Physicals and Health Maintenance*
The Types of Doctor Visits
For the most part, there are four main types of doctor visits: an Initial or New Patient Visit, a Follow-up Visit, a Sick Visit, and the Annual Physical Exam. An Initial Visit, or New Patient Visit, is a first visit with a new doctor, and a complete medical history and physical are performed. A Follow-up Visit is a visit that checks on the status of chronic or ongoing conditions, such as high blood pressure or diabetes, or checks on the effects of a new medicine. A Sick Visit is an urgent care visit when you are sick or have a symptom that could mean illness. An Annual Physical Exam (sometimes called a routine physical exam) is a preventative examination recommended once a year for nearly all adults. While an Annual Exam is usually done on its own, sometimes your doctor can provide several kinds of care in one visit. For example, you may get a flu shot when your doctor is checking on how your new blood pressure medicine is working.
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The Importance of Annual Physical Exam*
The Annual Exam allows the doctor to evaluate a patient’s overall health. This is also an opportunity to focus on prevention and screening. It will help detect any illnesses or medical conditions in the early stages. For example, at age 50, it's time to begin regular screening for colorectal cancer. People with immediate family members with colorectal cancer or other risk factors may need to be screened before age 50.
An annual exam also helps patients address any health issues they may have. It is also a good idea to see a doctor if you haven’t had health care in a long time. Lastly, it serves to establish a doctor-patient relationship -- it is important to have a regular doctor who helps make sure you receive the medical care that is best for your individual needs.
Some argue that younger, healthy people may not need annual physicals. And that most people should only have a test or screening if they have symptoms or risks factors. One problem of unneeded testing is getting a false-positive result. These false alarms can cause anxiety, and unnecessary follow-up tests and treatments. The reality, though, is that even in younger people an annual exam can help with issues like smoking, obesity, family planning, STD prevention and healthy eating. And the annual exam becomes more important as we get older and the number of our individual risk factors increase. So, for most of us, undergoing a routine physical examination and preventative screening tests, may increase the chances for living a longer, healthier life.
Presently, the importance of the annual exam has been recognized by most insurance companies and Medicare. So much so, that is it more than often done as a separate visit focused on preventative care and health maintenance only.
Parts of the Annual Exam
History
Prior to a physical examination, patients are encouraged to make a list of any questions or concerns that they may have regarding their health. Patients should discuss these concerns with the doctor during their appointment. Your doctor will also likely ask you about lifestyle behaviors like smoking, excessive alcohol use, sexual health, diet, and exercise. The doctor and staff may also check on your vaccination status and update your personal and family medical history.
Physical Exam
The exam begins with Vital Signs. These may include height, weight, blood pressure, heart rate, respiratory rate, oxygenation level, and temperature. Next is the General Appearance which may offer a large amount of information about you and your health just by watching and talking to you. Other aspects include Heart, Lung, Head and Neck, Abdominal, Neurological, Skin, and Extremity exams.
Laboratory Tests
Laboratory testing for screening is usually done once a year as determined by your age, gender, and risk factors. For most people, at least some testing is recommended.
For example, while a screening lipid panel (cholesterol test) is recommended every 4 to 6 years, according to the American Heart Association, your doctor might check more frequently if you have risk factors for heart disease. Abnormal cholesterol levels increase the risk for heart attacks and strokes. If you are overweight or have any risk factors for diabetes, your blood sugar will likely be checked. The American Diabetes Association recommends that all adults, beginning at age 45, should be tested for diabetes -- regardless of weight.
Depending on the history, physical exam, risk factors, and patient concerns, additional testing may include additional blood tests, vision tests, hearing tests, cardiovascular evaluation, lung cancer screening, and rectal exam. There are additional parts of the history, physical exam, and additional laboratory testing that are specific to men and women. Please go to the Men's and Women's Health page for more information on these.
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Physical Examination Results
After a routine physical examination, the doctor may recommend lifestyle modifications or prescribe medication for any conditions that may have been diagnosed. Additional diagnostic tests may be recommended to further evaluate suspected conditions and create an appropriate treatment plan.
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*Edited and adapted from www.choosingwisely.org/patient-resources/health-checkups/ and www.webmd.com/a-to-z-guides/annual-physical-examinations#1