Doctor’s Orders

Doctor’s Orders

Dr. Gena VennikandamWhat Patients Should Know

By Dr. Gena Vennikandam

When was the last time you visited the doctor?

In more scenarios than one, sadly, this question often elicits only a long pause followed by a shameful shrug of the shoulders. Understandably, our lives get hectic, but checking in on your health with your primary care physician should never take a back seat.

According to a survey conducted by the Commonwealth Fund, since the implementation of the Affordable Care Act (ACA), the number of Americans avoiding trips to the doctor’s office has dropped from 43 percent in 2012 to 36 percent in 2014, The purpose of the ACA was to make healthcare more accessible as well as more affordable. And according to the survey, the reason many people had previously avoided the doctor was because of the unaffordable cost.

But despite this encouraging news, many still underestimate the importance of regular visits to their doctors and don’t realize that prevention is paramount. “There is still a mind-set out there that you don’t go to the doctor when you feel well; you go to the doctor when you feel sick,” says James Clancy, MD, medical director at Rogers Park Family Medicine and attending physician at Presence Saint Joseph Hospital. “It is critical to visit [your healthcare provider]. We can pick things up that you may not even know are going on inside your body.”

Millions of Americans die each year as a result of medical conditions that, if caught at an earlier stage, could have been completely treatable. But without a regular visit to a primary care doc, something like hypertension can quickly become a killer. Taking the right steps to not only identify, but also manage, existing conditions, can change that trend as well as the misunderstanding that feeling healthy is not always the same as being healthy.

But what exactly should you and your doctor be looking for? That depends on you and your doctor.

Creating a checkup list can help avoid oversights at your next visit to the doctor. Start with a list of all issues you want addressed, and include any questions you may have; nothing is too insignificant to not mention. Above all, it’s important to be honest with your physician. According to a 2010 study conducted by General Electric, the Cleveland Clinic and Ochsner Health System, more than one in four patients lies to their doctors. Your treatment plan is based around what you say; leave embarrassment behind—because they have seen and heard it all, and everything is confidential.

Here is a list of things to think about before your next visit to the doctor:

If you have a preexisting condition, note any changes in your condition.

State any recent changes regarding how you feel or any new appearances on your body like abnormal moles or new blemishes on your skin. State when you noticed these changes and any other details you have regarding them.

Review your medications together, and tell your doctor how you feel about their effectiveness and whether you have been experiencing any side effects. If you are experiencing side effects, your doctor may be able to find an alternative treatment that better suits you.

Discuss your family history with your doctor. It is an absolute must, as it allows your doctor to evaluate your risk of developing certain conditions such as certain cancers, diabetes or heart disease. If you are at risk for a condition, it may require nonroutine tests. Also, preventive measures, such as lifestyle modifications, often can be taken to prevent the development of a condition that runs in your family. “We tend to individualize [checkups] based upon that person’s risk. We will do certain tests more frequently if we know what the person may be genetically predisposed to,” Clancy says.

So, how often should you visit your doctor? That answer will vary for each patient. But here’s my advice to you: Make an appointment with your primary care physician, and see what he or she has to say about that frequency. After discussing your health and history and checking you over, your doctor should work with you to design a personalized plan to retain your best health.

 

Dr. Gena Vennikandam is an Illinois native, born and raised in Skokie. She completed medical school at American International Medical University. Her sense of adventure took her to India, where she received her Bachelor of Health Sciences degree from Manipal University and completed her basic sciences portion of medical school, and subsequently her clinical rotations, at a variety of hospitals and clinics throughout Chicagoland.


What to Get When

Based on your age, gender, lifestyle habits, preexisting medical conditions or risk thereof, it is important to note whether you are due for any screening tests or immunizations.

 

Screenings

  • Hypertension (high blood pressure): all patients over 18 years old, at every office visit.
  • Breast Cancer: Mammography at age 50, then every one to two years. (Note: Mammography guidelines are controversial at this time; many clinicians state they will recommend and begin screening at age 40 rather than 50.)
  • Colon Cancer: Colonoscopy at age 50, then every 10 years
  • Cervical Cancer: Pap smear at age 21 (regardless of the onset of sexual activity), then every two to three years until age 65, unless no previous screening
  • Abdominal Aortic Aneurysm: All men at about age 65 who were ever smokers, screened once with an ultrasound

Vaccinations

  • Influenza: Annually for the general population; it has the greatest benefit for those who are over 50 years old, pregnant, are healthcare workers and anyone who is immunocompromised. (Patients on steroids, HIV-Positive patients, those with diabetes, cancer and with chronic medical conditions e.g., lung, heart, liver, kidney conditions)
  • Pneumococcal: Anyone over 65 years old and anyone who is immunocompromised
  • Varicella-Zoster (Shingles): This one-time vaccination is recommended for anyone over the age of 60. It is not recommended for anyone who is immunocompromised or pregnant.
  • Td or Tdap vaccine: Every adult should get the Tdap vaccine once, if not received as an adolescent, to protect against pertussis (whooping cough), and then a Td (tetanus, diphtheria) booster shot every 10 years. In addition, women should get the Tdap vaccine each time they are pregnant, preferably at 27 through 36 weeks.

See a complete list of the recommendations from the United States Preventive Services Task Force and the Centers for Disease Control and Prevention: (http://www.uspreventiveservicestaskforce.org/BrowseRec/Index/browse-recommendations

http://www.cdc.gov/vaccines/acip/)

Originally published in the Fall 2015 print edition.