At one time, this kind of visit began in childhood and happened every year. A regular annual schedule made it easier to remember. Many prescriptions last only a year, forcing people to review their medical situation again to get medications refilled. It is reasonable to do this review once a year, but a full annual physical may not be necessary.
Older terms used to describe the yearly physical include ‘check-up,’ ‘medical’, ‘preventative health visit’, or ‘screening visit’. The term ‘periodic health exam’ means visiting the doctor every once in a while to review your general health status. For a healthy person, this visit might happen every two or three years. Someone with many medical concerns might need one every year or more often.
A periodic health exam is a good time to review your overall medical status. However, your doctor may choose any medical visit to discuss screening or health improvement.
The purpose of this visit is for you and your doctor to identify ways to improve your health. Your doctor will be interested in your lifestyle, such as eating and exercise habits, and whether or not you smoke, drink alcohol, or use harmful drugs. Expect questions about whether you wear a seatbelt, and if you wear a helmet when you should. You may be asked about how you are sleeping, if you feel happy or sad, if your weight has changed, how well you care for your teeth, and whether your vaccinations are up to date, among other things.
Your doctor will consider your age, your family history, and your life situation to determine whether screening tests are appropriate for you. Tests might include Pap testing for women who have been sexually active, mammograms for older women, diabetes testing, and testing for cardiovascular risk factors like high cholesterol. For women of childbearing age, the doctor may discuss pre-pregnancy topics like vitamin supplements.
There are always pros and cons to testing. Your doctor may spend some time discussing controversial areas of screening if they apply to you. These include prostate cancer screening for men, and breast cancer screening for average risk women aged 40 to 50.
If you are feeling well, having tests done does not necessarily mean better health or better medical care. Your doctor is trained to carefully select which tests may benefit you. Avoiding tests that might actually do harm (like doing Pap tests for teenagers) is also important. For young, healthy people, blood tests are not required yearly. Older people with stable, treated medical conditions may not require yearly blood tests either.
Your doctor will also discuss any chronic medical conditions that you have, such as asthma, high blood pressure, or diabetes. Medications that you have been prescribed or that you take over-the-counter will be reviewed. Your doctor may suggest changes that could improve your health.
Next is the physical exam. Many doctors will do a head-to-toe exam. However, there is actually very little scientific evidence that this is helpful, especially on a yearly basis. The head-to-toe physical was established many years ago when experts thought it was the right approach. Some doctors continue to do it because it is their routine. They feel that they have not done a complete job without a full examination. Others do a more focused physical exam. For instance, a doctor may not find it necessary to listen to the lungs of a healthy, active, non-smoking young adult who does not have asthma.
As there is so much to cover, the periodic health exam is not a good time to bring a long list of new medical concerns. For instance, do not wait for your periodic health visit to mention that you are having chest pain or abdominal pain. Schedule a visit immediately so that your doctor can focus on that one particular issue. If you have a few small issues to mention at your periodic health exam, go ahead and do so. However, do not be surprised if your doctor asks you to book another visit to fully explore these new concerns.
While you may need to see your doctor yearly or more often if you take any prescription medications, you may not require a full physical every year. As the idea of the annual physical is changing, there is no strong opinion on how often a periodic health exam should occur. For young children under the age of five and for older people, a yearly visit is better. For healthy children and young adults, a periodic health exam every two or three years is adequate. For people over 50, a yearly visit is still best. Each person’s medical situation dictates the frequency of the periodic health exam. Ask your doctor what is reasonable for you.