Rectal Exams, how was your first experience?

[medigeek]

... what?

 

Does that make this more a case of homophobia rather than an issue of "ick" factor then?

 

You're going to get up close and personal with male patients, period. If its not a DRE, you could be examining a lesion on the penis, some dermatitis on the scrotum, etc etc. Its a professional setting, you go about your business and be on with your day.

 

Yes and I'm being honest about it

The idea of seeing a penis or scrotum isn't nearly as bad as a guy's anus.

 

Though obviously a manual disimpaction takes the win for the things I'd definitely not want to do, but I think everyone would agree with this one.

 

I know it's a professional setting, but that doesn't change the fact that I'd cringe a bit in the back of my mind.

[tooty]

Rough estimate as to how many times this would be done by a med student in total?

 

no idea what the norm is. i had to do it twice.

 

And why isn't this done by NPs/PAs/midlevels?

 

because it's disgusting and no one wants to do it but the buck stops with you, the physician, unless you have a med student with you.

[medigeek]

no idea what the norm is. i had to do it twice.

 

And why isn't this done by NPs/PAs/midlevels?

 

because it's disgusting and no one wants to do it but the buck stops with you, the physician, unless you have a med student with you.

 

Twice in your 3rd/4th year combined?

 

Well it seems like if those people are so persistent with having a larger scope of practice, they should be the ones doing "physician like" work.

[A-Stark]

I've never done it or been in any situation where I might have done it. Lots of DREs though.

[Larrivee]

my first experience I almost got diarrhead on. I was with gen surg and the patient had a distal 6cm carcinoma that the attending wanted me to feel, unfortunately for me, the floor, and the lovely resident who cleaned up the mess for me, the dude had not evacuated his bowels after taking bowel prep for the surgery and when I broke the seal his contents... well... I was very thankful I had scrubs and shoe covers on...

 

but they aren't bad at all. I would far rather perform a DRE than a bimanual pelvic exam.

[w_robin]

I would far rather perform a DRE than a bimanual pelvic exam.

 

OH ABSOLUTELY!

[Renin]

I've done probably less than 10 DRE's in my medical school experience; and I'd much rather do a DRE than doing a bimanual pelvic too!

[medigeek]

Definitely unaware, what's so "bad" about a bimanual pelvic exam? (legit question).

 

Another thing I'm curious about, I've yet to talk to a female that says they're comfortable with a male gynecologist. I know a couple girls who directly asked for a referral to a female one only. Understandable obviously, and perhaps expected.

[rmorelan]

Not sure if this is mentioned yet anywhere in the thread but we are well trained for all of these as well - we had standardized patients we practiced on (some very, very helpful volunteers) that helped us learn the procedure.

 

I think I am on the high side here of people doing this - I have done so many DREs I have lost count - urology selectives, family medicine screening, radiation oncology electives x 2 etc......

[aaronjw]

Somehow I'm thinking the depravity of the corporate world wasn't so bad after all lol

[FrenchToast]

Definitely unaware, what's so "bad" about a bimanual pelvic exam? (legit question).

 

Another thing I'm curious about, I've yet to talk to a female that says they're comfortable with a male gynecologist. I know a couple girls who directly asked for a referral to a female one only. Understandable obviously, and perhaps expected.

 

Uh, I was recently referred to a male gynecologist, and tbh, I couldn't care less. It's his job, lol.

[medigeek]

Uh, I was recently referred to a male gynecologist, and tbh, I couldn't care less. It's his job, lol.

 

Definitely some females that don't care. Just seems to be more common for them to prefer females.

 

Still waiting on someone to tell me what's so bad about a pelvic exam

[lost__in__space]

UofT's second years just had their DRE today in ASCM!

[futureGP]

i thought it wasn't bad,

 

it's just a finger in + sweep 360 degrees and out

 

 

it smells a bit after so better take that glove away

 

i did a rural elective and the doc there told me he wears 2 gloves cause sometimes a glove pops...

 

[ellorie]

Personally I think that I feel more confident doing a DRE than a pelvic simply because it is less complicated technically. In, sweep, and out. With a pelvic, there's the speculum to worry about, and IMO finding a prostate is a lot easier than finding a cervix.

[Karma]

Of course it only takes a few seconds! And it's not so bad when you think that you can detect prostate or colon cancer by one simple exam. In my urology rotation I was told that many cancers are missed because doctors (especially women) "cringe" at the thought of doing one.

 

A Doctor's job is to be able to explore every orifice of the human body if needed to in order to help that patient.

 

And there are much worse things than a rectal exam, extracting a fecal impaction being one of them.

[NutritionRunner]

Another thing I'm curious about, I've yet to talk to a female that says they're comfortable with a male gynecologist. I know a couple girls who directly asked for a referral to a female one only. Understandable obviously, and perhaps expected.

 

When I first started seeing a gyn, I did ask for a referral to a female doctor. I was young and a virgin, so I felt more comfortable with a female physician. Now, however, it doesn't matter as much to me. After being diagnosed with endometriosis and having male gynecologists and residents involved in my care, I've stopped caring about the gender of my gyn. I care much more about their experience in treating endometriosis, and the number of laparoscopies they've performed (and what technology they use). I'm also older, married (so no longer a virgin) and just overall much more comfortable with my body.

[NewfieMike]

I saw a post on **DELETED** the other day where a middle-aged American guy was pulled a side for a full-body search at a TSA screen and requested he had a female examiner.

[blindsideflank]

^^^ many men request that a female inserts a urinary catheter. I guess if you get an erection its not "gay"...

[aaronjw]

Speaking of manual disimpaction: http://www.huffingtonpost.com/2013/03/08/live-tweet-dildo-extraction_n_2838801.html?utm_hp_ref=anatomical-wonders

 

 

Hahahaha

[rogerroger]

Rough estimate as to how many times this would be done by a med student in total? By a resident in FM/IM ?

 

And why isn't this done by NPs/PAs/midlevels?

 

I have never done it, but I have ordered it.

 

always wondered about this, but how does this really work? The intestines combined are SO long. How does it actually make its way up into the stomach?

 

 

If you spend much time on IM, GenSx or EM you will see this... Feculent emesis is usually a late finding secondary to a bowel obstruction. When you have nothing moving through the GI tract it is a great place for bacteria to ferment and viola, you got yourself some feculent emesis created within the intestine.

[medigeek]

I have never done it, but I have ordered it.

 

 

 

If you spend much time on IM, GenSx or EM you will see this... Feculent emesis is usually a late finding secondary to a bowel obstruction. When you have nothing moving through the GI tract it is a great place for bacteria to ferment and viola, you got yourself some feculent emesis created within the intestine.

 

Interesting.

 

I swear the strong majority of constipation cases could have been cured very early with a high dose of vitamin C in the morning with a glass of water.

[Dr.Henderson]

Interesting.

 

I swear the strong majority of constipation cases could have been cured very early with a high dose of vitamin C in the morning with a glass of water.

 

Linus Pauling would agree.

[ldnk]

Really? A full prostate check is done in a few seconds? (serious question)

 

Pfft. I do them thoroughly. 3 minutes at least.

[RaVen777]

DRE is no big deal. I thought it would be, but it lasts like 10 seconds, and is "reasonably" comfortable for the patient. I'm more concerned about my first delivery that I assist/do.