Every once in a while, we have a patient who will say that they feel that their doctor did not do a thorough examination when they came in for a visit. When we ask why they feel this way, the patient usually says something like “Well, they barely touched me!” or “They asked me to move around and bend and walk, but they didn’t do any follow-up x-rays”. Sometimes, it is normal to feel like a physician should do a certain thing when we are in the examination room with him or her and we have certain expectations about what will occur. We usually base that on past experiences we have had with physicians, on what we have read, seen on TV or had a family member or friend tell us to expect during our office visit. When our physician doesn’t behave as anticipated, and touch our affected body part, do x-rays or ask us a lot of questions, does that mean that they did a poor examination?
Not at all. Examinations vary widely from physician to physician. Some physicians are very hands-on and want to touch and feel the patient. Some physicians like to observe the patient instead and may do this in a number of ways. They may ask the patient to perform a variety of movements which will give an indication of the severity of their illness or injury. For example, if a patient is complaining of a sore knee, the Orthopaedic physician may have the patient walk while being observed, to help determine if the problem is in the knee, the foot, the hip or back. If the patient is complaining of a sore upper arm and shoulder, the physician may ask them to rotate their head and bend their neck to see if a cervical disc problem could be causing the pain, instead of the shoulder.
Sometimes, physicians observe their patients more surreptitiously. They may talk to their patients a while, to get them to relax. During this conversation, they may observe how the patient moves their body in relation to their complaints. Do they forget and jerk the body part, that just a few moments ago was causing them agony at the slightest movement? Is their expressed level of pain commensurate with their injury or is it way out of proportion? The Orthopaedic and Pain Management Physicians at OSC have examined thousands of patients in their practice and with this experience comes an understanding of what examination techniques will help them to make their diagnosis and determine appropriate treatment.
Almost all patients who come in for a new complaint at OSC get x-rays. However, many do not get x-rays on a follow-up visit, especially if the diagnosis was made of a soft-tissue type of injury. X-rays would be ordered to rule out fractures, tumors and bone spurs and if none were found, the patient would be treated conservatively. If conservative treatment was not successful and the pain persisted, an MRI might be ordered to visualize the injury and to decide if surgery was required. Your OSC physician knows the appropriate type of diagnostic test to order and knows when your insurance company is most likely to approve coverage.
Another very important tool in the examination room is the conversation that your and your doctor have. Your doctor will ask you specific questions that will assist in making a diagnosis and in determining the best treatment options for you. By just asking several succinct questions, your physician may gather much of the information needed to move forward with your treatment.
Finally, if you have concerns about your examination, it is perfectly fine to let your physician know how you feel. If you have questions, ask them. If you need to know more, then say so. Your well-being is our main concern and we want to ensure that you are pleased with every aspect of your visit at OSC. That includes your examination by your physician.
Robert J. Snyder MD, is a Board-Certified Orthopaedic Specialist with Orthopaedic & Spine Center in Newport News, VA. Voted a “Top Doc” in both 2012 and 2013, Dr. Snyder specializes in Partial and Total Joint Replacement, Sports Medicine and conditions pertaining to the Foot and Ankle.