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Wednesday, April 1, 2009

An April Fool's Daydream: The physical exam

A few days ago I got a warm, funny postcard from my doctor, reminding me of my upcoming appointment, asking me to email him my medication list, and inviting me to email him with any questions I'd like to discuss. In the card, he congratulates me on the progress I've made on my fitness plan, which he has monitored by email since my last physical exam. (He'd asked whether I preferred a letter, postcard, or email for the reminder, and since I'm not concerned about confidentiality, I preferred the postcard.)

A day or so before the visit, I email him my medication list, which my pharmacy had emailed me.

When I arrive, as I've been told, I first fill out a form asking what I'd like to talk about during the visit. The assistant hands me some patient education materials about the condition I've mentioned, and I read it during the short wait to see my doctor.

In the exam room, the nurse takes my weight, blood pressure, and pulse, and shows me on a graph how they compare with my past readings.

The doctor runs through my written questions. He refers to the problem list in my electronic medical record, and the note that the ENT specialist had emailed into it, which recommended surgery for a benign nasal polyp. My primary care doctor discusses the trade-offs of different options, and supports my decision not to have surgery for now. He advises me on how to use an inhaler that can shrink the polyp, forestalling or delaying the need for surgery. He realizes from the pharmacy's medication list and refill history that I've been using the inhaler every other day instead of daily, and we discuss that. By the end of the visit, we have discussed my fitness plan and my risk factors. At the end of the visit, he hands me some printed information about my condition and his suggestions, and the recommended date for the next appointment.

Advice: Dream big dreams, and work hard to make them come true.

Read another physical exam story.

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