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The Doctor Is In: Your Annual Physical

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ST. LOUIS, MO. (KTVI) -- Emergency Doctor and Urgent Care Physician, Dr. Sonny Saggar and General Nurse Practitioner James Sandler, talked with Christine Buck about taking your annual physical.

You can also connect with Dr. Saggar, the Medical Director at St. Louis Urgent Cares, and ask him any questions you like.
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1. Is it worth getting an annual physical?

Most practicing physicians and nurse practitioners believe annual physicals are worth it.
Most primary care physicians and NPs find medical value in annual exams, and continue to perform them.

Other research suggests patients worry less about the state of their health when they're fully checked once a year, and that peace of mind is valuable to them. So is the relationship between patient and provider, which these annual visits may enhance.

It's advisable for you to do certain things before going for an annual checkup, to help assure you'll get the most out of it, such as making lists of medical complaints and all your medications. If the provider is new to you, get your medical records in order, including your family medical history.

Quite a few medical conditions run in families. The more the provider knows about your family's history, the better chance there is of finding something early, before symptoms even begin.

2. What exactly do you do at an annual physical?

At the annual physical, at Downtown Medical Internal Medicine, we treat every patient as if we’ve never seen them before, even though we may know them quite well. The reason for this is so that we have no preconceptions about their social history, family history and so on. For example, what if someone has started or stopped smoking since you last saw them? What if someone has a close family member who had a serious medical problem a few weeks earlier. The annual physical will pick up all this new data if done correctly.

As well as asking about the patient’s occupation, we also discuss smoking, alcohol, whom they live with, when was their last tetanus, whether they routinely get a flu shot. Are they due for a screening procedure such as a prostate blood test, a mammography or a colonoscopy?

We then go over their past medical history (even if we have it all charted) just to make sure we’ve got it all down correctly, all their medications, whether they are allergic (perhaps newly allergic) to any medications, any procedures or operations (perhaps they had their wisdom teeth out since we last saw them).

The final part of the history is going over a long list of questions covering every bodily function (neurology, cardiology, gastroenterology, endocrinology and so on) to make sure there’s nothing else going on that might alert us to an apparently minor concern that isn’t something worse.

After that we perform a thorough physical examination to make sure everything looks and sounds ok. Then we summarize the entire physical by going over a plan which we give to our patients, so that they know what we are planning and advising as a result of that visit.

3. Why are those steps important?

It's easy to give a provider a quick rundown of how you're feeling, then realize when you get home that you forgot something. This is more common with men, whose wives say “I can’t believe you didn’t ask him about X, Y, Z” and so on.

You'll remember better if you bring a written list with you. By your healthcare provider going through everything systematically, you won’t have to depend on your list as much, although we still love it if you bring it in for us to discuss.

4. What about all the tests that are done on an annual basis? Are they really necessary?

Not every test needs to be run once a year, but because so many people don’t bother to see their healthcare provider (which might be a doctor and it might be a nurse practitioner) unless they have an actual problem, and they don’t focus on preventative medicine (which they would in an ideal world), we do tend to check the full battery of tests in the real world, at the yearly physical.

Detailed medical histories can help a provider decide what tests are most worth doing.

5. How do we keep everything straight when people are on many medications?

Very often, several providers and specialists treating a patient prescribe medications separately, and the only way the providers doing the exam will have the full list is if you physically bring it in with you.

And he or she should also know what over-the-counter medications you are taking.

If you've gone to other providers in the past, get your records from them.

6. So the annual physical is really more of a full recap of everything?

That’s correct.  There are also things you write down ahead of time, including questions for the provider.

If you're not sure what certain symptoms or pains or marks on your body might mean, the yearly physical is the perfect time to ask. It is important to note that your physician or nurse practitioner will deliberately have set aside a longer time for your yearly physical than for a regular quick follow-up. This means that he is “all ears” and ready, willing and able to listen to your entire laundry list of questions and concerns. You can discuss the validity of every single medication you’re taking, or that annoying tingling or pain you’ve had for months (or years) but never got round to asking anyone about it. The annual physical is the time for those kinds of questions.

You also should ask if you're not completely sure how to take your medications, or which medicines might not mix well with one another. And you should be prepared to ask how you will learn the results of the tests you're given. Some are ready instantly, but others need to be analyzed by a lab. Will the provider send you the results, or should you call the provider?

The physical exam may be the best time all year to ask your provider everything that's on your mind, all at once.