Definition and Overview
An annual physical exam is a series of routine examinations performed every year that typically includes the following tests:
Blood tests: Some of the most common blood tests include complete blood count (CBC), fasting blood sugar, and chemistry panels such as lipid and thyroid hormone tests.
Urinalysis: The urine can provide a lot of information about infection, presence of excess protein and blood that may indicate problems in the urinary system such as the kidneys, and crystallized deposits to name a few.
Stool exam: A stool exam is the most basic method of determining serious problems in the colon such as colon cancer. In a fecal occult exam, a presence of blood may warrant further investigation through colonoscopy.
Vital signs: The doctor monitors the heart rate, blood pressure, the sound of the lungs, and temperature.
Physical appearance: In an annual physical exam, the doctor takes the time to observe and take note of changes in the physical appearance, including weight, posture, gait, balance, hair loss, and skin changes like appearance of new moles.
Imaging tests: Sometimes imaging exams like X-rays and ultrasounds are conducted to get a better idea of the structural changes of the internal organs.
Annual physical may also include reproductive and mental health. Women can use this time to undergo pap smear or mammogram, which is a standard breast cancer screening process. The doctor will also observe any changes in the mental acuity or cognition of the patient.
Who Should Undergo and Expected Results
The benefits of annual physical have long been debated as others contend that it’s a waste of both time and money. Nevertheless, one should consider getting one if:
He is getting older – Aging is a natural process that requires close supervision. When the body ages, different changes also occur down to the cellular level. For example, the oxidative stress levels can increase, increasing the production of free radicals that can lead to cellular damage. The vital organs such as the liver and the heart grow old as well, so they may not perform as efficiently as when a person is still young. Metabolism significantly slows down that it becomes more difficult to lose weight and build muscle. Hormones can also become imbalanced, which may then result in different metabolic disorders. Mental cognition tends to decrease, and older people may develop memory loss. Further, many conditions tend to become more prevalent among the aging population including but not limited to many types of cancer, dementia, hypertension, and heart disease. Usually, they develop slowly and with very subtle symptoms, which may be detected through an annual physical exam.
He is at risk of a disease – Being considered as high risk for a certain medical condition doesn’t immediately mean the disease will develop. However, many doctors want to exercise watchful waiting and close supervision with the goal of preventing the disease from happening or catching it as early as possible to increase the chances of survival.
He wants to build a better relationship with the doctor – Although many do not agree on the other benefits or uses of annual physical, most believe that the comprehensive exam is helpful in allowing both the patient and the doctor build a good relationship. A person’s health and well-being require team effort, and patients are more likely to cooperate with the doctor if they feel comfortable. On the other hand, physicians would have a much better idea of their patient’s medical history that it’s easy for them to spot if something is wrong.
He is undergoing treatment – An annual physical may be conducted to monitor the effectiveness of the present treatment or disease management. The doctor can then decide to reduce or eliminate medications, add more, or completely change the therapy.
How Does the Procedure Work?
An annual physical is conducted either in a clinic or hospital setting and usually is an outpatient procedure, although some may prefer to stay overnight especially if several tests have to be conducted.
During the consultation, the doctor reviews the previous year’s medical records and performs an interview to find out if the patient has a different problem or to get a new overview of the patient’s health and well-being. The doctor then proceeds with the annual physical. The doctor will:
- Get the vital signs such as blood pressure, respiration, and temperature
- Feel any lymph nodes especially on the neck
- Check for any changes in the skin, spotting moles, abnormal growths, and changes in skin texture
- Let the patient lie down to feel any tenderness or pain in the abdomen
- Check for reflexes or tenderness of the joints, especially those of the knee
- See if there are any skin injuries that are not healing properly
- Track the weight, height, body mass index, and waist circumference
- Check the eyes, throat, ears, and nose
Depending on the patient’s age and results of the initial physical exam, the doctor may recommend additional tests such as X-rays and ultrasound. He may also recommend medications or other forms of treatment if necessary. The patient may then have to return in the future to monitor the effects of the treatment.
Patients may see more than one doctor during the annual physical. For instance, a male patient may visit the family doctor or internist, then may be referred to a urologist who specializes in male reproductive health. He may also see a dentist for oral health.
Some of the exams may require certain preparations. For example, for fasting blood sugar, the patient is expected to fast for at least 8 hours before the blood is drawn. In an abdominal ultrasound, the patient may be requested to drink a lot of water and hold off peeing to allow the abdomen to expand and make the organs more visible.
Possible Risks and Complications
An annual physical is generally safe, but it can be uncomfortable and time-consuming. Further, it doesn’t guarantee that it can catch all serious diseases such as cancer.
- Simel DL. Approach to the patient: history and physical examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 6.