annual physical check :: Article CreatorAsk The Doctors: Yearly Physicals Set Baseline For Your Healthcare
Dear Doctors: I am baffled that what used to be a thorough and comprehensive physical exam is now just a few questions, taking some vital signs and a few blood tests. No checking eyes, throat, glands or reflexes. No breast exam. Why has this changed?
Dear Reader: As surprising as it might seem, there are no official guidelines as to what annual physical exams should entail.
Some doctors and medical practices recently have moved away from offering patients a yearly checkup, prompted by studies that, in parsing large troves of health care data, have questioned the efficacy of this ritual.
But the annual physical exam continues to be an important part of our practices.
Absent the existence of guidelines for the annual physical, we can only discuss the specifics of our own approaches. We see it as an overall assessment of health and a chance to reconnect with the patient, an opportunity for patient and doctor to take stock of the previous year, assess any changes. Set new goals and plan for the future.
In our practices, the annual exam begins with a review of the medical history, with any updates, including illnesses or injuries, vaccinations, medications prescribed by other doctors and mental health updates.
Family medical history, including new instances of diseases, get updated as well. Patients often deal with smaller, less pressing medical issues on their own, but adding information about these to their medical history can be important for future visits.
When we conduct a physical exam, we review blood pressure, heart rate, weight and body mass index. If there have been significant changes, we explore possible causes and discuss changes to diet, medication or behavior that might be needed.
We order a complete blood count, screenings for diabetes and cholesterol and tests that analyze liver, kidney and thyroid function. We also check vitamin D levels. We review those results, discuss them with the patient and offer mitigations if needed.
When screening tests such as mammograms, Pap smears and bone-density tests are called for, we recommend them. We also discuss the risks and benefits of the PSA test, which screens for prostate cancer. In keeping with newly updated guidelines, we recommend colon-cancer screening with a colonoscopy for patients 45 and older.
The information collected in an annual exam can help patients get a better understanding of their physical well-being. It also provides a baseline against which future changes or anomalies can be evaluated.
Dr. Eve Glazier and Dr. Elizabeth Ko are UCLA Health internists.
Harvard Health: What Should I Ask At My Annual Physical?
Q. I put off annual physicals during the pandemic and finally have a wellness visit scheduled. What should I make sure to ask my doctor?
A. You're certainly not alone in postponing your check-ups, since an estimated 32% of American adults delayed routine medical care during the pandemic. But it's wise to resume your annual visits, both to get a proper diagnosis for any health problems that have cropped up and to talk with your doctor about ways you can stay healthy.
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Beyond telling your doctor about any changes you've noticed or responding to her questions during the exam, you should ask several of your own:
Am I due for any vaccinations? Your age, health history, occupation, and lifestyle all affect the types of vaccines you need. It may also be time for a booster shot.
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Which health screenings or blood tests do I need? Mammogram, colonoscopy, and other screenings shouldn't be postponed for long, since early detection can mean the difference between a treatable or untreatable condition.
Do I need any changes to my prescriptions? Changes to your health or lifestyle can influence dosages. Some medications may no longer be necessary, or a new medication may be appropriate.
What lifestyle changes should I consider to improve my overall health? Blood pressure or weight changes may make it smart to tweak your diet or exercise patterns.
Toni Golen, MD and Hope Ricciotti, MD and Hope Ricciotti, MD and Hope Ricciotti, MD and Hope Ricciotti, MDHarvard Women's Health Watch
Men Encouraged To Get Annual Check-up
It is important to encourage men to be more proactive with their health and to get a yearly physical, which is a big reason why June is recognized as Men's Health Month.
That may sound simple enough, but many men have inherently resisted going to see a doctor, especially if they do not feel sick or have something bothering them.
"I have got a lot of guys coming in and they are in their 30s and 40s and it's the first time they have seen a doctor since they saw their pediatrician," said Bradley Lankford, DO, family medicine physician at Physicians Associates of Floyds Knobs. "Many times they are coming in because their wife is making them."
Dr. Lankford said it is important to get a wellness checkup each year to prevent future complications with high blood pressure or high cholesterol.
"It's really important to make sure we don't let things go too far," he said. "We are not just thinking about right now, we are thinking about the future. If we are riding high on our blood pressure in our 30s and 40s that is something that is going to affect us in the future. Same with cholesterol and blood sugar. Many times these are things we don't feel or we ignore them because we don't think we need help."
He also said a man's family history could play a role in overall health.
"We need to understand those things are playing a huge role in our future health. We want to try and reduce the risk of future heart attacks and strokes," he said. "That is what I am most concerned about, especially those with a family history of high blood pressure, heart disease or stroke. Those are important to jump on early. We need to prepare to deal with that in our 20s and 30s."
He said men need to start checking for prostate cancer at age 50 unless family history dictates they do it sooner. He said if a man's father was diagnosed with prostate cancer at 55, his son should be checked at 45.
Getting a yearly physical is a good habit to develop, Dr. Lankford said. He also provided advice to men who may not think it is important to get a wellness check.
"One tried and true thing is if we catch something earlier, they are more treatable and less likely to cause problems in the future," he said. "I really like preventative medicine and keep things from happening in the future that we can be in control over."
"The regularity and building a relationship with a primary care doctor is important and hugely beneficial for not only yourself, but for your children to have their dad around as long as possible and your grandchildren to have their grandfather around as long as possible."
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