When you are feeling sick, have a chronic illness, or had an injury, seeing a physician is often the first step to recovery. However, it is harder to get ourselves to the doctor when we are feeling fine. Many people don’t want to sit in a cold examination room, have someone ask personal questions, and then be poked and prodded if there isn’t anything bothering them. There are plenty of people who haven’t seen a physician since their parents took them to their pediatrician or that one time they slipped and fell years ago and needed a cast for a broken bone. What’s the point of going if nothing is wrong?
At first glance, physicals don’t seem to be looking for anything in particular. The physician will ask a lot of questions about your family medical history, your own medical and surgical history, if you have any allergies, if you are taking any medications or supplements, if you are exercising and eating well, and so on, followed by a comprehensive physical exam and blood work. Essentially, a wide net to see what is going on. This type of annual physical exam has been around since the 1940s. However, more recently, this type of catch all history and physical has changed but that’s a good thing.
A quick glance in any medical article or medical journal, you’ll notice that physicians, much like any group of people, will have a hard time completely agreeing on everything. Some things have much stronger support than others. Taking a brisk walk around the neighborhood is healthier for you than watching TV and a salad is healthier than ice cream. Others, not as much, such as how useful is vitamin D testing in someone who isn’t showing symptoms of vitamin D deficiency.
Although, the annual physical has been around for a while, it isn’t immune to physicians wondering how much benefit is derived from it, especially for someone who isn’t complaining of anything. There are concerns that maybe we are testing people too often, or testing for things that won’t tell us anything useful, or getting results that just lead us down the wrong path. On top of advancing medical research, publishing articles, and providing medical education courses, medical and governmental health organizations publish recommendations to physicians to help guide them on patient care. One example is screening people for colorectal cancer at age 50 or screening for osteoporosis in women at age 65. There is also leeway on when to do these health screenings. Colorectal screening can be brought up earlier if there is a strong family history for colon cancer.
The overall goal of these recommendations and health screenings, in general, is to catch diseases early, when they are easier to treat, and to check for risk factors that can lead to them.
Where does this leave the annual physical? Do we just stop seeing a physician as soon as we are too old for a pediatrician and wait until it’s time for a PAP smear or a cholesterol check?
The best time to find a physician is when you don’t need one
It can be difficult to find one that you are comfortable with or is convenient to get to. Having an initial comprehensive exam and medical review will get things rolling in terms of what screenings need to be done, what improvements in your lifestyle can be made, and what health issues exist that you may not be aware of. Unfortunately, things like high blood pressure and high cholesterol don’t cause symptoms until years after they first appeared when there’s already damage done that is more difficult to fix. If nothing is found, you may not have to come back for another screening for some time.
Sometimes, a separate visit isn’t necessary. Screenings can be made part of a visit combining several issues. If you are visiting your physician for one thing, you and your physician can review other things that you might be due for. On the other hand, if you are doing great and don’t have anything bringing you in on a regular basis, a regularly scheduled preventative visit is a great way to get caught up with your physician about how you and your family are doing healthwise.
Even if you are already coming in regularly for other issues, a visit dedicated to preventative screenings is a good way to make sure you are getting all of the care that you need.
Annual physicals, like any visit, are what you make of them. They can be a great way to focus on staying healthy and checking on things that can be caught before they can cause problems, without the distraction of dealing with acute or chronic health issues. They can also be used for you and your physician to get to know each other and find what testing or treatment you actually may or may not need. The focus of these exams simply switched from a catch-all, comprehensive physical, to a physical based on the most appropriate screening exams and tests based on your personal and family history.
So get to know your physician and let your physician get to know you. It is an opportunity for both of you to discuss your overall well being and uncover what is best to keep you as healthy as possible. Don’t be afraid to ask the embarrassing questions, ask about what is the best way to stay healthy, and what tests are being done, what they mean, and how they will help you.
Bell, R Warren. “Annual History And Physical Examination Has Been Dead For Decades”. Canadian Family Physician, vol 64, no. 3, 2018, p. 168., Accessed 16 Nov 2018.
Bloomfield, Hanna E, and Timothy J Wilt. “Evidence Brief: Role Of The Annual Comprehensive Physical Examination In The Asymptomatic Adult”. VA Evidence-Based Synthesis Program Evidence Briefs [Internet], 2011, https://www.ncbi.nlm.nih.gov/books/NBK82767/. Accessed 15 Nov 2018.
Shein, David M., and Valerie E. Stone. “The Annual Physical: Delivering Value”. The American Journal Of Medicine, vol 130, no. 5, 2017, pp. 507-508. Elsevier BV, doi:10.1016/j.amjmed.2016.12.036.
“The Annual Physical Exam Is KILLING Us | Incident Report 134”. Youtube, 2018, https://www.youtube.com/watch?v=6Gh7IOzkBUE. Accessed 15 Nov 2018.