What an interesting VA physical

[AF_PedsBoy]

So I had a patient - in a 20 minute slot of course - come in for a VA physical to evaluate her for disability for shin splints and flat feet. This person was 22 so I thought it was silly, but not outrageous.

Then I saw the VA requirements.

So I went through the physical's requirements with this girl who was 9 months pregnant with an EDC 7 days away and said, "So I'm evaluating you for your shin splints and flat feet... and they want me to do a breast exam, a pelvic exam, a rectal exam... oh and draw labs and do x-rays on you. Yes, we're not going to do any of that today." So I mentally gave the VA the finger and figure they'll either send her back - by which time she'll be postpartum - or get their own doctors to do their crack head physical... I will say, though, that making a 9 month pregnant woman do the duck waddle was somewhat amusing however - unwise, perhaps, but amusing!

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[AF_PedsBoy]

Ooh our clinic PA gave me a few tips on those VA physicals... apparently the smart thing to do is block off a few appointments so you can get 30-45 minutes... and you can get around the pelvic-rectal by referencing the note if someone has done it recently, so I linked it to the sterile speculum Ob exam a month prior - I'm pretty sure she hasn't broken anything in the interim!

Or those Army-Navy physicals we do, apparently it's okay if they haven't seen Imms/Dental or have no medical records available as long as you put the follow ups in their plan (i.e. Patient sent to Immunizations for review, Dental and Optometry for annual examination, etc. etc.) Of course profiles are always a bit sticky since they don't use PIMR and we almost never have their profile forms in stock...

Thankfully they haven't made me do the green card physicals yet since no one in clinic has ever had to do one (ended up sending them to the embassy....)