Physical Exam

[Toastayy]

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This might be a silly question, but I've recently started my FM residency and started my first mini-peds outpatient rotation today. Started with a few patients and shadowing an attending. My question is regarding physical exams. Are you examining genitalia at every well child visit? Up to what age do you stop, or don't you? It seems different physicians practice different things when it comes to physicals and I just want to make sure if there's any evidence behind doing this. (I had one FM physician do DREs on all older male patients at their annual visit which is not indicated).

 

[sliceofbread136]

Yes at every well. Especially important at age 6,7,8 and age 13,14 (cut offs for precocious or delayed puberty based on the demographic)

 

[Toastayy]

Yes at every well. Especially important at age 6,7,8 and age 13,14 (cut offs for precocious or delayed puberty based on the demographic)

Good to know thanks.

 

[Goneril]

I don't do it at every well visit. I rarely do it in late adolescence especially if their height has plateaued and there are obvious signs that puberty has ended.

Before puberty and mid-puberty, I will check and I will check every other year, assuming everything was appropriate the year before.