Dr Liza Macdonald FRCR MA

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The Examination

  Getting The Best out of Your Doctor

What happens when the doctor examines you

Once the doctor has a good idea what has brought you to see him or her they will probably want to examine you.

They certainly should usually want to examine you if your problem is in any way physical.
Quite often nowadays an examination is not done. This may be because of lack of time or, for example, because the doctor thinks that a scan or an X-ray will give a better answer. This is not always right. A scan will not for example see a skin rash or hear the heart sounds or measure the limitation of a shoulder joint. An X-ray will not see a patient wince in pain or find one set of muscles weaker than another.
Good doctors know that the information gained from doing an examination is invaluable.

How should a doctor examine you?
The examination procedure is part of professional training and to do this well takes care and practice. A good doctor can gather a wealth of information from an examination and the best physicians become very skilled at putting together a combination of clues about the patient's health, diet and style of life as well as clues to an underlying problem.
To examine you properly the doctor will need a clean couch that is firm, not spongy.
The doctor will need a good light and a quiet private setting. They will need a few pieces of equipment...a blood pressure machine to measure your blood pressure and a stethoscope ( the set of listening tubes) to listen to your lungs, your heart and perhaps your abdomen. They may need some small special items to examine your ears, nose and throat.....a tongue depressor to allow them to see the back of your throat and an auroscope ( small coned torch) to look in your ear. They may need a couple of special tools to examine your nerves...a small rubber hammer to test your reflexes and perhaps a blunt pin and some cotton wool to test skin sensation.

The examination usually starts with some general observations looking at the lining of the eyes to check for anaemia or jaundice, feeling the pulse and looking at the nails for signs of anaemia and strangely enough for evidence of lung disease.
Then in a methodical way the examination proceeds to check over the skin for rashes, moles and lumps....to check the neck and under the arms and in the groins for lumps, lymph nodes or swellings...to listen to the heart and lungs and feel the abdomen for the normal organs and any variation in size or tenderness.
Depending on the problem, the examination may check an area or a system in greater detail.

And when the examination is complete (and for some details as it goes along) you can expect the doctor to make a careful note of the findings (best to let the doctor do that in silence. Don't interrupt! They may get distracted and fail to note something important)

And what next? Perhaps the findings will prompt further questions...perhaps not.
But you would probably like to know what the doctor found. Does he or she think anything is unusual or unexpected?
What is their view of the way the history, the symptoms and the examination findings stack up together? Have they reached a provisional diagnosis? What do they think at this stage?
Hopefully the doctor will have formed a view. They may have a firm diagnosis by now. But more often they may just have a hunch or perhaps a couple of possibilities. Next we need to know how we are going to find out more...what else can be done to clarify things?

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