Preventive Care

My son Chris and I went for our annual physicals yesterday, which prompted me to think about how many people skip their annual preventive care visits to the doctor.  Why is it important for you to get your annual checkup?

One of the most important reasons to take advantage of your annual physical is that it’s free.  The Affordable Care Act states that insurance plans must provide an annual preventive care visit with NO cost sharing to the patient.  That means no deductibles, no copay, no coinsurance.  You can’t schedule a physical because you have chest pain and expect it to be billed as a preventive visit, though, so don’t try it 🙂

There are different reasons to go for different groups of people.  Everyone needs a primary care doctor they can visit if they are sick or hurt or worried about something.  Everyone needs to make sure their immunizations are up to date.  Everyone needs to keep their primary care doctor current on their health problems, medications, allergies, medical and surgical history and family history of illnesses.

Babies have very frequent visits to the doctor.  They need regular checks to make sure they are growing and developing normally.  Parents (especially first-time parents) need regular opportunities to ask questions and receive guidance about keeping their kids healthy.  And of course children under 2 years of age are getting their primary series of vaccinations to avoid preventable diseases like measles, chickenpox, diphtheria and rotavirus.

Older kids and teens still need to be monitored for their growth and development.  School performance, puberty, Internet safety, sports participation and guidance about risky behaviors are discussed at visits.  Immunizations are also part of the plan at certain ages.

My young adults generally disappear on me.  Young men can’t be bothered to go to the doctor for checkups unless their mother, girlfriend or wife forces them to go.  This is unfortunate because we still should check blood pressures, monitor weight, and talk about diet, exercise, smoking, alcohol, safety and mental health topics, among others.

Young women often don’t realize that their primary care doctor can provide all their preventive care.  Some older male doctors are not comfortable performing Pap tests, but many ARE comfortable with it, so they should ask if they can get their routine checkups done at their primary care doctor’s office.  Unless they are pregnant or need surgery, I tell my patients we’ve got you covered for Pap tests, birth control and other screening tests.

Women at 40 years of age need annual mammograms.  Men and women at 50 should have a screen for colon cancer.  Most of the time that’s a colonoscopy which, if normal, is good for 10 years.  Prostate cancer screening is controversial and should be discussed between a man and his primary care doctor.

When a patient hits Medicare age, they start getting Medicare Wellness visits.  This is NOT a physical.  This is a visit where the doctor has a LOOOONG list of questions to ask about everything from last mammogram and colonoscopy to advance directives, falls prevention, dementia screening, depression screening and planning for nursing home care.

Physicals also allow a longer visit for patients and doctors to sit down and get to know each other.  This is really valuable and definitely under-recognized.  A patient is more likely to bring a sensitive concern (like depression, drug abuse or STD worries) to a doctor they know, like and trust.

Please call and schedule your physical.  Talk with your doctor and get to know him or her a little, let the doctor get to know you.  Find out what screening tests are recommended for you.  Make sure your blood pressure and your weight are what they should be.  Make a plan to deal with it if they are not.  Talk about ways to improve your health and help you live well.

QUESTION: Do you get your physical every year?  Why or why not?