Duke Raleigh Hospital

By Heidi Doyle, PA-C, North Hills Internal Medicine

A recent medical study¹ called into question the value of something many of us have long believed was essential – your annual check-up. The news, combined with recent updates in cancer screening guidelines², left many people confused.

There’s no stock answer to how often you should see your healthcare provider for “preventive maintenance.” Regular check-ups are important to maintaining good health. And establishing a relationship with your doctor leads to individualized counseling and, ultimately, to better long-term care.

Age, family history and disease risk all factor in to how often to get a physical.

Let’s take a closer look at the guidelines:

• If you’re under 30 and healthy (meaning, you don’t smoke, you don’t have disease risk factors and you’re not on prescription medications), then getting a check-up every two to three years is fine. If you’re a woman and sexually active, get a Pap smear to screen for cervical cancer beginning at age 21. Discuss with your doctor how often you should be screened thereafter.
• If you’re healthy and between the ages of 30 and 40, a physical every other year is acceptable. Baseline mammograms are now recommended for women once they turn 40, and they should be repeated every one to two years.
• If you’re 50 or older, an annual physical is a good idea. That’s also when men and women should undergo colonoscopies to screen for colon cancer. Repeat every 10 years unless there is a family history of colon cancer, colon polyps or the test results are abnormal. In that case, you should have one more frequently. How often depends on your family history and the results of your test.

If you’re on prescription medications and have chronic disease risk factors, an annual physical is strongly recommended. Your doctor will likely want to run blood tests to check the effectiveness of your medication and adjust it, if needed.

Being overweight, as you know, puts you at risk of high blood pressure, high cholesterol, heart disease and diabetes. It also influences how often you should get a physical. Guidelines suggest the annual physical is still a smart idea for individuals who are not at a healthy weight.

Here are a few ways you can make the most of your check-up:

• Be on time.
• Maximize the time you spend with your doctor or PA. Have medical questions and concerns ready. Write them down in advance if you need to. Know that it may not always be appropriate or there may not be enough time to address every concern at a single visit.  Physicals are primarily for preventative care and not to address acute problems.
• Know the names and doses of any medications you are taking, including over-the-counter supplements. Bringing your medications with you is always a good idea.
• Bring your vaccine record including when you got your last flu shot (annual), tetanus (every 10 years) and pertussis (in the last 10 years).
• Know the dates of your last cancer screenings including mammograms.
• Be candid. Being honest about your emotional and mental health and your habits (smoking and drinking, for instance) gives us the information we need to serve you.
• Be ready for your doctor to suggest lifestyle changes, where he or she thinks they may be needed. Changing your behavior is always more effective than any pill I could prescribe.

Heidi Doyle is a physician assistant at North Hills Internal Medicine, a Duke Primary Care clinic conveniently located on the Duke Raleigh Hospital campus.

1. “A Check on Physicals” by Jane E. Brody featured in Health|Science section of NYtimes.com on January 21, 2013

2. Guidelines for the Early Detection of Cancer by the American Cancer Society