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The Annual Physical Exam - 10 Steps to Having a Better Interaction With Your Doctor

A few years ago I went to the Cooper Clinic in Dallas, Texas for a comprehensive physical examination. The exam last nearly eight hours and every opening and structure on my body was probed and explored. Are these costly and lengthy "extreme physicals" necessary or useful?

The main benefit of these extensive examinations is the convenience of one stop shopping or to provide you with an opportunity for a physician to give you a comprehensive exam at one time rather than forcing a you to piece together appointments with a half-dozen different experts. Many patients say it is worth the expense to get a one-stop, comprehensive look at their health.

For those who aren't willing or able to spend big chunks of time, there still is a lot to learn from these exams with your primary care physician. A savvy patient can always ask their own physician to perform a selection of such tests. Any doctor can order the blood work, such as C-reactive protein tests or advanced cholesterol screening, that is standard fare during a superphysical. Your family doctor should be able to refer you to a nutritionist or exercise physiologist for additional counseling.

Getting regular physical exams is a great start. To get the most benefit from your visits, you must communicate clearly with your physician, understand the exam's results, and know what actions you and your healthcare team need to take. Here are some more steps to help you make the most of your physical exam.

1. Be honest with your physician about your behaviors and symptoms. Don't just tell the physician what he or she wants to hear. For example, if you smoke, say so. If you don’t exercise, mention that. If you are sexually active and have multiple sexual partners, indicate this to your doctor even if he/she doesn’t ask. If you are suffering from erectile dysfunction (ED), volunteer this as there is treatment for this condition and it may indicate other more serious illnesses such as diabetes mellitus, hypertension, high cholesterol levels and even coronary artery disease.
2. Don't be shy. Many people don't tell their physicians about depression, incontinence, and sexual problems because they are embarrassed to discuss these issues. It is natural to feel reluctant, but it is not in your best interest. Your physician can give you the best treatment only if he or she knows what is really going on.
3. Tell your physician about changes in your life and any new symptoms you've experienced, even if you think that they may not be significant. For example, mention changes in your appetite, weight, sleep, or energy level. Also let your physician know about major changes or stressors in your life such as a divorce, significant financial problems or the death of a loved one.
4. Ask questions. This is crucial to getting the most from your annual examination. If you don't understand a test, a word or medical term the physician has used, or want more information about your condition, you must ask for clarification. When you don't ask questions, your physician will assume you understand. Also ask for educational materials. Most physicians have brochures and forms related to the most common medical conditions and will be happy to provide them to you. Also, ask for relevant or credible Web sites so that you can learn more about your condition and learn about healthy habits and life styles. Whenever possible, have the physician or staff provide you with written advice or instructions.
5. Come prepared. Write down questions or topics you want to discuss before your appointment. For example, include a new symptom you want to mention or a question about a new treatment.
6. Take notes and/or bring someone along with you. If you think that you may not remember what your physician says, taking notes will help. Bringing a family member or friend to your appointment will also help. If you tell your family member of friend what you want to get from your visit, he or she can help you stay on track.
7. Share your point of view about the exam, tests, and treatment. Your physician needs to know what works well for you and what doesn't, but he or she can't read your mind. If you feel rushed, worried, or uncomfortable, say so. If you feel you need more time with your physician, ask when you can return or schedule another appointment to review what is important to you.
8. Before agreeing to proceed with a medical test, ask your physician to explain why it is important for you and what it's designed to show. When the results are available, make sure your physician explains them and answers your questions. Ask for a copy of the results. If a specialist does the test, ask to have the results sent to your primary care physician.
9. If your physician suggests a treatment and especially a surgical procedure, be sure you understand what it is and what it will and won't do. If your physician suggests a treatment that makes you uncomfortable, ask about other treatment options and even about getting a second opinion.
10. Ask about your medication's side effects. Be sure to let the doctor know what medications, vitamins, herbs and over the counter medications you are taking. Then ask if the newly prescribed medications have any interactions with food or drugs you are currently using.

Bottom Line: I can’t insure that every experience with your doctor will be positive. But I can promise you that if you use these 10 action steps and become pro-active regarding your health care, you will have a more meaningful dialog with your doctor and be on your way to good health.

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Reprinted with permission from Neil Baum, neilbaum.com

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