What Are General Medical Checkups?
People make appointments to see their doctor for many different reasons.
Some people only go to the doctor when they are sick or are experiencing a new problem or concern, and are looking for a specific diagnosis or treatment.
Some people see their doctor at more regular intervals for ongoing follow-up of a chronic problem or disease.
For many people, however; the frequency of office visits for a regular health maintenance checkup is not clear.
The requirements are different for
annual medical physicals,prescription drug follow-ups,prenatal, childhood checkups, andwell-woman examinations.Some people expect to have a yearly checkup, and others feel that a checkup once every two to three years is sufficient.
How Often Should You Get a Medical Checkup?
In the past, most medical groups advocated an annual health exam. However, more recently, the American Medical Association and other similar groups have moved away from the yearly exam. They now suggest that medical checkups be referred to as Periodic Health Assessments or Examinations and that they be performed every five years (for adults over 18) until age 40 and every one to three years thereafter. The requirements are for more frequent evaluations for those taking prescription medications.
Most people younger than 40 years of age are generally free from diseases that could be diagnosed by physical examination alone. In this age group, health problems usually show specific signs or symptoms that would prompt you to seek medical attention. Also, a lot of the testing that was done routinely in the past has not been found to be cost effective and, in some cases, causes unnecessary additional testing and anxiety.
Purpose of the periodic health examinationAs primary preventionTo identify risk factors for common chronic diseasesTo detect disease that has no apparent symptoms (secondary prevention)As a way for the doctor to counsel people to promote healthy behaviorTo update clinical data since last checkupTo enhance the relationship between you and your doctorHow Often Do You Need Regular Checkups to Prevent Diseases and Conditions?
A panel of doctors under the direction of the U.S. Department of Health and Human Services studies the effectiveness of screening tests for early detection and prevention of disease. This group is called the U.S. Preventive Services Task Force.
The main goal of prevention and health promotion is to reduce the burden of suffering for the major preventable diseases. This task force has identified the 70 leading causes of death and disability in the United States and has ranked them by severity, prevalence, incidence, and potential for improvement. The task force has made recommendations on methods of avoiding these diseases through specific interventions.
There are three levels of preventive care: All three of these levels of preventive care are important components of disease prevention and health maintenance.Primary prevention includes interventions that can completely prevent the disease in people at risk. One example is immunizations against certain vaccine-preventable diseases such as measles and tetanus.Secondary prevention identifies established risk factors for disease. Checking blood pressure, cholesterol, and performing Pap tests for cervical cancer screening are examples in which identifying abnormal results can lead to effective interventions that may prevent serious disease from developing.Tertiary prevention is a process for optimizing health once a disease has been diagnosed. An example is a management plan to prevent a person from having another heart attack once they already have established heart disease.Preventive interventions your doctor may use at your checkup are:Screening tests are useful in the early detection of disease. Some examples include the physical exam, blood pressure reading, Pap test, and laboratory tests.Immunizations include shots such as a tetanus booster, flu shots, and other vaccinations.Medication prescription may be as simple as suggesting that a person with heart disease risk factors take an aspirin daily.Counseling for health promotion either before or during a health problem may decrease the burden of suffering or prevent the disease. Examples of counseling topics include smoking cessation, safe sex practices, and pre-pregnancy advice on folic acid supplements.What Can You Expect During a Typical Medical Checkup?
What can you expect at your checkup?
Clinical history: Updating information on your chart or medical record is important. Some of the items you will likely be asked about include the following:Dates and results of previous preventive procedures (such as prior immunizations, Pap tests, mammograms, cholesterol levels, and blood pressure readings)A complete and updated family history of diseases: This will give your health care professional an idea about which diseases are common in your family.Your past medical history, including a review of all medications you take and previous surgeriesInformation about your workplace and leisure and living conditions at homeYour habits such as recreational drug use, alcohol use, smoking, exercise, sexual practices, and seat belt useInformation about your normal body functions such as eating, sleeping, urination, bowel function, vision, and hearingPhysical examination and diagnostic testsThe number of physical examination maneuvers your doctor performs and tests that are ordered will vary depending on your gender, age, and information obtained from the clinical history.The physical exam is most useful in identifying disease in people who already have symptoms, but it is often of little use as a screening test in people who have no complaints.The U.S. Preventive Services Task Force has developed age-specific charts for periodic health screening for the general population, with special interventions for high-risk populations. See more detailed information in the next section.Procedures no longer done routinely: Unless there is a specific reason for these tests to be done, the U.S. Preventive Services Task Force does not advocate routine testing of the following:HemoglobinBlood chemistriesUrinalysisVision and hearing testing up to 75 years of ageECG: Heart tracingScreening for ovarian cancerScreening for prostate cancerHow Often Should Different Age Groups Have Disease Screening and Prevention Tests?
Preventive services for ages 19-39
Schedule of visitsMales: Every five yearsFemales: Every three to five yearsScreeningA thorough individual risk assessmentHeight and weightBlood pressureClinical breast examination (every three years starting at age 20)Blood cholesterol levelsPap smear (at least every three years after three consecutive annual normal results)In high-risk groups, sexually transmitted disease testingCounseling and educationLimit dietary fat, general nutrition adviceFolic acid supplementation in women of childbearing ageTobacco cessationAdvance directivesDrinking and drivingSafety beltsContraception and safe sexual practicePhysical activityImmunizationTetanus-diphtheria booster every 10 yearsVaricella vaccine (if you have a negative test and no history of chickenpox infection)Rubella vaccine (if you have a negative test)Hepatitis B vaccine (if not done previously)Influenza vaccine (optional, depends on personal preference)High-risk groups offered pneumococcal vaccine, influenza vaccine, and hepatitis A vaccine (Ask your doctor if you qualify for any of these.)Preventive services for ages 40-64
Schedule of visitsMales: Every five yearsFemales: Every three to five yearsScreeningIndividual risk assessmentHeight and weightClinical breast exam yearlyBlood cholesterolPap smear (up to every three years after three consecutive annual normal results)Mammogram (optional 40-49, yearly 50-75)Colon cancer screeningIn high-risk groups, sexually transmitted disease testing and diabetes screeningCounseling and educationLimit dietary fat, good nutrition adviceTobacco cessationAdvance directivesDrinking and drivingSafety beltsPostmenopausal hormone replacement therapyPhysical activityImmunizationsTetanus-diphtheria booster every 10 yearsInfluenza vaccine (optional)In high-risk groups hepatitis A and B vaccines, pneumococcal vaccine, influenza vaccine, rubella vaccine, and Lyme disease vaccine may be recommendedPreventive medicationsDaily aspirin for people with risk factors for or established heart diseasePreventive services for ages 65 and over
Schedule of visitsEvery one to two yearsScreeningIndividual risk assessmentReview of medicationsHeight and weightBlood pressureClinical breast examinationBlood cholesterolColon cancer screeningPap smear (may be performed at the mutual consent of the woman and doctor after age 65)Annual mammogram until age 75Vision testing after age 74Hearing testing after age 74Counseling and educationLimit dietary fat, good nutrition adviceDrinking and drivingSafety beltsPostmenopausal hormone replacement therapyPhysical activityImmunizationTetanus-diphtheria booster every 10 yearsAnnual influenza vaccinePneumococcal vaccineIn high-risk groups, hepatitis A and B vaccinesPreventive medicationDaily aspirin in people with risk factors for or established heart diseaseHow Often Should People Who Are At Risk for Complications From Other Diseases or Conditions Have a Medical Checkup?
The recommendations of the task force are for healthy people. Those with specific diseases or who are at increased risk for certain health problems may be required to see their doctor more often and may undergo certain other tests. You and your doctor should mutually decide on a checkup plan that is suitable for your particular situation.
8 Reasons to Carry a Copy of Your Family Medical Records
Having your personal medical information readily available can be important:
During a visit to the emergency roomGoing to urgent-care centersBeing evaluated before surgeryVisiting a new doctor or a specialist for the first timeFrom
References
American Academy of Family Physicians. Summary of AAFP recommendations for periodic health examinations. 2001. Summary of AAFP recommendations for periodic health examinations.
Canadian Task Force on the Periodic Health Examination. Canadian guide to clinical preventive health care. Ottawa: Canada Communication Group; 1994.
Centers for Disease Control and Prevention. National Center for Health Statistics. 2001. National Center for Health Statistics.
Institute for Clinical Systems Improvement. ICSI Health Care Guideline. 2000. ICSI Health Care Guideline.
U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. Report of the US Preventive Services Task Force. 2nd ed. Baltimore, MD: Lippincott Williams & Wilkins; 1996.
