Why should I get a yearly physical?  I am healthy!

What is the purpose of a yearly physical?

I went in for my yearly physical, but I left without feeling any different.

I do not come here very often, doc, so I have a few things to talk about in addition to my physical.

These are all routine things that family doctors hear on a weekly basis.   Please allow me to answer each of these questions / statements individually.

Austin family medicine Physicals or Wellness ExamsWhy should I get a yearly physical?  I am young and healthy!
I am not sure if you have ever thought about it, but it is hard to find out about medical problems without ever seeing a doctor.  How else do people find out that they have high blood pressure, cholesterol problems, or thyroid disease?  Many medical problems, especially ones that shorten your life expectancy, do not cause any symptoms until that momentous day when it causes a heart attack or stroke.  Those people always look back and wish they had taken better care of themselves years earlier.  The idea behind a physical is to get fully evaluated in order to limit the medical problems later in life.   There is a difference between thinking you are healthy and knowing that you are healthy!

What is the purpose of a yearly physical?
The yearly physical contains many different aspects.  Most of these aspects you may not even realize that your healthcare provider is even doing for you.  Do you think we look in your mouth and listen to your heart for fun?  Well, sort of.  It is fun being a physician, but we are actually listening for an abnormal heartbeat that may cause a stroke or fatal heart attack at a young age.  We are looking for oral cancer, enlarged tonsils, acid reflux, and dry mouth.  Your healthcare provider watches you walk in the room, sit in the chair, and climb onto the examination table.  You are being examined the entire time.  Your healthcare provider is watching everything you do, waiting to pick up on that one subtle finding that could help you.  We are even examining you while you speak.  Are your thoughts logical? Are you delusional? How is your short and long term memory?  Are you slurring words? Are you easily confused? Are you evasive when we ask about alcohol and illegal substance usage? Do you smell like smoke? Do you look your actual age, older, or younger? We may be more aggressive with cholesterol levels since smoking ages your skin and blood vessels equally.

I went in for my yearly physical, but I left without feeling any different.
As I stated in the previous question, your healthcare provider is examining every aspect of you even if you do not realize it.  If you left without any new problems being uncovered, this is good news for you.  This means that your blood pressure, heart rate, physical examination, and psychiatric evaluation were within normal limits.  Usually we order lab testing that follows a physical examination.  You are not “off the hook” until you have reviewed the lab results.  At Austin Family Medicine Associates, we do extensive laboratory studies, hormone testing, genetic testing, vitamin levels, and cardiovascular assessments that most other offices are not doing.  Because of the extent of the testing, we ask that you return to the office after all the results have come in.  This way, we can sit down and review all of the results with you.

I do not come here very often, doc, so I have a few things to talk about in addition to my physical.
This is a critical mistake that many patients make, and it is to their own detriment.  During your wellness exam or yearly physical, we focus on your wellness.  The components of this exam have already been discussed in previous questions.  If you bring up any problems during your exam, then you are actually taking away your healthcare provider’s ability to focus on your wellness.  We allot a certain amount of time for your physical.  If you wish to discuss a problem at your wellness exam, then another component will have to be sacrificed.  This is a natural problem, and healthcare providers do not intentionally do it.  You only have 20 minutes scheduled for a physical (based on insurance payments), and there is only a finite amount of things that can be discussed in 20 minutes.   Your healthcare provider cares about you, and they want to help you with all of your problems.  Your provider may not say anything to you, but it is inevitably the wrong time to discuss problems.  You should save problems or issues for a follow-up problem visit.  If the problem is more urgent than your physical, then ask your healthcare provider to delay the physical and address the urgent problem instead.   I do not know any healthcare providers that want to make you come back for a follow-up visit and miss another day of work for a simple problem, but we are forced to abide by these rules because of insurance companies.  Did you know that your insurance company might not pay for a problem during your wellness visit?  They believe that you are perfectly well at the time of your wellness exam, so if your healthcare provider handles a problem at your wellness exam, you may actually get a bill.
Another important point is that your healthcare provider has other patients scheduled and must respect other patient’s time as well as your own.
If you discuss a problem at your wellness visit, then something has to give.  You probably will not notice the aspect of your wellness exam that gets overlooked.  Your provider may abbreviate his physical examination, or neglect to notice that you need earlier colon cancer screening because of your family history, or your healthcare provider may not notice that you are overdue for a stress test that may save your life.

As my mother always told me, “You only get one body – you better take care of it!”

Here is my take home message: 

Do not neglect your health.  Even if you feel great, you should keep up to date on your yearly wellness exams.  Genetics are a funny thing.  One year you are fine, the next year you are on cholesterol medicine for the rest of your life.   Finally, do not discuss problems at your wellness exam – it may shorten your life.

#DrOubre

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