Even for the healthiest of people, getting a yearly physical is a great way to ensure you are doing everything you can to stay healthy. It is your chance to build a trusting and collaborative relationship with your personal physician. Staying healthy is no accident, and your physician would love to give you the tools you need to do just that. I am very passionate about catching problems early by doing basic medical screening and health coaching and nothing gives me more joy and fulfillment to see my patients succeed! Keep in mind these are generally what I recommend but make sure to check with your personal physician for his or her recommendations.
It is often hard to talk patients into coming in for a physical. When people do come for physicals, it is often because they are having a problem and feel like a physical will help solve the problem. Unfortunately, if you only come to the doctor when you have a problem, you are missing out on SO MUCH. In addition, it is very important not to expect your doctor to “catch whatever is wrong” during a basic physical. The purpose of a yearly wellness exam is to look at the current state of health and recommend screening tests and lifestyle modifications that could improve health. If you have lots of problems to discuss at your physical, you will be missing out on a wealth of information. Take care of those problems first. Give them the attention they really need. Then come back for your physical. If you try to do both at the same visit, there is a strong probability that your doctor won’t have the ability to get to all the things you can do to stay healthy. What does your basic wellness exam include?
The goal of your annual wellness exam is to use evidence-based guidelines to help maintain and achieve optimal health, to lower morbidity and mortality from chronic medical problems by optimizing control of those issues, and to provide age-appropriate screenings and immunizations. There is no current consensus about how often wellness exams should occur, but I generally tell my adult patients that they should get a wellness exam every two to three years beginning around age 18 and then every year or so beginning around age 40. This might not be what your doctor recommends so be sure to check with him or her to see what he or she prefers.
For all adults, the visit should include time to update the chart. That includes any changes to your personal history (such as tests done by specialists, surgeries that occurred etc.) that your primary care doctor may not know about. You should spend some time discussing and updating your family history. While you are discussing your recent health history, make sure to inform your doctor of any changes to your health habits, like exercise, smoking, changes in marital status and similar things that may have an effect on your health. Be prepared to talk about your diet. Your doctor will do an exam that includes looking at your vitals to be sure they are normal. Not every physical need labs, but I like to draw labs in patients around age 35 to begin screening for diabetes, hyperlipidemia, metabolic syndrome, and thyroid disease. As your doctor does your physical exam, she may see signs of problems and may ask to do more testing based on those findings.
Your wellness exam lets your doctor screen for many things that can have a huge effect on your quality of life. Some of these things include screening for tobacco abuse, drug or alcohol abuse, depression, anxiety, poor dietary habits, and obesity. Without a wellness exam, you have to hope your doctor brings these things up at a regular visit. Some doctors do, but often the regular office visit doesn’t allow the doctor to adequately address all these issues. Your yearly wellness exam also lets your doctor recommend other screening tests like colonoscopy, pap smears, mammograms, and more. It also gives your doctor a chance to update you about changes that have occurred in regular screening recommendations.
What exactly should you get at your yearly wellness exam? Here is a basic though not all-inclusive list of tests for men: labs beginning at age 35 and over to screen for diabetes, hyperlipidemia, kidneys, and liver, screening for colon cancer beginning at age 45 (this is 5 years earlier than previously recommended), screening for an aortic aneurysm in men 65-75 who have a smoking history, TDaP booster done to protect from pertussis and tetanus every 10 years, shingles vaccine after age 50, and pneumonia vaccines after age 65 or sooner if you have certain chronic illnesses.
Women have some different needs. Here is the basic list for women: Labs at age 35 and over to screen for diabetes, high cholesterol, kidneys, and liver, screening for colon cancer beginning at age 45, pap smear every 3-5 years depending on age and circumstances (It is important to talk to your doctor about your own personal situation to determine the best schedule.), mammogram yearly beginning at age 40, osteoporosis screening after menopause, TDaP booster every 10 years, shingles vaccine at age 50, and pneumonia vaccine at age 65 or sooner with chronic medical problems. Ask your doctor if you should be getting a vaccine to prevent cervical cancer.
As you can see there is a lot of talking and work to do when your doctor sees you for your yearly wellness exam. Don’t short change yourself or your doctor by trying to tackle problems at your wellness exam or you will miss out on great information about your health, diet, exercise regimen, etc. I really enjoy coaching my patients about all aspects of their health — physical, mental, and spiritual. I enjoy having time to give recommendations about how making a couple of small changes could make a big difference. I love seeing patients’ progress. I thrive on knowing that my patient left the office armed with ways to make their lives better. When was your last wellness exam?
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