Standardized Patients

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Does anyone else think there is something a little weird about people getting paid to get rectal and genital exams? Getting paid to have your private parts examined seems a bit strange to me.
So is it the payment that surprises you or the willingness to be examined? It is important for students to learn to do a complete physical examination, including breast, pelvic, rectal and male genital. In ancient days, we used to have students examine each other, but originally most students were male and there was awkwardness but not gender differences. As more women started going to medical school, there developed the attitude that they would not want their classmates to examine them. I think that is a bit crazy, since they will not be giving their real patients any choice, so why are they getting a choice, but then again I am a dinosaur and I admit it. What concerns me is that you seem to find only the genital examination strange. Why would someone be willing to have a student examine him/her in any other part of his/her body. The money may be part of it, but I do believe here s altruism and there are those who hope that they can teach students how to do an examination without offending the patient and thorough enough to be useful.

Over the years I have watched the art of the physical examination slowly erode away. This despite my putting in hours trying to help guide students and residents to do one the right way. I don't think I have been able to do it effectively. I will soon be retiring from active practice/teaching and have considered what to do with my time. One thought is to "donate" my body to science, but not after I am dead and in the anatomy lab, but perhaps while alive and work as a standardized patient. I can guide students, perhaps, through the uncomfortable first steps in physical examination. I am worried about who will be made to feel more awkward, the student or me. If the student knows that I am a former faculty member and is now examining me, how we will each feel then, and when we cross in the halls. I was a patient in the hospital and had students, nurses, etc take care of me. The awkwardness disappeared immediately. Perhaps they really didn't identify me as being their professor, so there was not problem.

Our bodies are just that, bodies, they are symbols of who we are, we may be fat, fit or otherwise, but perhaps if more students, etc., agreed to act as standardized patiens, we could teach medical students the art of the physical examination and turn around the awful trend to technology and away from the actual bedside.
 
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