How to Prepare for Your Annual Physical Exam

 Will my insurance cover an annual physical exam and screenings?

Most commercial insurance will cover an annual wellness visit if you have not had one already in the last 12 months. If you are unsure if you have had an annual physical exam or not, you can contact us and we can confirm if you are due for one. IF you require lab work that is not standard for annual screening, then this can incur additional charges.

 Insurance will not cover the visit if you have new medical issues to address during the annual visit: Illness, Sinus Infection, joint pain, etc.

How should a patient prepare for an annual physical exam?

First and foremost, healthcare providers like to know as much as possible about your medical history. This includes medical history, family history, medications, allergies, and any past/recent surgeries you may have had.

What is pertinent to a patient’s medical history?

For your healthcare provider to get an accurate assessment of your general health, they need to know about any significant/chronic medical problems you have endured throughout your lifetime. This information will give your provider a sense of what to look out for in the future, and which screening tests they may need to order.

Medical problems your provider needs to know about include chronic medical issues like high cholesterol, high blood pressure, heart disease, and diabetes. Providers also need to know about any significant medical issues you may have had in the past (even if it is not an active issue), such as blood clots or skin cancer.

How much family history do you need to know?

It is helpful to know any medical problems a patient’s parents, siblings, and grandparents have had, such as diabetes, high blood pressure, colon care, breast cancer, and heart disease. Any family history that has a genetic component is going to influence health screenings for potential disease. If the patient has a first-degree relative who had colon cancer at an early age, for example, your provider may want to order a colonoscopy before the recommended starting age.

Should you bring their medications with you to the physical exam appointment?

It is very helpful for your provider to review all of the medications you are taking. You do not necessarily need to bring the bottles in, but you should make a list of what you take with names, dosages and whether the medications are prescribed or non-prescribed. Be sure to include vitamins and over-the-counter drugs as well as many of these can interact with prescription medications or influence what labs your provider may order. It is helpful to always keep a medication list in your wallets, in case you wind up in the emergency room. 

What other information do you need for your annual physical?

Allergies, including any side effects to medications, are important for your provider to know, so they do not inadvertently prescribe them.

It is also helpful to be ready to discuss your vaccination history. Adult vaccines need to be maintained, updated, or even delivered for the first time. Some patients do not know what they’ve received in the past, so it’s ambiguous whether they will need it now. Patients in their 60s should receive pneumonia vaccines and shingles vaccines. Tetanus shots should be given every 10 years, to prevent tetanus infection after a laceration or injury.

Past lab work can also be helpful. If you have received lab work from an outside clinic, especially if it was used to diagnose a chronic disease, illness, or infection, then this is important for your provider to review.

What should you bring to the appointment?

It is always helpful to bring a list of questions/concerns about your wellness/overall health. Write down your health goals ahead of time so we can discuss them. It is normal to be nervous during appointment and forget to bring up your concerns and goals at the time of your visit.

Be sure to bring pen and paper to write down notes once the exam is over as well. During the appointment, your provider will recommend screening exams and tests — mammograms, colonoscopies, eye exams and skin cancer screenings, among others — writing them down ensures that you won’t forget to follow up with these screenings. You will be asked to scheduled a fasting lab appointment after your annual physical exam.

If you would like to discuss improving your diet and exercise habits, we recommend keeping a food and exercise diary for a couple of weeks before your appointment. It is best to document your current habits (you will not be judged for having a bad diet or poor exercise habits) so we can help recommend changes. There is a wonderful free app called “My Fitness Pal” that can help you document your meals. It considers your age, weight, and gender and makes great recommendations on which nutrients you need as an individual.

Should you fast before their lab appointment?

For any annual lab visit, it is advised that patients fast eight hours prior to the appointment for the bloodwork. Water and a cup of black coffee is fine if you usually drink it in the morning, though. You do not need to withhold your morning medications unless they cause discomfort on an empty stomach. You should withhold any insulin or medications that could cause your blood sugar to drop without eating a meal.

What about attire? Does it matter what the patient wears?

For annual physicals, you may be asked to wear a gown or you may be due for an immunization, so you should not wear constricting, hard-to-remove clothing. The most accurate blood pressure reading will also result from taking the blood pressure without material between the blood pressure cuff and your arm (a short sleeved t-shirt is best). 

What do providers typically ask the patient in an appointment?

You may review all of your intake questions with your provider. Expect to talk about surgeries, dental care, the use of sunscreen, etc. You may be asked if you have had a skin cancer screening or ever been anemic? Your provider may ask about eating disorders and other subjects that you may be too embarrassed to list on the intake form but wish to talk about. We will ask if you want to be checked for any STDs.

Your healthcare provider will want to know about your lifestyle, exercise habits, drinking habits, and how your diet is, including any dietary restrictions and whether you may be vegetarian or vegan. This opens a door to a conversation about counseling if needed and lets your provider know whether to check for any vitamin deficiencies.

Your provider may also wish to get to know more about you on a personal level, so they may ask about social aspects of your life: If you are feeling depressed or anxious? Do you feel safe at home? Do you feel like you have access to affordable housing and food?

What makes for an effective appointment?

The most effective appointments occur when you arrive with a basic knowledge of your medical problems and the medications you take and when you are prepared with a list of things that you want to talk about.

It is also important to feel like you can be honest and forthcoming. Patients should never feel ashamed or embarrassed. If you have a sexually transmitted disease or had one in the past, or have or had depression, be candid. When asked about alcohol, be accurate in the number of glasses you drink in a week. If you smoke, be honest about how much you smoke per day. Your healthcare providers want to help you become healthier and happier and they are not going to make judgements about any of your decisions. Healthcare providers, believe it or not, also are human and have their own health improvements they are always working on too.

What about an ineffective appointment?

It is challenging if you do not know your medications or when or if you have had screening exams. It is also challenging if you do not know the details of their medical history. Make sure to review these issues before your appointment.

What are some common questions you may ask?

“Can you give me advice on how to lose weight?”

“Why am I so tired all of the time?”

“What are you checking for in the blood tests?”

“How can I improve my diet while in Skagway?

How might your provider answer?

For weight loss, your provider may have an extensive conversation assessing food intake meal by meal, and making recommendations for dietary changes. They may also assess exercise habits and give tips.

For fatigue, your provider may do an extensive review of the your medical and social history and associated symptoms, and then do an exam and order blood work to rule out possible causes.

For routine blood tests, it is common to order a blood count, lipid panel, metabolic panel, diabetes screening and urinalysis. Depending on the patient’s age and sex, your provider may also order tests for PSA (prostate-specific antigen) to screen for prostate cancer and TSH (thyroid-stimulating hormone) to check for thyroid gland problems. They may have to place referrals for annual screenings such as colonoscopies, mammograms, etc.

For eating healthier in Skagway, your provider may be able to discuss some options for affordable food co-ops and may discuss how they try to eat healthy in Skagway over the winter.