Some things in medicine are abnormal, but normal for the patient. For example a common HEENT exam (Head, Ears, Eyes, Nose, Throat) finding that is abnormal, yet normal for the patient, is a lack of dentition. Some people have lost all their teeth by the time they hit Medicare age. It's one of those things most people just accept. It's very difficult to hide. You can hide erectile dysfunction. You can hide a funky rash on your belly. You can't hide the lack of teeth. You don't need a doctor's HEENT exam to document no teeth. Any lay person can make that diagnosis. So when I come upon a patient who has no teeth and I need to perform a neurological exam to check for a 7th cranial nerve facial palsy by having the patient smile, here's how that conversation usually goes:
Happy: I need to test your facial muscles. Smile so I can see your teeth.
Patient: I don't have any teeth.
Happy: Then show me your gums.
Most of the time it gets a good laugh and I get a really good look at their muscle strength. Knocking off two stones with one throw. Great patients satisfaction scores and a great HEENT exam. Now that's how you practice hospitalist medicine at the bedside.