QUESTION: I am used to going to my doctor each year for a complete physical examination.
I must admit I was somewhat surprised when he informed me that I wouldn't need one this year.
I don't mind skipping the bother, but I don't want to jeopardize my health.
Can you please advise me of the current thinking about these examinations.
ANSWER: Yes and no.
You don't need the complete annual physical anymore, every third year will do for most people under age 50, but certain medical tests should be done more frequently than that for some people. It used to be widely recommended that everyone have a complete physical, with a general examination and blood tests, every year to make sure they were in tip top health.
But, as medical costs soared in the 1970's, this idea came under fire as both a waste of time and money, especially for younger individuals.
Some tests and screening procedures simply don't need to be done every year, if a person is basically healthy. The primary purpose of a health exam is to catch any disease that is present in its earliest stage.
The exam must in itself be safe and effective. It is no use to run routine tests for uncommon diseases or tests that are not very accurate.
If screening every third year is just as effective as screening annually, there's no good excuse for doing it more frequently. The new system of physicals calls for selective tests for selected diseases at selected intervals.
In other words, a general physical exam, including exams for thyroid, testicle, prostate, ovarian, lymph node, and skin cancer, can be done every third year until age 40 or so.
Pap smears for women need to be done for two consecutive years to get a baseline reading, then every third year.
A baseline mammogram for breast cancer should be done between age 35 and 40 and then annually after age 50.
Women and men older than 50 should have yearly tests for colon cancer, including digital rectal exams and stool guaiac tests.
After age 50, sigmoidoscopy should be done every three to five years. Certain procedures can be individualized.
Blood tests for cholesterol, triglycerides, and blood lipids can be done annually if they are needed. Tests for hearing and visual acuity should be done only if needed. Immunizations for diphtheria/tetanus (needed every 10 years), flu (annually after age 65), and pneumonia (once after age 65), are a part of checkups. The only medical test that needs to be done yearly for everyone is a measurement of blood pressure.
If the first results are a bit high, then you should have the pressure rechecked a time or two before embarking on any costly testing.
Blood pressure can change rather dramatically depending upon the state of your emotions, circumstances and surroundings, as well as your physical state, and requires some rechecking before valid readings are obtained. Just because these tests are being done less often doesn't mean that you should be any less motivated about your own health care.
The fact is that you can really save some money without increasing your risks, if you assume some of the responsibility for your own wellness, and follow the rules of healthy living.
And if you are not too sure about those principles, keep reading, and I'll try to make you both healthier and wiser.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
