Dr. Ronald Schwartz, medical director at Masonicare Health Center in Wallingford and a physician with Masonicare Primary Care Physicians, is a dedicated and outstanding physician who has been serving Masonicare’s residents and patients for more than 20 years. In a recent interview, Dr. Schwartz was asked to discuss the importance of having a yearly physical exam and what steps should be taken to properly prepare for it. He’s offered some sound advice below that adults of all ages should heed.
Why should I have a yearly physical exam?
Some doctors and medical groups have said an annual physical exam is not always necessary for people who are generally healthy, but I believe that for the majority of adults, visiting their primary care physician each year for a complete physical is a good idea – and for several reasons. Catching potential health problems before they become serious is, of course, the most important one. It gives doctors a good opportunity to review a patient’s medical status over the past year and tie all issues together to help diagnose any current issues. I’ve also found that people tend to worry less about their health when they’re fully checked once a year. The peace of mind the annual physical can bring is important, and the special relationship many patients would like to have with their doctors can be enhanced by these annual visits.
What are the first steps I should take to prepare for my physical?
To get the most out of your exam, it’s important that your physician have your complete medical history. If you’ve seen another doctor or specialist during the past year, for example, check to be sure a copy of any test results have been forwarded to your primary doctor.
Make a list of any medical complaints or questions you have and bring that with you. It’s easy to give your doctor a quick rundown of how you’re feeling, but then realize when the exam is over that you forgot something that might be important in spotting a potential problem. And if you’re not sure what a symptom, pain or unusual mark on your body might mean, be sure to ask about it.
Several doctors treating a patient prescribe medications separately. The only way to be sure your doctor has a complete and accurate list of all of your medications is to write them down, including the dose and strength of each, and bring the list with you. You should also list the over-the-counter medications you’re taking every day, such as vitamins, calcium, or a low-dose aspirin, for example. Ask questions if you’re not completely clear on how to take your medications or which medicines might not mix well with one another.
Many doctors want a detailed family medical history. Why is that important?
Since many medical conditions tend to run in families, a detailed family medical history is important, and it can help your doctor determine what tests you should have. And as a physician, I know that reviewing a patient’s family medical history increases my chances of finding a potential problem early – sometimes before symptoms even begin.
For those who might be making that initial appointment with a primary care physician for a physical, you’ll be asked to complete a detailed form that requests information about your parents’ and siblings’ current health status and past medical history. It might be done in the office, or it may be mailed to your home for completion prior to the appointment. Be sure to provide your doctor with as much information about your family’s health history as possible, as it will become an important part of your permanent records.
For each subsequent physical, your doctor might ask if anything has changed in your family’s medical history during the past year. If there have been changes, it’s important that you mention them.
What does a thorough examination entail?
Checking your vital signs – blood pressure, heart rate, respiratory rate and your temperature – is usually the first thing your doctor will do. A blood pressure less than 120 over 80 is considered normal, for example, but if yours is higher, your doctor might diagnose hypertension and discuss ways you can lower it to an acceptable range.
Your general appearance can give your physician a good idea of your current health status. Is your skin a healthy color? Do you stand and walk with ease? How is your memory and mental agility? She or he can determine a lot about you just by observing you during the initial conversation.
By listening to your heart with a stethoscope, your doctor can detect a heart murmur, irregular heartbeat, or other signs of heart disease, while crackles or wheezes in your lungs can be clues to the presence of bronchitis, pneumonia, or other lung diseases.
Your doctor should examine your head and neck thoroughly, including your ears, nose, eyes, lymph nodes, thyroid and carotid arteries. Tapping your abdomen can help detect the presence of abdominal fluid or tenderness, and listening to bowel sounds with a stethoscope can alert your doctor to any bowel irregularities. All patients 50 and over should have a rectal exam to check for rectal bleeding or other abnormalities.
A thorough exam will also include an assessment of muscle strength, balance and reflexes. Pulses in your arms and legs should be checked, and an examination of joints can help to detect abnormalities.
What type of lab tests will be done?
Blood for your lab tests, which can determine a great deal about your current health status, can be drawn in your doctor’s office, or your might be sent to a lab. Standard tests will include a check of cholesterol levels, a blood count to rule out anemia or infection, a urinalysis, a fasting blood glucose test to rule out diabetes or pre-diabetes, and a test to determine liver and thyroid function.
Be sure to ask how you’ll learn the results of these tests. Will the doctor’s office automatically send the results to you or should you call the office? Be sure to request and keep copies of all lab work results, diagnostic studies, and any reports for your records. Keep them organized and in one place, which will make it easier to take charge of your own health.
Use the exam as a catalyst to make you think seriously about your health.
Having an annual physical exam and talking with your physician can prompt you to think more seriously about your health and how you can prevent or delay the onset of illness in the future. It will give you the opportunity to discuss a schedule of recommended preventive screenings.
For example, if you’re at or near age 50, you’ll be encouraged to begin regular screenings for colorectal cancer. Women aged 40 will be urged to begin having annual mammograms to help prevent breast cancer. Healthy behaviors such as taking a brisk walk several times a week and eating a balanced diet will be stressed to help reduce your risk of diabetes, cardiovascular disease and other illnesses. Of course, quitting smoking and reducing alcohol intake will be a must with all physicians. Remember – what you tell your physician is always held in strictest confidence. If during your exam, your doctor asks questions about your lifestyle and your eating and drinking habits, be sure to answer honestly, even though that can be sometimes be uncomfortable.
Doing whatever you can to stay as healthy as possible is ultimately your responsibility. As physicians, we can offer sound medical advice, along with strong support and encouragement, but it’s up to you to do the rest