DEAR MAYO CLINIC: I am a 39-year-old woman and haven’t been to the doctor for many years, other than to get a yearly flu shot. Are there other vaccines or tests I’m missing by not having an annual checkup? Is an annual exam really necessary if I’m not having any health issues?
ANSWER: First, let me congratulate you on getting your flu shot. Not only are you protecting yourself, you’re also protecting others from a potentially lethal disease. Reviewing your need for vaccines, such as the flu shot, as well as discussing other tests and screenings that may be right for you, are all part of an annual checkup. That review is just one of the many reasons to schedule this important visit, even when you’re a healthy adult.
For adults, periodic checkups usually involve a visit to a primary care provider in family medicine or internal medicine. For women, a healthcare professional in gynecology or in women’s health may be a primary care provider in some cases.
Patients often mention that one potential barrier to having a regular checkup is cost. However, the majority of medical insurance plans typically allow for an annual wellness visit. Review your benefit options with your insurance carrier prior to your checkup so you know what may or may not be covered. Unfortunately, every medical plan has a different set of allowable coverage. While your healthcare provider will consider these allowances, they should always present you with recommendations based on your personal overall health profile and assist you in making a decision on what examinations, tests, screenings, or treatments are in your best interest.
Over the past several decades, healthcare has become more centered on evidence-based medicine. This means that the standards for providing medical care should be backed by good science and, as appropriate, show a favorable cost benefit.
In a related effort, the American Board of Internal Medicine Foundation recently started a campaign called “Choosing Wisely” (choosingwisely.org) that addresses many of the potentially unnecessary tests that may be recommended or considered during most medical assessments. So the trend is to focus on individualized care that a patient truly needs, rather than one-size-fits-all recommendations.
Although patient-doctor interactions are not necessarily measurable events that can be documented with evidence-based research, most healthcare providers strongly agree that regular visits to a primary care provider help build a relationship. And that relationship allows your provider to offer you the best overall care, tailored to your individual needs.
At your first visit, you and your healthcare provider can review your medical and family history, and based on that, along with your age, determine the interval of regular checkups, screenings, tests, and vaccines that’s right for you. For most adults, an annual checkup is appropriate. The time between visits may be a bit longer for younger people who have few risk factors. But there should never be more than three years between checkups.
Assuming that you have no significant medical concerns and a relatively benign family medical history, your provider may recommend blood or urine tests to evaluate your kidneys, electrolytes, blood sugar level, thyroid, blood counts, and cholesterol, to name just a few. And you may undergo screening for conditions such as high blood pressure, obesity, diabetes, and depression. You also can take the opportunity to discuss any personal, medical, social, or emotional questions or concerns that you may have.
The visit will involve a discussion of cancer screenings that may be right for you. Common cancer screenings include tests for breast, cervical, colon, and skin cancer. As mentioned earlier, a review and update of recommended vaccines, such as tetanus, diphtheria, pneumonia, influenza, and varicella, will be included, too.
Based on findings from your examination, screenings, medical history, and family history, your healthcare provider will assess any potential health risks you may have and, if necessary, recommend next steps that you can take to decrease those risks. You and your provider also can talk about healthy lifestyle choices that are a good fit for you.
Overall, it is important to stay up to date on all your recommended screenings and vaccines, and a regular checkup will ensure this occurs. But more importantly, the time spent face to face building a relationship with your primary care provider will allow you to create an individualized care plan that meets your needs and optimizes health outcomes. — Jeffery Crick, DO, Family Medicine, Mayo Clinic, Jacksonville, Florida