Haven’t gotten a physical lately? You’re not alone.
Even before the coronavirus pandemic, preventive care wasn’t on everyone’s agenda. Adults are less likely to receive preventive care than children, according to data from the Centers for Disease Control and Prevention. And in 2018, the most recent year studied, just 23 percent of office-based doctor’s visits were for preventive care.
Physicians insist on the importance of regular wellness screenings — just don’t call them physicals.
The term “physical” is outdated, says George M. Abraham, president of the American College of Physicians and chief of medicine at St. Vincent Hospital in Worcester, Mass. In reality, he says, what patients need is less a head-to-toe examination than an annual preventive visit — a chance for doctor and patient to check in and cover topics that might not come up during more focused sessions.
Over the years, there has been a movement away from annual physicals and toward routine preventive screenings. Researchers are split on the concrete value of general health exams. In 2019, a systematic review of general health checks published in the Cochrane Database of Systematic Reviews concluded that routine physicals are “unlikely to be beneficial” and can lead to unnecessary testing.
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Others argue that there is no evidence against the practice, either, and that the value of preventive exams lies in the connections they foster between patients and physicians.
There are plenty of reasons to check in with your doctor regularly, whether you’re on an annual schedule. During preventive visits, doctors such as Abraham ask patients about everything from sexual health to seat belt usage, firearm safety, risky behaviors such as drug use, and vaccination status. And for patients 40 and over, it’s important to stay on top of recommended screenings such as mammograms and colorectal cancer tests.
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“We make sure people know the things they need to do or consider if they would like to lengthen their lives and have a longer time being healthy,” says Carol Mangione, vice-chair of the U.S. Preventive Services Task Force and a practicing primary-care doctor. The task force publishes evidence-based recommendations for preventive care, as well as an up-to-date list of its recommendations on its website, uspreventiveservicestaskforce.org.
How often should you seek preventive care? “In general the expectation is once a year,” Abraham says. “However, in people who are young and healthy with no issues, if it’s every other year, it’s perfectly okay.”
Depending on your health status, your doctor may want to see you more or less often.
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Many Americans have gotten behind during the pandemic. A national survey conducted by Johns Hopkins University found that in the first-half of 2020, 41 percent of respondents delayed or skipped medical care.
Shame can play a role in postponed preventive care — fear of questions about weight or high-risk behaviors, or a reticence to see the results of long-postponed screenings. Others may skip visits because of a concern about high costs. The Affordable Care Act requires insurers to cover a variety of preventive services, and Medicare covers an “annual wellness visit” for beneficiaries. But terminology is tricky when it comes to insurance, and when visits veer beyond prevention into treatment, it can generate additional costs.
Medicare wellness visits are supposed to be free — unless you call it a physical.
Ready to touch base with your physician? Be prepared to ask questions and share your concerns about your physical and mental health. And expect to receive information about necessary screenings, counseling on things such as alcohol intake and physical activity, and prescriptions for medications to prevent disease down the line, such as statins that can reduce the risk of stroke or heart attack, if applicable.
If you’re behind, don’t stress, Mangione and Abraham say. Make sure you’re up to date on screenings and get to your doctor when you can.
“Don’t punish yourself,” Mangione says. When she sees patients who have put off preventive screenings, she tells them: “You did the right thing. You got the test when you could — and we’re going to take great care of you.”
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