suggest she come in for full physical next week

"Oh doctor, I'm embarrassed. You don't want to poke at my full figure now do you?"

You press and tell her that it is difficult to diagnose with an examination. 

"Oh, I'm so busy with the upcoming production. Can't you examine my back now?"

She allows a very limited exam of her back which shows only some marked tenderness around T10. When you suggest she lie down on the exam table, she demurs, saying that she is far too large.