I want to sugest a few things:
1. Anal exam on the gynocheir. Model lies on the back, lifts her legs pushed to the chest and grabs her legs with hands. Doctor lubes her asshole and inserts a finger. Then he starts to bend his finger inside and twist it at direction of models back. Ideally all finger manipulations may be visible outside with butt chicks bulging.
2. Perineum exam. Same models position. Doc inserts a speculum in horizontal orientation (front and back vaginal walls are free), inserts a finger into anal and starts to push front anal wall while bending a finger. Back vaginas wall is moving up and down.
3. Camera work. Try to change the viewpoints and angles more often with 5-15 sec fixation on general views and closeup views. Try to hold in focus models face, espetially when she affraids or feels discomfort.
4. Actress play. Let them express their abuse on doctors actions, and let them saing when theyre filling pain.