To wonder if medical professionals have lost the art of examination

[Lancspop]

And is this good or bad.
Two recent examples. Person A suffering from anxiety and depression. Had F2F appointments and prescribed beta blockers dnd dentist depressant but no physical exam. Not even blood pressure.
Person B f2f appointment. Mentions random pains in stomach and trunk. Also slightly light headed at times. Again no physical exam but scan to be ordered apparently.
Just wondering if this is the way forward now or are these isolated incidents and what the pros and cons to this approach are. I can only see cons tbh.

And anti depressant. FFS autocorrect changing just as you press send.

Imo yes.

There seems a much greater reliance on tests and following protocols.
Also, contacts with the health service seem now to be dealt with as individual episodes and there is very little joining up of these to see a long term picture.

@LaMarschallin I agree re that too. My last phone consultation was not with a GP but a PTA and it was blatantly obvious they were reading from a script like the 111 service does.
No chance of them considering anything outside the narrow remit of the appointment.
No joined up thinking. Just feel so much stuff will be missed but of course I am no expert.

I'm being professionally defensive here. But maybe it's just impossible to please everyone? There was a thread a few days ago slating GPs for being rubbish, underdiagnosing or underinvestigating, whereas this thread seems to infer the opposite.

My colleagues practice defensive medicine as you've described above because a strange sounding abdominal pain could be a variety of issues and often even with a thorough history and examination some serious diseases may be missed. Certain investigations are near definitive and so in the broad schemes of things it probably saves everyone's time to go straight to them. Also, protocols (presuming you are talking about NICE?) are useful tools to make sure clinicians make evidence based decisions (both to improve health related outcomes for everyone, as well as save money).

It's not how medicine historically was done, but people's expectations are changing and we ought to give people the best care. I'm convinced by the time I retire the 2-week wait for cancer diagnosis will have changed to a next day diagnosis even though there is no clinical need but people want to know. I'm also certain that the system won't be appropriately funded for this though.

Thank you @countrywalks1 It is good to have a professional opinion on this but I currently have person A in a state because they are suffering from anxiety, depression and a certain amount of paranoia as they are now worried that if their blood pressure was low the beta blockers will lower it more and is refusing to take them. I have tried to reassure etc etc.
I am person B and I am am probably biased right now as I have had a few issues of late with my GP surgery. I have numerous health issues and symptoms but feel the one appointment one problem misses stuff as things are often connected. Referring to specialist or for tests is good but what happens in the meantime?
I had months of pain whilst waiting to see a specialist for a fairly rare skin condition. This could have been improved months earlier by checking the strength of the ointment I was using for example. But no one did.
Because of the Lichen Sclerosus disease progression my urine flow has altered and will likely need surgery.
Sorry that became personal and ranty.

Incidentally I have had the LS for 10 years now but because the biopsy wasn't conclusive I think it wasn't taken seriously by anyone and as a result I never had a steroid on repeat and no one took action when the one I was using stopped working.

Yeah would a protocol not be in place to check someone's blood pressure before prescribing a drug which can lower it?

If the person is anxious over their blood pressure, it might be worth buying a home machine perhaps. I have one as I need to monitor my BP a little. It cost about £20 from Boots and came next day. I took mine to the surgery nurse who checked my machine's reading with the one at the surgery and it was accurate.

Assessment takes skill, time and experience.

GP appointments do not have the time for full physical assessment - it has to be a 'quick glance assessment' - how the person walks in the door, sits, talks and then specific assessment/examination matched to described symptoms.

This will work 99% of the time, but there is always going to be a 1% it doesn't work for.

countrywalks1

I'm being professionally defensive here. But maybe it's just impossible to please everyone? There was a thread a few days ago slating GPs for being rubbish, underdiagnosing or underinvestigating, whereas this thread seems to infer the opposite.

I was on that thread and posted a couple of times in defence of GPs.

My colleagues practice defensive medicine as you've described above because a strange sounding abdominal pain could be a variety of issues and often even with a thorough history and examination some serious diseases may be missed.

I totally agree with this. I'm not even sure I'd call that "defensive medicine". Extra tests are often indicated, but a good history and examination can often point in the direction of which tests.

However, just as an example, twice now I've been in hospital (pre-Covid) and developed a mild temperature. On both occasions I've been checked out for standard things such as a UTI and also had my chest examined. Both times I was told my chest was clear but "we'll get an X-ray, just in case".
So, the doctor was presumably wasting their time examining me because they had no confidence in their own findings.
Or money was wasted on chest X-rays (and I was exposed needlessly to radiation) in case the doctor needed proof of not doing wrong later.
I would say that in the case of a mild temperature, the absence of respiratory symptoms and, presumably, signs (or none detectable at that time) and the fact I was already in hospital, a chest X-ray was pointless. And potentially harmful.