Midlife Medical Minute: The Annual Physical

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If you’re in midlife and are still managing your medical health like you did in your early 20s, then it’s time for a reboot. We are past the age of relying purely on just-in-time medical care and only queueing up the corner walk-in clinic whenever the sniffles or a sore throat gets us down . . . and getting by fine on that alone.
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By the time you hit your 30s and beyond, it’s time to take a more proactive and decisive approach to your healthcare. Part of that means no longer being reactionary to potential problems – only going to the doctor when you think something is wrong. It requires a shift in mindset and a new understanding that you need to get proactive about your well-being.

Being proactive means to get ready for something before you need to. It means anticipating, predicting and preparing ahead of time.

One of the most proactive things you can do for your health is to get an annual physical. An annual physical is exactly what it sounds like; it is a yearly visit to a primary care doctor to do a general review of your health status and to check on the vitals that keep you running. The doctor who performs a physical may go by different titles, such as general medicine physician, adult medicine doctor, internal medicine physician, general practitioner (GP) and family medicine doctor. Whatever the name, these doctors are basically generalists who have broad-based knowledge about the body, its systems and its functions. This is different from, say, a specialist whose expertise lies in a specific organ, system or part of the body, like a cardiologist focuses on the heart, a psychiatrist deals with the brain, an endocrinologist concentrates on hormones and an oncologist addresses cancer.

Ideally, a physical should happen every year. Why? Because the initial physical helps to establish your baseline and every future visit then can be used to monitor current health but also reflect on patterns that merit more consideration.

What Happens During a Physical?

A physical is nothing to fear. Even for the most doctor-phobic, a regular yearly physical is little to feel apprehensive about. This is what usually happens:

You sign in and let the staff know you’re there. You may need to provide additional information, like your insurance card and ID. You may also need to complete forms about your health history and current medications. After this, you may wait for a bit – maybe 15-30 minutes on average. (If it takes 45 minutes or longer to get called back, this may be a sign the practice has poor scheduling practices [overbooks], poor patient service skills or other issues that may be worth seeking another doctor later on.)

A nurse will usually call you back. Once in the clinical area, you will typically be weighed, asked about your height (or measured) and your blood pressure will be taken. Then you are escorted to the actual patient room, usually asked to disrobe from the waist up and wear a paper gown, and will wait for the doctor. (Again, the wait should not be too long – 20-25 minutes max.)

The doctor will come in and greet you, and introduce himself or herself if it’s the first encounter with you. They will ask you some general questions about your health history and the information you’ve already indicated on intake forms. Usually this will relate to prior surgeries, current medications, any allergies and any recent health problems or ongoing diagnoses / conditions that are being managed.

You should have the opportunity to ask questions or bring up any concerns about your health. This is a good time to bring up any symptoms you’ve noticed, changes in the effectiveness of any medications you’re on or general questions about your health and wellness.

The doctor will typically perform a few cursory examinations – listening to your pulse, heart and lungs; checking your ears and eyes; checking your reflexes; looking at your skin; appraising your general demeanor (though this will go unmentioned usually); and asking about your mental health, sexual health (behavior), fitness level and dietary habits.

The doctor will then typically order routine bloodwork. The things they check for in these labs are usually the complete blood counts, blood sugar, indicators of kidney function, cholesterol and, in some cases, thyroid. Note that you can request any labs you desire. If you want a hormone panel, ask for one. If you want to check for an autoimmune condition, ask for those labs. If you need a clear head about your STD status, ask for those tests, too.

Assuming no potential problems are noticed, your appointment will conclude uneventfully. You will be told that your lab results will be available via the patient portal (if the practice has one) or that they will call you with the results or send them in the mail. It is important to read the lab results for yourself. Even if there are no current problems “on paper,” there could be signs that something is amiss or just not quite right, especially for numbers that are trending on the higher end of normal or the lower end of normal. The entire office visit for a physical may take about an hour and certainly no more than two hours, though this should be at the upper limit for sure.

Most insurance plans cover annual physicals in full, or they cover all of the costs except for the initial visit copay, assuming you go to an in-network doctor. Realize that on some occasions the lab work will later be billed separately, sometimes by a separate company or a different department within the practice. In those instances, insurance will usually cover most of the costs.

You should get a physical every year. Why? For starters, it helps to maintain an established relationship with your primary care provider. This is the go-to doctor for your basic needs, like antibiotics for a sinus infection or a UTI. They are also who you’ll need to go through, in many cases, if you end up needing a specialist; the primary care doctor provides the referral. Additionally, a lot can change in a year. Preventive care is often the first step in identifying and treating a medical issue before it becomes a bigger problem.

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