If you feel fine, is there any reason to go to the doctor? Most of us might say yes, but we don’t actually do it, despite there being at least two very good reasons:
• Periodic health examinations (PHE)—the new term, replacing ‘regular check up’—can serve as effective preventive medicine against diseases as well as identify health problems early, early enough to control or cure.
• PHE’s also help you to get to know your doctor better and to develop a rapport and mutual trust.
A PHE requires seeing a primary care physician, who is specially trained to keep close tabs on the health of their patients as well as refer their patients to specialty care when necessary. They also provide preventive education to keep you healthy. A primary care physician can be:
• A family practitioner (or general practitioner), who can treat everyone in your family due to training in several medical disciplines such as pediatrics, gynecology, general surgery and psychiatry.
• An Internist, who can diagnose and treat diseases in adults.
• A pediatrician, who can treat children ranging in age from birth through the teen years.
Periodic health examinations are vital to staying healthy—this is beyond dispute. However, experts do dispute how frequently people should have them and what tests should be carried out during them. Talk with your doctor to determine which is best for you and what your health insurance will cover.
Check Ups and Routine Tests: The Periodic Health Examination (PHE)
What constitutes a routine PHE? Well, there are four basic elements: a medical history, a physical exam, counseling on risk factors, and any necessary lab tests.
A Medical History should include the following vital information to tell your physician:
• Diet and exercise habits
• Alcohol and tobacco use
• Sexual behavior
• Family history of diseases and illnesses including cancer, diabetes or heart attack
• Any symptoms you may be experiencing related to any health issue
Don’t wait to be asked; volunteer as much as you believe is relevant. With this information your doctor can determine your risk factors for certain illnesses and make diagnostic decisions (such as lab tests) accordingly. If your doctor acts at all impatient or unreceptive, find another one.
The physical exam might include the physician:
• Checking height, weight and blood pressure;
• Checking mouth, ears, lymph nodes, thyroid, rectum, skin and abdomen for any abnormalities like signs of cancer;
• Listening to your heart, lungs and carotid artery for any abnormalities like a heart murmur or an obstruction in the lung.
Counseling on risk factors should follow your history and your exam, since by then your doctor can ascertain what health problems you are at risk for, and what steps you can take to prevent them and maintain good health. The information should also allow your doctor to determine the lab tests you may need, and how frequently they need to be performed. Take this opportunity to discuss with your doctor how frequently you should have a PHE.
Any necessary lab tests should follow, based on what your doctor determines you need from your history and exam. Aside from that it is possible your doctor will order tests for diabetes, sexually transmitted diseases (STDs), tuberculosis or prostate cancer. Your doctor may also want to screen your heart, liver, kidney, blood and urine.
Now, the frequency of some tests (such as mammographies and pap smears) are usually done according to guidelines established by respected research organizations like the National Institutes of Health (NIH).
Check Ups and Routine Tests: Recommended Routine tests
The following routine tests are recommended by the American Medical Association (AMA), along with the frequency for people at low and high risk:
Test: Eye Exam
Purpose: To detect visual defects or eye muscle disorders, to look for signs of disease such as glaucoma.
Frequency for people at low risk:
Teens to Age 30: Every 2 years if you have problems with your vision
Adults 30 to 50: Every 2 years (if you have good vision start exams at 40)
Adults Over 50: Every 2 years
Frequency for people at high risk (i.e. Having diabetes or high blood pressure or a family history of glaucoma)
Teens to Age 30: At least once a year
Adults 30 to 50: About once a year
Adults Over 50: At least once a year
Test: Dental Checkup
Purpose: To check on the health of the teeth, gums, tongue and mouth, and to look for oral cancer.
Frequency for people at low risk:
Teens to Age 30: Every six months until age 21, then at least once a year
Adults 30 to 50: At least once a year
Adults Over 50: Every 1-2 years
Frequency for people at high risk (i.e. Chewing or smoking tobacco)
Teens to Age 30: As dentist recommends
Adults 30 to 50: As dentist recommends
Adults Over 50: As dentist recommends
Test: Cervical (PAP) Smear
Purpose: Women should have a Cervical (PAP) Smear to detect abnormal cells in the cervical lining that could develop into cancer.
Frequency for people at low risk:
Teens to Age 30: Annually for women over 18 and all sexually active women
Adults 30 to 50: Every 1-3 years
Adults Over 50: Every 3-5 years
Frequency for people at high risk (i.e. Having been diagnosed and treated for pre-cancerous changes or for herpes or genital warts)
Teens to Age 30: Annually
Adults 30 to 50: Annually
Adults Over 50: Annually
Test: Blood Pressure
Purpose: Blood Pressure measurement to detect hypertension at an early stage, before complications develop.
Frequency for people at low risk:
Teens to Age 30: Begin at age 20; then every 3-5 years
Adults 30 to 50: Every 1-3 years
Adults Over 50: Annually
Frequency for people at high risk (i.e. Having a family history of it, heart or kidney disease, stroke, diabetes, or being overweight or taking oral contraceptives)
Teens to Age 30: Annually
Adults 30 to 50: Annually
Adults Over 50: Annually
Test: Blood Cholesterol Test
Purpose: Detects people at high risk of coronary heart disease
Frequency for people at low risk:
Teens to Age 30: During first physical
Adults 30 to 50: Depends on results of last test, if normal, repeat in 3-5 years
Adults Over 50: Same as for ages 30-50
Frequency for people at high risk (i.e. Having a family history of early-onset coronary heart disease)
Teens to Age 30: If abnormal, follow your doctor’s advice
Adults 30 to 50: If abnormal, follow your doctor’s advice
Adults Over 50: If abnormal, follow your doctor’s advice
Test: Mammography
Purpose: Detects breast cancer early, before it can be felt during a physical examination
Frequency for people at low risk:
Teens to Age 30: None
Adults 30 to 50: Once between 35 and 40; every 1-2 years between 40 and 50
Adults Over 50: Annually
Frequency for people at high risk (i.e. having a close relative with breast or colon cancer)
Teens to Age 30: None
Adults 30 to 50: Every 1-2 years, beginning at age 35
Adults Over 50: Annually
Test: Rectum and Colon Exam
Purpose: There are three separate tests to detect colorectal cancer: A digital rectal exam, blood in the stool, & Sygmoidoscopy
Frequency for people at low risk:
Teens to Age 30: Usually not necessary
Adults 30 to 50: a) Annually after 40
Adults Over 50: a) Annually; b) Annually; c) Every 3-5 years
Frequency for people at high risk (i.e. Having a close family member with cancer of the colon or rectum, polyps of the rectum, or long-standing ulcerative colitis)
Teens to Age 30: a) Annually after age 20
Adults 30 to 50: a) Annually; b) Annually ; c) Every 3-5 years
Adults Over 50: Same as for ages 30 to 50
Test: Complete Physical Exam
Purpose: Determines your health status and develops your relationship with your doctor.
Frequency for people at low risk:
Teens to Age 30: Twice in your 20s
Adults 30 to 65: Every 1-2 years or as your doctor recommends
Adults Over 65: Every year
Frequency for people at high risk:
Teens to Age 30: Twice in your 20s
Adults 30 to 65: Every 1-2 years or as your doctor recommends
Adults Over 65: Every year
