Routine physical examination
In the first half of the last century if someone mentioned preventive health it was not most likely they were talking about projects that improved the public water or food quality , or other population health initiatives. Visiting a doctor was only seen in the context of having an illness or condition that needed treatment. No-one who felt well was in need of a doctor.
As time went on, developments in the area of immunisation and advances in medical knowledge shifted the public focus. It became apparent that investing some time and energy into health when you were well had significant impact on your future well being.
Preventive health is now a catch cry of many government health initiatives and is responsible for a considerable proportion of GP consultations. The general checkup is seen as the key--not only for detecting previously undiagnosed conditions but also for identifying risk factors that can often go undetected. High blood pressure, high cholesterol, sunspots and cervical changes rarely give symptoms but are highly predictive of future problems if they are left untreated. So which tests do you need and how often? For some conditions the answer is easy--government-funded screening programs for breast cancer and cervical cancer, for example have determined the type of test and the screening interval. For other condition it is less clear-cut. Health authorities make recommendations according to your particular medical history, age, sex, lifestyle and sometimes ethnic background. You need to discuss with your doctor which screening tests you need and now often, then stick to a plan. Think of it as a responsible investment in your future.
About the examination. Taking your medical history and giving you a routine physical examination offers your doctor a unique opportunity to assess your overall health. Periodic checkups are also a good time for you and your doctor to talk openly and build a partnership. At these times you should discuss any health problems or lifestyle concerns you may have and ask the doctor for specific tips on staying healthy. Among the components of a routine physical are:
How is it done? During a routine visit, your doctor will ask you questions, perform a physical, order appropriate tests, prescribe treatment and offer advice. A typical checkup includes many or all of the following components:
Questions about personal and family history. Especially on your first visit, your doctor will ask you at length about past illnesses, any medical problems that may be affecting your close relatives and lifestyle issues (stressors, unhealthy habits, diet) that are of concern. The history will also include a series of questions about the many different parts of your body as well as questions about any allergies you may have and your mental health. Your doctor will also address any current health issues.
Physical examination. The doctor will probably:
Lifestyle concerns. The doctor will also bring up various lifestyle and safety matters including:
A full blood count (FBC) to determine if you are anaemic and if you have the normal number of red and white cells.
A chemistry profile to check blood sugar levels for diabetes and liver and kidney function.
A lipid profile to check levels of total cholesterol, LDL ('bad') and HDL ('good') cholesterol and triglycerides, which comprise much of the fat stored in the human body.
Various other tests. A number of targeted tests, detailed shown on next, may be performed or scheduled to screen for diseases or assess therapies you are undergoing. Your doctor may do the test directly or you may be referred to a specialist.
You'll need a physical more often if...
Vaccines create immunit by boosting the body's natural immune response. Their benefits outweigh the risks in most cases.
Tetanus booster
After age 15 you will need one more tetanus booster at age 50.
Flu injections
Immunisations for the flu (influenza) are given each year in autumn before the start of the flu season. You should get a flu injection if you are 65 or older or if you have a chronic lung ailment (such as asthma or emphysema), heart disease, diabetes, sickle-cell anaemia or cancer. These conditions put you at high risk for flu complications. Younger adults may also benefit from the vaccine.
Pneumococcal vaccine
To prevent pneumonia and infections of the blood or brain, you should get a pneumococcal vaccine after the age of 65. You should go be immunised if you are under the age of 65 and have heart, kidney, liver or lung disease; diabetes; Hodgkin's or an immune system disorder. It is recommended that you have booster injections of the pneumococcal vaccine every five years.
Rubella vaccine
If you are a woman of childbearing age, you should be immunised against rubella (German measles). The injection is not recommended during pregnancy.
Hepatitis B vaccine
Children and infants are now routinely immunised against hepatitis B. Young adults and others at high risk should also be immunised.
Other immunisations
Special immunisations can protect against infectious diseases such as diphtheria, meningitis, typhoid and chickenpox.
In the first half of the last century if someone mentioned preventive health it was not most likely they were talking about projects that improved the public water or food quality , or other population health initiatives. Visiting a doctor was only seen in the context of having an illness or condition that needed treatment. No-one who felt well was in need of a doctor.
As time went on, developments in the area of immunisation and advances in medical knowledge shifted the public focus. It became apparent that investing some time and energy into health when you were well had significant impact on your future well being.
Preventive health is now a catch cry of many government health initiatives and is responsible for a considerable proportion of GP consultations. The general checkup is seen as the key--not only for detecting previously undiagnosed conditions but also for identifying risk factors that can often go undetected. High blood pressure, high cholesterol, sunspots and cervical changes rarely give symptoms but are highly predictive of future problems if they are left untreated. So which tests do you need and how often? For some conditions the answer is easy--government-funded screening programs for breast cancer and cervical cancer, for example have determined the type of test and the screening interval. For other condition it is less clear-cut. Health authorities make recommendations according to your particular medical history, age, sex, lifestyle and sometimes ethnic background. You need to discuss with your doctor which screening tests you need and now often, then stick to a plan. Think of it as a responsible investment in your future.
About the examination. Taking your medical history and giving you a routine physical examination offers your doctor a unique opportunity to assess your overall health. Periodic checkups are also a good time for you and your doctor to talk openly and build a partnership. At these times you should discuss any health problems or lifestyle concerns you may have and ask the doctor for specific tips on staying healthy. Among the components of a routine physical are:
- Review of specific symptoms you may have experienced since your last examination.
- Discussion of any family predisposition to particular medication conditions that you are aware of.
- Complete physical examination with visual observation, hands-on palpation and listening through a stethoscope (auscultation).
- Education about hygiene and other habits.
- Immunisations as required to prevent infection diseases (see below)
- Screening tests for early detection of illness.
How is it done? During a routine visit, your doctor will ask you questions, perform a physical, order appropriate tests, prescribe treatment and offer advice. A typical checkup includes many or all of the following components:
Questions about personal and family history. Especially on your first visit, your doctor will ask you at length about past illnesses, any medical problems that may be affecting your close relatives and lifestyle issues (stressors, unhealthy habits, diet) that are of concern. The history will also include a series of questions about the many different parts of your body as well as questions about any allergies you may have and your mental health. Your doctor will also address any current health issues.
Physical examination. The doctor will probably:
- Measure your height and weight, which determines your Body Mass Index (see on next).
- Take your pulse and blood pressure (see on next).
- Listen to your heartbeat, the blood vessels in your neck and breath sounds.
- Check your reflexes, joints and range of motion, spinal alignment and balance.
- Feel or lymph nodes or swellings in the neck, armpits groin, abdomen and other areas.
- Palpate the thyroid at the base of your neck.
- Feel for any hernia in the groin region.
- Examine your skin, mouth, gums and throat.
- Mental health examination. The doctor will ask you about your overall mood and whether you are having any problems with depression or with anxiety. The doctor may also do tests do assess your memory.
Lifestyle concerns. The doctor will also bring up various lifestyle and safety matters including:
- Do you smoke or use other tobacco products or illicit drugs?
- If you drink alcohol, how much?
- Are you sexually active?
- How much exercise do you get?
- What is your typical diet?
- How much sleep do you get?
- Do you wear a seat belt? A bike helmet?
- Are you regularly exposed to any toxins, such as solvents or asbestos?
- What has caused any stress in your life since your last examination?
A full blood count (FBC) to determine if you are anaemic and if you have the normal number of red and white cells.
A chemistry profile to check blood sugar levels for diabetes and liver and kidney function.
A lipid profile to check levels of total cholesterol, LDL ('bad') and HDL ('good') cholesterol and triglycerides, which comprise much of the fat stored in the human body.
Various other tests. A number of targeted tests, detailed shown on next, may be performed or scheduled to screen for diseases or assess therapies you are undergoing. Your doctor may do the test directly or you may be referred to a specialist.
You'll need a physical more often if...
- You've been diagnosed with a medical condition. (The type of examination you receive, and how often, will depend on the nature of your illness and its treatment.)
- You're taking medications that require regular blood tests to check blood count and detect liver or kidney problems. (At doctor's discretion).
- You have a potentially recurrent disease such as cancer. (Your doctor will establish a schedule and routine that is right for you.)
Vaccines create immunit by boosting the body's natural immune response. Their benefits outweigh the risks in most cases.
Tetanus booster
After age 15 you will need one more tetanus booster at age 50.
Flu injections
Immunisations for the flu (influenza) are given each year in autumn before the start of the flu season. You should get a flu injection if you are 65 or older or if you have a chronic lung ailment (such as asthma or emphysema), heart disease, diabetes, sickle-cell anaemia or cancer. These conditions put you at high risk for flu complications. Younger adults may also benefit from the vaccine.
Pneumococcal vaccine
To prevent pneumonia and infections of the blood or brain, you should get a pneumococcal vaccine after the age of 65. You should go be immunised if you are under the age of 65 and have heart, kidney, liver or lung disease; diabetes; Hodgkin's or an immune system disorder. It is recommended that you have booster injections of the pneumococcal vaccine every five years.
Rubella vaccine
If you are a woman of childbearing age, you should be immunised against rubella (German measles). The injection is not recommended during pregnancy.
Hepatitis B vaccine
Children and infants are now routinely immunised against hepatitis B. Young adults and others at high risk should also be immunised.
Other immunisations
Special immunisations can protect against infectious diseases such as diphtheria, meningitis, typhoid and chickenpox.
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