Physicals in a time of plague

When I was a boy (and a young man), my annual physical exam was a a detailed "examination."  Every square inch of my body was studied.  Ears were looked into with lighted instruments.  My tongue was depressed with a "popsicle" stick.  Hernias were embarrassingly sought for.  Rear end was examined.  Knees were struck with a small rubber hammer. 

Not to mention the routine use of a stethoscope to check heart and lungs.

Over the years, the exam became shorter and shorter.  The doctor spent more time chatting with me than actually doing a hands-on examination.  More and more, any concerns my hypochondriac mind could dream up were dismissed with the unsettling comment that by the time that became a problem, I'd be dead from old age.  I still saw death as being a theoretical event in the far distant future; the doctor was looking at actuarial tables.

Then, during the last year or so, Medicare has replaced the old-fashioned exam with a "wellness" visit.  The doctor still checks blood pressure and listens to your heart.  He sends you to the lab for blood draws.  He (unnervingly) subjects you to a simple (sorry, Mr. Trump) cognitive test to check for incipient dementia.  But mainly, he just chats, asks how you're doing and whether your stairways have banisters and how often per day you fall.  This wellness visit is supposed to allow him to decide if further testing is required. 

Rather than stripping to your underwear (or less), you stay fully clothed.  The doctor even listens to your heart through your shirt.  Apparently, by the time you reach Medicare age, the medical professional prefers not to be subjected to  the appearance (let alone touch) of your actual, in-the-flesh body

The wellness visit may be useful to the doctor.  I expect it is useful financially, both to Medicare and to the clinic.  To me, as patient, it feels like a waste of time and leaves me with no assurance that my body is still clicking on all cylinders.  I subject myself to it only because the doctor won't otherwise renew prescriptions for another year.

Then came the pandemic.  Yesterday, I had my first wellness visit since last summer. The clinic encouraged me to do my visit on-line, rather than make a personal visit to the clinic  So much for checking my heart  and blood pressure.  All we could do was talk.  I communicate using an i-Phone.  I see only the doctor's face, and he sees nothing more of me.

He asked how I was.  "Fine."  How's the muscle ache in your back.  "???" I didn't even recall that from last year.  I asked if I should have a PSA blood test for prostate cancer.  I told him that a good friend had prostate surgery last summer, and was told he had been lucky to have caught it before it spread.  He assured me that prostate cancer was slow developing, and that with my life expectancy being what it was ... "Right, I get it, doctor."  He renewed my prescription and authorized various routine blood tests.

At least I didn't have to go down an elevator, packed in with various diseased patients and their visitors.  I didn't have to get my car out of the parking garage and pay the attendant.  I didn't have to drive home through city traffic.  I just pressed the "LEAVE" button on my i-Phone.

But somehow, as a kid leaving a traditional physical exam, I felt more confident that I was good to go for another year.