Is it only children who should visit the doctor on a regular schedule? Is there any benefit for healthy adults to have regular annual medical check-ups?
Christopher Peckins, M.D., an internist at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, says, “There are many potential benefits to annual doctor visits, including earlier diagnosis and treatment of existing health problems and prevention of future problems.”
The idea of an annual doctor’s visit, or what commonly became known as “a physical,” originated in 1922 when the American Medical Association recommended that all adults have physical exams on a yearly basis. This idea further evolved as medical technology started developing a range of screening tests that doctors could use to diagnose different medical conditions and diseases—from cancer to diabetes and from osteoporosis to cardiovascular disease.
Today annual visits to a primary care physician or internist are generally recommended for all adults after the age of 18 to 20. This is usually the point at which a young person makes the transition from a pediatrician to a doctor for adults. Women who see a gynecologist for regular pelvic exams and pap smears should also visit their primary care physician to discuss their other healthcare needs.
Dr. Peckins notes that healthy young people frequently don’t think they need to see a doctor every year, but he says, “Even young people should see a doctor to help maintain their good health and prevent future problems.”
While doctors have their own individual approaches to conducting an annual visit, most doctors usually review the patient’s medical history and the family’s medical history, while also asking about the lifestyle the patient leads. Dr. Peckins points out the importance of this information. He says, “Medical histories may indicate possible risks for certain diseases or medical conditions the patient may have. It is also important to understand a patient’s lifestyle and offer advice when appropriate, especially for young people who are just starting to establish lifestyle habits. For instance, I try to make sure my patients are very aware of the dangers of smoking and understand the importance of wearing seat belts in cars and helmets while biking.”
A tailored hands-on physical exam also takes place at annual visits, along with appropriate screening tests, based on the person’s age, gender, health risks, and current condition. Dr. Peckins says that every physical exam should include a blood pressure reading, since high blood pressure is a major health problem that can affect people of all ages and really can’t be detected in any other way.
At the end of the visit, the physician typically makes recommendations for lifestyle modifications, such as dietary changes or establishing an exercise routine. Physicians can also teach patients to do self-examinations and take other steps to stay healthy between visits. If the patient’s condition warrants, the physician may also prescribe medications to help with such issues as high blood pressure or high cholesterol levels.
Dr. Peckins says, “We’ve learned that no simple recipe for physical exam and battery of tests applies well to all people. Despite some standard procedures, each physical needs to be individualized.”
For instance, Dr. Peckins points out that blood tests aren’t necessarily part of every patient’s visit. If cholesterol levels or the possibility of diabetes or other conditions diagnosed through blood tests are a concern, then a blood test is warranted. In other cases, blood tests may not be necessary. Similarly, the particular questions asked, the focus of the physical examination, and the diagnostic tests performed are specifically chosen for each individual.
For most people, an annual visit is a preventive measure. By having a visit every year, certain problems can be caught at an early stage when treatment is easier. In addition, most doctors encourage patients to ask questions about their own health and to express their concerns. At the end of a visit, the doctor and patient together usually agree on a plan for the patient to follow to address any health concerns.
If problems do develop in the future, a baseline record of the patient’s general health has been established. This will be very helpful if changes occur and comparisons need to be made to previous health conditions.
Dr. Peckins emphasizes, “After the annual visit, it’s up to the patient to take responsibility for the mutual decisions that we’ve reached concerning making any lifestyle changes, having any further screening tests, or taking any medications.” Doctors may make recommendations, but it’s up to the patient to decide to endorse them and carry them out in their day-to-day life.
Building a good doctor-patient relationship through annual visits is important to a patient’s general well being now and in the future. “If the patient and physician form a good alliance, then when issues come up in the future they can be dealt with better because we understand each other and, hopefully, the patient has developed a sense of comfort and confidence in the physician.” Dr. Peckins says.
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