Checkups: how often should I have them?

What should you expect from your doctor as part of the "annual service?" Should it even be annual? Or is every 2-3 years sufficient?
 
It pays to be an informed consumer of medical services. Then you have some idea of what to expect and what to ask for. The following information may help you to get the most from your doctor.
 

How Often?

If you're healthy and under 35 you don't really require an annual checkup, every 2-3 years will suffice. Also if you've never had your cholesterol checked or don't know your Blood Pressure(BP), then consider this - 55 per cent of the adult Australian population has elevated cholesterol and 1 in 5 has high blood pressure. The odds are greater than 50:50 that you'll have at least one of these risk factors. If you don't find out you have a problem, you probably won't take the appropriate action to rectify it. If you are 35-45, and in good health, with no known risk factors, then a check-up every few years will suffice. Beyond 45 an annual checkup is a worthwhile investment of some money and 20 minutes of your time. It could save your life!
 

Personal/family history

A must if your doctor is to do his job properly. Should include lifestyle issues such as smoking, nutritional and exercise habits as well as questions on emotional well-being (stress).
 

The physical examination

Needs to be thorough - every mole and freckle inspected (this can't be done with your clothes on!), pulse felt, blood pressure taken, chest listened to, breasts checked, thyroid felt, eyes/ears examined, reflexes checked, lymph glands palpated and so on.
 

Depending on...

Age, gender, family and personal history, a rectal examination may be required. Your GP should also advise you on the need for a PAP smear, a vision test, a colonoscopy, mammography, bone scan, chest X-ray, fecal occult blood test, ECG, assessment of lung function or any other test which may be required in light of the examination results.
 

Pathology

A blood test that includes cholesterol, HDLs, LDLs, triglycerides, fasting blood glucose, liver function tests and any other relevant tests should be performed.
 

A measure of "fatness"

Should be taken. Commonly, a BMI (Body Mass Index) is calculated from height-weight data, or the doctor simply looks up a height-weight chart to determine whether you are within an acceptable range. A better measure is the waist-hip ratio which picks up the "high-risk" abdominal fat. Of course, eyes are still a good examination tool. A subjective assessment performed by your doctor by simply looking at your body isn't often far removed from the reality of the situation (that's how most of us do it ourselves!).
 

Examination

Your examination is not an event in which the doctor practises his or her examination skills. The results need to be communicated with you in an informative and meaningful way. You need to leave the surgery with a clear understanding of your risk and what action may be required. If medication is needed, ask how long you are likely to be on it. Can improved lifestyle negate the need for medication? Did your doctor tell you your blood pressure (e.g. 125/80) or did he just say it was okay? When should you come back to recheck any problem areas? Did you get your results in writing so that if you move or change doctors, you have the information?
 

Relationship with your Doctor

A good relationship with your doctor has significant benefits in the long term. Research consistently shows that "the ability to use the medical system" is a major determinant of health and longevity. Be an active participant in the process by being an informed consumer. If you not satisfied with the service you're getting from your doctor, shop around!
 
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