse practitioner or a physician's assistant, instead of an MD, for a checkup/complete physical. They tend to have more time to be thorough, and at many locations the wellness checks are delegated to them.

Your checkup should have included a testicular exam and a digital rectal exam. While I wouldn't go so far as to characterize your doc as negligent, he should have been more thorough. I'd find another group if I were you.

A doctor I know recommended seeing a nurse practitioner or a physician's assistant, instead of an MD, for a checkup/complete physical. They tend to have more time to be thorough, and at many locations the wellness checks are delegated to them.


I agree. He even went so far as to tell me that I wouldn't need another exam until I was 45. I'm 41 now, so that's 4 more years.

I think next year, I'll try someone different. I've heard or read that even Planned Parenthood does male physical exams. They'd even probably be an improvement over what I've been getting for an exam.

Here's a suggestion guys: if, during the routine physical, the doc does only a superficial exam down there, say to him, "would you mind checking the penis and testicles please, and doing a DRE?" If you're shy about saying the words, repeat the above, in private, in front of a mirror, until they sound natural. The doc uses correct anatomical terminology all the time -- no need for shyness.

I haven't seen a doctor do a testicular exam on me in probably 20 years. I always thought that they would do it as part of a complete exam without "asking" them to do it, for pete's sake. I examine my own testicles from time to time, but a doctor should still do it once a year. You can still miss things.

I have a hydrocele, which came back shortly after I had it surgically removed when I was 16 years old. It's never really bothered me, but it still should be looked at once in awhile.

When you read what is part of a complete genital/rectal exam, I don't think doctors bother with 90% of it anymore. Turn your head and cough, and that's it: you're done.

Mine on 6/12/07, completely missed the urine test or turn your head & cough, think it is time to look for another one....will call him tomorrow to see what his reply is RE: why he omitted it!

The doctors today just "push you through"....just enough to get you in & out and on to the next patient. I question how many doctors do physicals by the book anymore---I bet not too many.

You might want to look for an older doctor, mine is in his 50s (I base this on his graduation date). He checks everything. He does the turn and cough but checks penis, testicles, forskin and even pulling back the foreskin and checking there, rectal exam, the works. This was the last part of my my physical after he had checked everything else. I guess I was with the doctor for about an hour all together. It took a while to find a doctor who checks everything. I went to three other doctors before finding this one. Is all this necessary - I don't know but I feel much better with him checking everything. Keep searching until you find someone you like.

I have read that men should see a urologist for a yearly exam, the same that women do with the gynocologist. Might not be a bad idea.

I have read that men should see a urologist for a yearly exam, the same that women do with the gynocologist. Might not be a bad idea.

I think I might do that next time. Seems as though they might be the only ones who will do a thorough exam on a male.