Blood tests have replaced traditional medicine for a large part.
When we moved to Georgia, we had a great doctor who was old school - because 15 years ago, medicine was old school. A lot has changed since then - in a short period of time. Not long ago, a medical "exam" was just that. You went into a doctor's office and disrobed - entirely - and then put on this paper gown that covered only your front (just barely) and laid on an "examination" table, with some sort of weird paper on it. A nurse would take your temperature, weight, and blood pressure.
The doctor would push and prod and probe, and look in your ears and your mouth ("say Ahhhh!") and even up your nose. The doctor would listen at your heart and lungs and check your cartoid artery for blockage. Then you would be asked to turn over and whoo-hoo! you got a finger up your butt for the old prostate exam. It was very in-person and personal and represented medicine, to me, for the first 50 years of my life - and was what medicine was like 50 years before that.
But life started to change, and even our old doctor started recommending a bank of blood test for both of us, even if we were generally in good health. When our doctor died unexpectedly, our new doctors seem less interested in prodding and probing, and more interested in running blood tests. One "doc in a box" we went to, ordered a blood test and then proceeded to read the results and what they meant, right from the report created by the blood laboratory (I know this, as I read along with him).
The pandemic accelerated the trend. "Telemedicine" became a thing, and maybe we started to realize all this prodding and probing wasn't necessary - and that contact with others is more dangerous than not. Another friend passed away the other day (typical of Old People Island). He was a very strong man, but had an embolism. He survived that, but didn't survive the hospital, getting one infection after another until it finally killed him. Death by nurses and doctors who don't wash their hands. It happens, a lot, and often Doctors are the worst offenders.
Blood tests have gotten better - and there are more of them as well. Instead of a finger-up-your-butt, they order a "PSA" test, which tells whether you have prostate cancer or not, and if it indicates a high level, well, there ain't much you can do about it anyway - unless you have a young doctor who wants a new Porsche and sees you as a pile of billable hours. "We can remove your prostate" he says, "but then you'll be incontinent for the rest of your life!" So you say, "What's in it for me?" and he replies, "Nothing, but I get a new Porsche!"
Yes, medicine works that way - and even "good" doctors (and lawyers - I've seen it!) will recommend treatments that generate a lot of billables, and not even consciously realize they are doing it. It is human nature that if you are on a quota, and have bills to pay, you work to the quota. Act shocked.
Whether this new no-touch medicine is a good thing or not, I don't know. Because the other side of the equation is the pharmaceutical industry. You go to a doctor, they order a blood test, and if anything is out of wack, they prescribe a pill. So my purine levels were high (gout) and they prescribe a pill (alopurinol) and when I go back next year, the levels are fine - but we keep testing for the rest of our lives.
Mark went through a similar thing with slightly high blood pressure. As I noted before, his Mother died of a heart attack and his brother has chronic high blood pressure. They measure this and put him on a pill and within a week, his BP is down to normal (and he has more energy than ever, it seems!). It is not like we even see the doctor for blood pressure testing - there are machines at the pharmacy and we even have a home sphygmomonometer device. Mark even has a watch that measures blood pressure, while other friends have them that measure EKG (as well as heart rate, etc.). All this data can be uploaded to the doctor's "portal" and you need not even see the Doctor for a diagnosis!
Even blood testing is farmed out to a testing center, and a new career of plebotamist - a person who takes blood samples. This skill has been around a long time, of course, but in the past, it was part of a nurse's routine duties, not that of a specialist who does nothing else.
So today, it seems there is less touchy-feely and more measuring and testing - and prescribing - in terms of General Practice of medicine. Or, at least that is how it feels from this patient's point of view. In many cases, a "checkup" means only going to get blood drawn and then talking on the phone (or informally in the office, with your clothes on) without so much as a handshake.
There are, of course, exceptions. My dermatologist has two assistants who freeze off chunks of weird skin or pick at odd looking things ("I love to pick" one says, as she pops a zit on my leg). But I don't think I've even met the Doctor himself. Mark has, when he had a chunk of his ear removed (it was cancer, but a benign type).
And of course, my proctologist is very "hands on" and while he doesn't shove his finger up your butt, he's got something else a lot more up close and personal. Fortunately, I shouldn't need that exam again in my lifetime.
So what's the point? Well, I think two things. First, this is one of these deals where everything has changed in a matter of a few years and we don't notice it because the change is fairly gradual. The practice of medicine has fundamentally changed from a traditional "hands on" approach, where the Doctor prodded and pokes and talked to his patients to a modern technique of measuring parameters and then prescribing medicine. We seem to let this happen without thinking about it too much.
Second, "hands on" medicine might have some advantages, still. When you talk to a patient, you might get some tidbit of information that might indicate something is wrong - something you can't measure with a blood test. And tests can be wrong on occasion. The test-and-pill approach can be dangerous as well - I recounted before how we had a number of "pill mills" locally that prescribed pain meds for "sports injuries" (as rural Georgians are indeed so fond of playing watching sports).
It turned out the best thing for back pain wasn't a pill, but massage, some heat, maybe some cold, and rest and regular (but not too strenuous) exercise. It worries me that we are going down this road of treating patients like cars - plug in the diagnostic connector, let the computer figure out what is wrong, and replace whatever part is mentioned in the error codes.
I know this is a bad idea with cars - an "Oxygen sensor adaptation limit reached" error doesn't mean your car needs a new oxygen sensor, but that you have a leak in the intake bellows downstream of the mass air flow sensor (a $10 fix). But many a mechanic will rip out perfectly good oxygen sensors and still not fix the problem. Could a doctor do the same thing?
That's my worry - that medicine will turn into a "plug and play" type of practice - and already is. So many times now, you don't even talk to a doctor, but to a nurse practitioner or other type of medical assistant. And the routine is the same - blood test and then put you on (or adjust your) "meds."
Was the practice of medicine always like this? Not ten years ago, I think. Maybe this is a good thing - and advancement. Maybe not. All I can say is, it was a sea change and no one seemed to notice it happening.
