A yearly physical means different things to different people. For some it is a quick blood pressure check and a refill. For others it is a full morning of tests. The evidence sits somewhere in between, and it changes with age, sex and health history.

This article walks through what a physical is for, what the U.S. Preventive Services Task Force (USPSTF) recommends for adults over 45, and where personal judgment comes in. It is general information, not a plan for any one person.

What a physical is for

A good annual visit does three things. It catches silent problems early, such as high blood pressure, diabetes or kidney disease. It keeps your medicine list and screening schedule current. And it gives you and your doctor time to talk about what has changed over the year.

That last part is easy to underrate. Changes in sleep, mood, memory, balance or energy often come up only when there is time to ask about them.

It helps to arrive prepared. Bring a current list of your medicines and supplements, the dates of your last colonoscopy, mammogram or bone density scan if they apply, and any results from doctors outside the practice. A few minutes of gathering saves a lot of guessing during the visit.

Screenings the USPSTF recommends by age

The USPSTF is an independent, volunteer panel that reviews the evidence on preventive services. Its recommendations are a reasonable baseline for adults without symptoms. Highlights for adults 45 and older include:

The USPSTF also recommends that clinicians prescribe a statin for adults 40 to 75 with at least one cardiovascular risk factor and an estimated 10-year risk of 10% or more. Estimating that risk usually needs a cholesterol panel and a blood pressure reading, which is one reason basic labs are part of most physicals.

Where judgment comes in

These recommendations are written for people without symptoms or known disease. Many of our patients have neither situation. If you have kidney disease, diabetes, heart disease or a strong family history, your schedule may look quite different.

Age also changes the math. Several recommendations stop at 75 or 80, or become a shared decision, because the balance of benefit and harm shifts. A good physical includes the conversation about when to stop a test as well as when to start one.

Some tests are done because of your history rather than a population recommendation. A kidney panel for someone on blood pressure medicine is a common example. Our article on the executive physical discusses how extra testing fits in, and when more is not better.

Medicare’s wellness visit is not a physical

Medicare Part B covers a yearly “Wellness” visit once every 12 months. Medicare describes it as a conversation-based visit to create a prevention plan, and states plainly that it is not a routine physical exam. It includes a health risk questionnaire, routine measurements, a review of your medicines and a cognitive assessment.

That visit is useful, but it is different from a hands-on exam. If you have Medicare and want to understand what is and is not billed at a concierge practice, see our piece on whether Medicare covers concierge medicine.

The annual executive physical

At Legacy Medical, members have an annual executive physical with labs and an ECG. Labs are drawn in the office, and the visit is unhurried, so there is time to review your screening schedule against the recommendations above and against your own history. Our preventive care page describes it in more detail.

If it has been a while since your last thorough physical, or you are not sure which screenings you are due for, a complimentary meet and greet with Dr. Shtern is an easy first step. Bring your recent results and a list of past screenings, and we can see where things stand.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.