It is often said that a journey of a thousand miles begins with one step. The New Year serves as a unique time to embark on a journey to transform both mind and body and can begin with a simple first step: a visit to your primary care doctor’s office for an annual physical. Often overlooked, the annual physical serves as a proactive measure that can help you establish a baseline level of health and fitness, identify potential health risks, collaborate with your primary care physician on an overall health plan and formulate specific health goals. It is also an indispensable opportunity to ask your doctor general questions about your health and is typically free or low cost with insurance.
Part of the annual physical is dedicated to a comprehensive review of your past medical history and your family medical history — both of which play a significant role in your current and future health. Medical conditions such as high blood pressure, diabetes, high cholesterol, heart disease, depression and anxiety can be passed on from one generation to the next. Having these conditions in your family history does not guarantee you will end up with them, but it can increase your risk of developing the conditions in the future. Reduce these risks through regular doctor visits for monitoring, and develop an ongoing dialogue about diet and exercise habits as well as your mood and stress levels. In addition to a review of cardiovascular and mental health history, your doctor will also review your family history of cancer. Breast, ovarian, colorectal, prostate and certain skin cancers (amongst others) can be familial and are typically checked at certain ages. Having a family history of any one of these could prompt early screening and thus early detection, which is key.
The annual physical is also a great time to review your lifestyle habits such as tobacco and alcohol use. If your resolution is to improve these areas of your life, discuss this with your doctor and formulate a game plan. Discuss your current tobacco and alcohol use patterns, your motivations for quitting or cutting down, why previous attempts have failed and any barriers to success. This can help you and your doctor craft a plan unique to your situation. For example, if you’ve tried and failed quitting cold turkey or using over-the-counter methods, talk to your doctor about prescription medications. Discuss therapy if your tobacco and alcohol use is related to stress and anxiety. Is a lack of accountability an issue? Consider frequent follow-ups with your doctor or therapist. Whether your plan involves medications, therapy, follow-up visits for accountability or a combination of strategies, communicating with your doctor can optimize your chances of success.
Other lifestyle factors discussed during your annual physical include diet and exercise, which offer an opportunity to determine your baseline fitness and identify areas of improvement. People are often surprised to find that the American Heart Association recommends 150 minutes of weekly moderate-intensity exercise or 75 minutes of vigorous exercise, and that only one in five Americans admits to meeting these exercise goals. You should talk to your doctor about choosing the best exercises to achieve your fitness goals as well as strategies to avoid injuries. Talk about proposed dietary changes you are planning, as certain diets may be better suited to your needs than others. For example, if you have high blood pressure or heart disease, the DASH (Dietary Approaches to Stop Hypertension) or Mediterranean diets would be a good fit for you. Avoiding the Keto diet would also be helpful if you have high cholesterol. Another example would be trying a low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols) diet to help those with irritable bowel syndrome. Diet and exercise regimens can and should be individualized to best suit your needs.
The Physical and Labs
As important as it is to see your doctor when you are sick, it is arguably more important to see him or her when you are healthy. During the physical, your doctor will examine your height, weight and vital signs (i.e. blood pressure, pulse rate, respiratory rate and temperature) — valuable objective metrics to assess your health, especially when measured over a period of several months or years. Tracking these trends can provide context about the efficacy of your current diet and exercise regimen.
An examination of your cardiovascular, respiratory, musculoskeletal and neurologic systems helps to determine your fitness to start a new exercise regimen. Abnormalities of the heart and lungs could impede your exercise capacity and lead to easy fatigability, shortness of breath, chest pains or lightheadedness while exercising, while those of the neurologic and musculoskeletal systems can lead to bone, joint and muscle injuries. Having these systems checked prior to starting a new exercise regimen can go a long way in preventing injury.
Blood tests checked during the annual physical can vary but typically include a complete blood count (CBC) for infections and anemia; a comprehensive metabolic panel (CMP) that checks electrolyte levels, liver and kidney function; a lipid panel to check your cholesterol levels; and the hemoglobin A1c to assess for diabetes. Your doctor will also discuss your cancer risk, and an individualized decision can be made about when to perform certain screening tests for cervical, breast, prostate, colon and skin cancers.
Just like all things in life, it is better to be prepared than to leave things to chance. Familiarizing yourself with your medical history and current health status empowers you with the knowledge necessary to make the best decisions for your health moving forward. It is always easier to treat minor issues early and prevent them from becoming major issues down the road. So, whether you are well into your fitness journey or just starting out, make the annual physical your next step!
Dr. de Lota is a Family Medicine physician working at Austin Regional Clinic. He enjoys treating people of all ages and has a passion for preventative care, evidence-based medicine, and patient education.