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drz
11-19-2011, 02:08 PM
I was wondering if there has been a change over the decades in amount of physical contact and touching doctors do in their visits. It seems to me that now many doctors never touch their patients but rely on technology and just review the lab results, nurses notes, and then maybe ask a couple questions and write a prescription. I know some this probably relates to charges of sexual abuse that made headlines with some doctors ending up in prison and some of it probably results from time pressures to see more patients for shorter periods to maximize efficiency.

I have a couple doctors that touch me every time, like a podiatrist trims my nails, and my endocrinologist usually checks my feet and lungs and does a physical exam, my treating rheumatologist usually checks me over, and my ENT doctor usually looks up my nose or ear or throat depending upon my concern, and some specialists like urology, opthalmology, usually touch patients it seems and some times my internist checks me over depending upon my reason for visit. I remember when I was a child the doctors always checked you over by listening to you heart, lungs etc. and often gave you some kind of shot too it seemed.

Some studies have suggested that patient satisfaction is often related to having some appropriate physical contact, eye contact, and the amount of time spent with patient. Doctors with satisfied patients are less likely to be sued for malpractice even when they screw up.

Dryhill
11-19-2011, 08:33 PM
Here in the UK when you see your GP it is still a one-to-one meeting but when you have a consultation at a hospital the doctor normally has a nurse or trainee doctor present. My GP still touches me (mind you am I ever likely to complain she is about 20 years younger than me and is an attractive female?), but it must be a concern for some doctors.

A few years ago a fellow taxi driver drove a teenage female to a night club she then refused to pay and threatened to call the police and say he raped her. He locked the car doors and started driving, when the girl asked what he was doing he replied going to the nearest police station so we can both be examined and have dna tests. She very quickly backed down ....... oh he charged her twice the fare for her troubles.

delorisdoe
11-19-2011, 10:18 PM
lol. My weg doctor does not really touch me. His residents do to varying degrees. I had one of them once take both his hands and rub them up and down my legs vigorously...I was sooo embarassed. It was winter and I had not really shaved them for a little while. I still dont know why he did that.

Dryhill
11-20-2011, 01:08 AM
delorisdoe, perhaps he has a fetish about unshaven female legs? :flapper:

Sangye
11-20-2011, 02:11 AM
I think the lack of touch has more to do with an over-reliance on diagnostic tests than worries about improper behavior. Chiropractors hear all the time how healing touch is for patients. I could tell a lot about my patients' physical and emotional state just by touching their arm or their back. Many people go for days, weeks, even months without being touched by anyone. If they're a patient with a chronic illness, often the only time they get touched is during painful procedures.

Dirty Don
11-20-2011, 03:52 AM
I don't settle for lack of touch. I/we need it, especially for this disease...it helps, every bit helps. I usually initiate 'touch' with a friendly handshake, a joke and a pat on the back, asking the doc what she/he needs from/for me today. Some docs don't like it, but I do...tough on them...get what you need for this disease...be persistent...be patient!!

Al
11-20-2011, 05:54 AM
I think the lack of touch has more to do with an over-reliance on diagnostic tests than worries about improper behavior. Chiropractors hear all the time how healing touch is for patients. I could tell a lot about my patients' physical and emotional state just by touching their arm or their back. Many people go for days, weeks, even months without being touched by anyone. If they're a patient with a chronic illness, often the only time they get touched is during painful procedures.

I think Sangye is correct. Abraham Verghese, at the Stanford School of Medicine, has taken it as a mission to train his students in the art of the exam. Remember when your family doctor knew everything about you, including your grades and social situation? And would talk you through your whole set of problems, and do his own urine testing? Rare, these days. It is too easy, and utterly efficient, to outsource all that and just luck at the tests. When is the last time a doctor has really dug into even your medical history, let alone how you live, how you work, and all those other things that have brought you to where you are today? Of course, we can't go back to the old days, for economic reasons, nor would we really want to; the tests really do tell a lot. And yet, there is a lot to be said for Dr. Verghese's campaign. It really does seem to me that many doctors have little sensitivity for important cues, including their patients' emotional states; they have not been trained in how to conduct an exam in the full sense. The older doctors established trust, in large part, because they were both hands-on and giving you their full attention. I wouldn't mind seeing a return to that...

Al

Dryhill
11-20-2011, 06:01 AM
The older doctors established trust, in large part, because they were both hands-on and giving you their full attention. I wouldn't mind seeing a return to that...
Al

Well said Al.

maria garcia
11-22-2011, 12:20 PM
We had a doctor who kept poking my daughters( Amandas) butt. I didn't know what to do my daughter looked at me and I was about to crack up. It was actually a rheumatologist but im not sure was he was checking. After we left the office we couldn't stop laughing. Till this day we talk about it. This is not the same doctor my daughter Christina is seing these days.

Al
11-22-2011, 03:09 PM
We had a doctor who spanked my daughters( Amandas) butt. I didn't know what to do my daughter looked at me and I was about to crack up. It was actually a rheumatologist but im not sure was he was checking. After we left the office we couldn't stop laughing. Till this day we talk about it. This is not the same doctor my daughter Christina is seing these days.

Strange story, Maria. I can't guess what he might have been "checking" either, but I am glad you can laugh about it!

Al

maria garcia
11-22-2011, 03:40 PM
Strange story, Maria. I can't guess what he might have been "checking" either, but I am glad you can laugh about it!

Al

Al im sorry I just edited my story I went over it with my daughter and he kept poking her butt not spancked! There i go again (im cracking up)lol!

Sangye
11-23-2011, 02:27 AM
If you don't know what your doctor is doing during an exam it's important to ask. A doctor certainly could be overstepping his bounds, but sometimes they are looking for something and you might be able to help by providing more info. It's your body and your care-- it's important to take control and not be a passive patient.

In my practice I never wanted my patients to feel uncomfortable, and I also liked to educate them. As I did an exam or worked on them I'd describe what I was doing and why. I heard all the time that they'd never had a doctor do that before. That was very upsetting to me.

Al
11-23-2011, 11:36 AM
Al im sorry I just edited my story I went over it with my daughter and he kept poking her butt not spancked! There i go again (im cracking up)lol!

Thanks for explaining, Maria. One bit of advice: Even when the doctor is being comical (whether intentionally or unintentionally), you deserve an explanation what is happening. I know you were giggling too hard at the time, but you should always ask what the point is. (Actually, he should have told you without the asking, but sometimes you've got to step in on your own, even if you have to make yourself comical to do it!)

Al

jola57
11-23-2011, 03:41 PM
Maria, I would ask the doc at the next visit what he was poking at. Could it have been the hips or the musle, I agree with Sangye, the doc MUST explan what he is doing and why. As to doctors touching, well the last time I wa looked at properly was when I was in my teens and my doctor in Toronto was an old Polish surgeon/family doc. He looked in my eyes, at my hands, my walk, at my spine, in my throat, ears, behind and under me ears, my neck. He was very thorough. My visit was never less than 20 minutes. Now if I see my family doc for more than 5 minutes it is a miracle:ohmy:

drz
11-24-2011, 11:42 AM
Maria, I would ask the doc at the next visit what he was poking at. Could it have been the hips or the musle, I agree with Sangye, the doc MUST explan what he is doing and why. As to doctors touching, well the last time I wa looked at properly was when I was in my teens and my doctor in Toronto was an old Polish surgeon/family doc. He looked in my eyes, at my hands, my walk, at my spine, in my throat, ears, behind and under me ears, my neck. He was very thorough. My visit was never less than 20 minutes. Now if I see my family doc for more than 5 minutes it is a miracle:ohmy:

Yea, that is the old time doctor visit experience and now it takes a half dozen visits to several specialists to get that much of an exam.

Trudy
11-25-2011, 08:53 AM
Yea, that is the old time doctor visit experience and now it takes a half dozen visits to several specialists to get that much of an exam.

So what do your doctors do??? My rheumy/internist always checks eyes, ears, throat, glands, hands, lungs, reflexes, ankles; and whatever he deems relative that month. A normal visit is about 1/2 hour plus time with blood draw etc. I guess I should consider myself lucky to get this much attention?!

Al
11-25-2011, 02:33 PM
So what do your doctors do??? My rheumy/internist always checks eyes, ears, throat, glands, hands, lungs, reflexes, ankles; and whatever he deems relative that month. A normal visit is about 1/2 hour plus time with blood draw etc. I guess I should consider myself lucky to get this much attention?!

Yes, you are lucky, Trudy. The typical allotment the doctor gets from the insurance company is now 7 minutes. If you take longer, it comes out of the next patient's time. It largely turns doctors into money pumps, channeling wealth from your estate into the coffers of the medical-industrial complex. (This is, of course, the dark way to view the situation. But I submit there is much truth in that assessment, though it reflects nothing about the motives or desires of individual clinicians, most of whom are truly dedicated and caring.) I think we can do better.

Al

Sangye
11-26-2011, 03:29 AM
Most of my docs at JHU spend at least 30 minutes with me, often more. The time is spent with updating my symptoms, an exam and any procedures, answering questions and explaining procedures, test results, etc.... I rarely feel rushed. I know this is not the typical experience most people have with MDs.

chrisTIn@
11-26-2011, 04:35 AM
The first time I saw my specialist he examined me thouroughly. We discussed my medical history, he did a complete body-check up. It took over an hour in his office, and then (it was in a university-hospital) a picture of my skin-rash was taken, two skin-biopts and I guess also a chest x-ray. Don't remember excactly...
Afterwords I had to go to the lab for a blood- and urine test. About ten bloodsmples were taken.
When I see my specialist now, I only get to see him about ten minutes. Afterwords labwork.

Due to political factors and cuts in the budget the immunology research center of this excellent scientist will end. I still see him a few times a year, but don't know what the future will bring... :frown:

Al
11-26-2011, 08:42 AM
The first time I saw my specialist he examined me thouroughly. We discussed my medical history, he did a complete body-check up. It took over an hour in his office, and then (it was in a university-hospital) ....Due to political factors and cuts in the budget the immunology research center of this excellent scientist will end. I still see him a few times a year, but don't know what the future will bring...

For what it is worth, I have found that doctors at university hospitals much freer with time allotments than those at commercial clinics. But, as you suggest, they are under similar constraints in the long term: They must bring in the grant money or lose their laboratories. So it is still a problem....

Al