Do I Need an Annual Physical?

As a family physician, my patients often ask if they need a physical and, if so, how often. The answer is yes, you need a physical, but the frequency depends on your health. A good way to assess your health is to see the doctor for a physical. A bit of a Catch-22, right? In my opinion, there’s no better time to schedule a physical than at a new beginning, like a new year.

The evidence as to when and how frequently a person needs a physical may be unclear, but regardless, it’s a good opportunity for the patient and physician to build a relationship. As opposed to a visit for a medical problem (sometimes called a problem-focused visit), the physical is a time to discuss in detail your current medical history and future health risks, and to be updated on necessary health measures. This may include laboratory testing, imaging such as a CT, or a procedure like a colonoscopy. It may also include discussion and an update on recommended vaccines for your age and current health status.

[See: 10 Questions to Ask Your Doctor About Prostate Cancer.]

What types of questions should you expect your physician to ask you during the physical? In general, either the physician or a member of his or her team will ask the same questions to all patients, though there will be some differences depending on the patient’s answers. The questions will start with whether you have been diagnosed with any new medical problems by other doctors. Next, the doctor will move on to surgeries or times when you have been put under anesthesia.

Then the medical team will review allergies, either to medications or environmental exposures. If you’ve been told you’re allergic to something, this is a good time to delve further to understand what type of reaction you had when you were exposed to this substance. It’s helpful to know whether your reaction to this substance was mild and eventually went away on its own, or more serious, causing you to have difficulty breathing or requiring other medications, an injection or a tube down your throat.

The success of the next two parts of the history discussion — your family history and current medications — depends largely on your preparation. Before your physical, I recommend gathering information on what medical problems run in your family, in other words, your family health history. The same is true for medications; if you take any medications daily, know the name of the medication, the dosage and when you take this medication before you walk into the office for your physical. This critical information can save a good bit of time during your physical, leaving you and your provider more time to discuss other important facets of your health history.

[See: 12 Signs You Should Fire Your Doctor.]

The physician will then turn to your social history. This section is fairly broad, and questions can range from your habits such as smoking, drinking or substance use to your current profession and level of education, your diet, how well you sleep at night, whether you own a gun, your mental health and your current stress level. Your physician may notice important clues to your health based on your answers to these questions. Be honest, as your insight affects other aspects of your health history.

Your physician will finish with a review of any symptoms that you may have, and he or she may perform an exam on certain parts of your body. After this portion, your doctor will develop a plan for your health. The plan may include diet and exercise strategies, vaccine recommendations, lab or imaging, and future health needs. If one of your previous doctors did routine testing such as certain lab work, heart or urine testing, you might come to expect your current physician to do the same things. Current evidence however, shows that many of the tests traditionally performed during a physical exam may be unnecessary and lead to further expensive and unnecessary testing. Obtaining a good health history will help your provider identify necessary from unnecessary testing.

Sometimes a physician will choose not to perform a physical if this is the first time he or she is seeing you, or if you have several active medical problems that are priorities. Physicians are trained to help you improve your health, but economic and time constraints limit them from completing a preventive health visit (a physical) and a problem-focused visit at the same time. It may seem a nuisance to have to return to see a doctor for your physical, but it’s in your best interest, as that touch point is an opportunity to explore your health and be proactive in managing it without rushing to discuss what might be urgent medical issues.

[See: 10 Questions Doctors Wish Their Patients Would Ask.]

Some people may believe an annual physical is unnecessary, but seeing your doctor routinely allows you to establish a connection with a trusted health professional who can serve as your health care “hub” now and in the future.

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