What does a comprehensive physical exam include?

What does a comprehensive physical exam include?

A comprehensive physical exam is sometimes referred to as an executive physical. This exam include laboratory tests, pulmonary function testing, chest x-rays, audiograms, EKGs, full-body CAT scans, heart stress tests, mammograms or prostate exams, and a urinalysis.

What are the 3 components of a complete physical examination?

What are the three parts of a complete patient examination? Health history, the physical examination , and laboratory and diagnostic test.

How do you document patient general appearance?

Appearance

1. Age: Does the patient appear to be his stated age, or does he look older or younger?
2. Physical condition: Does he look healthy?
3. Dress: Is he dressed appropriately for the season?
4. Personal hygiene: Is he clean and well groomed, or unshaven and unkempt, with dirty skin, hair or nails?

What are the advantages of going through a comprehensive medical exam?

Regular medical checkups allow doctors to pick up signs of diseases that the patients may not even know to exist. With routine screenings, the doctor can diagnose potentially severe or life-threatening conditions and prevent any kinds of risks before it is too late or it takes a turn for the worse.

What do you observe on general appearance of a patient?

The general appearance of a patient may provide diagnostic clues to the illness, severity of disease, and the patient’s values, social status, and personality. The astute physician will begin to gather this information immediately upon meeting the patient.

How do I document normal nose assessment?

Documenting a normal exam of the head, eyes, ears, nose and throat should look something along the lines of the following: Head – The head is normocephalic and atraumatic without tenderness, visible or palpable masses, depressions, or scarring. Hair is of normal texture and evenly distributed.

What is a full physical exam?

A full physical examination is a way for your doctor to establish a baseline of your overall health and then continue to monitor your health for any changes that occur over time. Family physicians use their ears, eyes and sense of touch to identify any possible medical conditions that may exist.

Are doctors allowed to touch your private parts?

In summary, a doctor is NOT allowed to touch your private parts, but the patient can grant them permission (and they MUST respect the patient’s decision).

What are the 1995 and 1997 guidelines for documenting physical exams?

The 1995 guidelines identify Body Areas and Organ Systems as a framework for documenting the physical exam, but do not say what to chart under either. The 1997 guidelines define mandatory physical exam elements and called them Bullets. A comprehensive exam requires all bulleted items to be examined, and at least 2 per system to be documented.

What are the exam content and documentation requirements?

To qualify for a given level, your exam must meet the following content and documentation requirements (these are summarized in the table “Exam content and documentation requirements”): Problem focused– should include performance and documentation of one to five bulleted elementsin at least one organ system or body area;

What is a bulleted physical exam?

The 1997 guidelines define mandatory physical exam elements and called them Bullets. A comprehensive exam requires all bulleted items to be examined, and at least 2 per system to be documented.

What is the difference between detailed exam and comprehensive exam?

Detailed exam – an extended exam of the affected body area (s) or organ system (s) and any other symptomatic or related body area (s) or organ system (s). Comprehensive exam – a general multisystem exam, or a complete exam of a single organ system and other symptomatic or related body area (s) or organ system (s).